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Low-density lipoprotein cholesterol estimation by the Anandaraja's formula – confirmation
Lipids in Health and Disease volume 5, Article number: 18 (2006)
The number of the indirect methods for LDL-C estimation is growing. Our result support the reliability of new Anandaraja's formula for low-density lipoprotein estimation from total cholesterol and triglycerides.
Gazi et al  presented results of evaluation the accuracy of various formulas for the calculation of low-density lipoprotein cholesterol (LDL-C) levels – indirect methods – in patients with the metabolic syndrome. LDL-C according Friedewald's formula showed significant differences from other formulas in the total cohort, as well as in patients with metabolic syndrome. Different plasma lipid and lipoprotein analytical techniques – direct methods, however, yield results, which are highly correlated, yet significantly different, too .
It is possible to supplement next calculation. Anandaraja et al  published new formula for LDL-C estimation from two other parameters, total cholesterol and triglycerides, as substitution to well known Friedewald's formula.
Our team recently compared two methods of estimation of low-density lipoprotein cholesterol, the direct Wako method versus Friedewald's formula . We studied over 10 000 consecutive patients with different diseases, from mixed rural and urban Brazil population.
We re-counted our data with Anandaraja's formula. Main results are expressed in Table 1. Direct LDL-C and LDL-C calculated from Anandaraja's formula shows substantial better correlation in both total population (r = 0,969) and patients with triglyceride <350 mg/dl (r = 0,974) by comparison with calculated according to the Friedewald's formula (r = 0,924 and r = 0,935).
In each very low-density lipoprotein particle secreted from the liver, and therefore in each intermediate-density lipoprotein, low-density lipoprotein and lipoprotein (a) particles, a single molecule of apolipoprotein B (apo B) is present from the time of its assembly to its catabolism, which does not exchange between lipoproteins. More than 90% of apo B is in the low-density lipoprotein particles, and therefore, plasma total concentration of apo B can be considered as a measure of the number of atherogenic particles. New Anandaraja's equation takes into account only total cholesterol and triglycerides. Some authors recommend including apo B measurement as acomponent of the standard lipoprotein measurements performed to assess cardiovascular disease risk . Contribution of LDL-C calculation with help of measured apo B is questionable. Apo B is real an independent risk factor.
In conclusion, LDL-C is the major indicator for initial classification of coronary heart disease risk status and lowering its level is a primary goal of therapy. The NCEP Working Group on Lipoprotein Measurement recommended the development of accurate direct low-density lipoprotein cholesterol methods. All available direct methods have yet limitations for general use. Our results support the reliability of Anandaraja's formula as indirect low-density lipoprotein cholesterol estimation – originally used in Indian population – in Brazil population, too.
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I would like to thank to the contributions Prof de Cordova, University of Blumenau, Blumenau, State Santa Catarina, Brazil.
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Gasko, R. Low-density lipoprotein cholesterol estimation by the Anandaraja's formula – confirmation. Lipids Health Dis 5, 18 (2006). https://doi.org/10.1186/1476-511X-5-18
- Coronary Heart Disease Risk
- Brazil Population
- Plasma Total Concentration
- Atherogenic Particle
- Lipoprotein Measurement