以Friedewald formula推估低密度脂蛋白膽固醇濃度在台灣的準確度研究

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ATP Adult Treatment Panel III 

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N C E PNational Cholesterol Education 

P r o g r a m 

N a t i o n a l 

low density lipoprotein 

Institutes of Health 

very low density lipoprotein 

 

2001 

 

ATP Adult III Treatment Panel 

III 

Tr i g l y c e r i d e 

1 : 5 

 

 

 

 

 

 

low density lipoprotein 

2001 

 

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Friedewald formula 1972 

 

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formula L D L =T - C H O- HDL -T G / 5 

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Tw Fam Med Res 2004 Vol.2 No.1 

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S c h a r n a g l 2001 

 

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Friedewald formula Dahlen Modification 

 

 

ischemic heart 

 

d i s e a s e 

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4. Li KM, Wilcken DE, Dudman NP: Effect of 

 

serum lipoprotein(a) on estimation of lowdensity 

lipoprotein cholesterol by the 

outcome study 

 

Friedewald formula. Clin Chem 1994; 40: 571- 

 

3. 

 

5. Wang TY, Haddad M, Wang TS: Low 

 

triglyceride levels affect calculation of lowdensity 

lipoprotein cholesterol values. A rc h 

 

 

Pathol Lab Med 2001; 125: 404-5. 

6. Matas C, Cabre M, La Ville A, et al: 

Limitations of the Friedewald formula for 

 

1994; 40: 404-6. 

 

7. Eblen-Zajjur A, Eblen-Zajjur M: Estimation of 

 

low density lipoprotein cholesterol 

 

concentration: regression analysis versus 

 

Friedewald's formula. Rev Med Chil 2001 ; 

 

estimating low-density lipoprotein cholesterol 

in alcoholics with liver disease. Clin Chem 

129: 1263-70. [Spanish] 

8. Hernandez C, Chacon P, Garcia-Pascual L, et 

al: Lipoprotein(a) and the evaluation of low 

1. 

91 

density cholesterol by the Friedewald formula: 

 

2. Grundy SM: National Cholesterol Education 

Program (NCEP)-The National Cholesterol 

Guidelines in 2001, Adult Treatment Panel 

a new problem for an old equation. Med Clin 

(Barc) 1999; 113: 290-1. [Spanish] 

9. Branchi A, Rovellini A, Torri A, et al: 

Accuracy of calculated serum low-density 

( ATP) III. Approach to lipoprotein lipoprotein cholesterol for the assessment of 

management in 2001 National Cholesterol 

Guidelines. Am J Card i o l 2002; 90(8A): 11 i - 

21i. 

3. Friedewald WT, Levy RI, Fredrickson DS: 

Estimation of the concentration of low-density 

lipoprotein cholesterol in plasma, without use 

of the preparative ultracentrifuge. Clin Chem 

1972; 18: 499-502. 

coronary heart disease risk in NIDDM patients. 

Diabetes Care 1998; 21: 1397-402. 

10. Scharnagl H, Nauck M, Wieland H, et al: The 

Friedewald formula underestimates LDL 

cholesterol at low concentrations. Clin Chem 

Lab Med 2001; 39: 426-31. 

11. Scanu AM: Lipoprotein(a), Friedewald 

formula, and NCEP guidelines. National 


17

Cholesterol Education Program. Am J 

Cardiol 2001; 87: 608-9, A9. 

12. Marniemi J, Maki J, Maatela J, et al: Poor 

applicability of the Friedewald formula in the 

assessment of serum LDL cholesterol for 

clinical purposes. Clin Biochem 1995; 28: 

285-9. 

13. Cantin B, Lamarche B, Despres JP, et al: 

Does correction of the friedewald formula 

using lipoprotein(a) change our estimation of 

ischemic heart disease risk? The Quebec 

Cardiovascular Study. Atherosclerosis 2002; 

163: 261-7. 

18 2004

Original Article 

Study on the Accuracy of Using the Friedewald 

Formula in Predicting Serum Low Density 

Lipoprotein Level in Ta i w a n 

Ho-Shien Lai 1 , Wen-Jing Liu 1 , Ching-Yu Chen 1,2 

According to the latest version of NCEP ATP-III guideline, controlling low density lipoprotein level 

to reduce the risk of cardiovascular diseases (CVD) has been emphasized and suggests to collect a 

complete lipid profile during the initial assessment of patient with hyperlipidemia But, because of the 

limitation of technology, the common practice has heavily relied on the calculated LDL level from 

Friedewald formula. Even today, the Friedewald formula is still being used to calculate the LDL level as 

stipulated in National Health Insurance (NHI) regulation regardless of the recent technology improvement 

has been made. Past studies had revealed some questionable accuracies of Friedewald formula in the 

clinical context of Taiwan. Our study was designed to examine the accuracy and its applicability of 

Friedewald formula in Taiwan. 

We collected 99 patients' complete lipid profile including total cholesterol level, LDL level, HDL 

level, and TG level as measured by colorimetric method in laboratory From these data, we estimated 

individual's LDL level as calculated from Friedewald formula. Then, we examined the two LDL levels by 

paired T-test. The result showed T value of 11.94, and the P value is less than 0.001. We therefore 

concluded that we should pay special attention to the inaccuracy of estimated LDL level from Friedewald 

formula and reconsider its applicability in the clinical practice of Taiwan. 

(Tw Fam Med Res 2004; 2: 10-19) 

Department of Family Medicine, National Taiwan University Hospital; Department of Family Medicine, College of 

Medical, National Taiwan University, Taipei, Taiwan. 

Received: October 20, 2003; Accepted: December 24, 2003. 


19

以Friedewald formula推估低密度脂蛋白膽固醇濃度在台灣的準確度研究

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