LDL-C CDC β-quantification BQ g/mL VLDL. BQ IDL g/mL Lp a g/mL. BQ 4 TC mg/dl HDL-C mg/dl TG mg/dl 5

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1 原著 LDL-C F LDL-C Friedewald F 3,545 2,146 1, ± 6.7 F TG LDL-C FLDL-C TC non HDL-C FF LDL-CD LDL-C / D LDL-C 100 TGTGTG VLDL-CF TG 0.16 ± 0.06 TC HDL-C TG TG 0.1 VLDL-C TG TG 0.12 TG TG mg/dL F LDL-C FTG F TGTGTGTG TG FTC LDL Friedewald LDL- LDL-C TC 2007 TC LDL-C TG Friedewald F LDL-C F 2 LDL-C LDL-C LDL-C CDC β-quantification BQ g/mL VLDL TC HDL HDL-C BQ IDL g/mL Lp a g/mL F BQ 4 TC mg/dlhdl-c mg/dl TG mg/dl 5 LDL-C VLDL TG 5 1 TG 400mg/dL Tel & Fax Vol.27 No ( 729 )

2 VLDL TG 1/5 F LDL-C VLDL β-vldl TG 5 1 VLDL-CF LDL-C LDL-C 5 BQ TG LDL-C F LDL-C TG LDL-C F LDL-C 3% LDL-C 8 LDL-C LDL LDL-C HDL VLDL IDL LDL VLDL <1.006 IDL1.006< <1.019 LDL 1.019< <1.063 HDL >1.063 VLDL IDL 82% LDL 96% LDL-C CDC/CRMLN LDL-C gov/1abstandards/crmln.htm FFriedewald LDL-C= TCHDL-C 1/5 TG t- SPSS Ver TC LDL-C HDL-C TG 4 12 AU640 TC TGHDL-C LDL-C , , BMI TC HDL-C LDL-C TG 1 ±2, ± 6.9 1, ± 6.5 TC HDL-C 60 ( 730 ) Vol.27 No

3 1 =3,545 SD 50.9 ± BMI kg/m ± cm 82.2 ± TC mg/dl ± HDL-C mg/dl 65.4 ± non HDL-C mg/dl ± LDL-C mg/dl ± LDL-C/HDL-C 2.17 ± F LDL-C mg/dl ± VLDL-C mg/dl ± TG mg/dl ± SBP mmhg ± DBP mmhg 75.0 ± mg/dl 94.0 ± Friedewald 2 VLDL-C= TCHDL-CLDL-C TC HLD LDL IDL VLDL TC HDL-C LDL-C LDL-C IDL LDL LDL-C TC HDL-CLDL-C VLDLVLDL-C TC HDL non HDL-C 1 VLDL TG5 50mg/dL 100mg/dL200mg/dL300mg/dL 400mg/dL TG 1 TG VLDL-C LDL-C F LDL-C F LDL-C F t p<0.001 F 1 TG 2 LDL-C F ± SD ± ± ,469 1, ± 132 ± 32mg/dL 126 ± 32 mg/dl F 126 ± 30mg/dL 123 ± 31mg/dL p<0.01 LDL-C F% = F LDL-C LDL-C 100 TG Vol.27 No ( 731 )

4 2 Pearson TG LDL-C TC HDL-C non HDL-C VLDL-C TG LDL-C TC HDL-C non HDL-C VLDL-C TG 2 ±-4.04± TC non HDL r=0.855 LDL-C TC r=0.889 LDL-C non HDL r=0.973 VLDL-C TG r=0.850 TG 0.8 TC LDL-C r=0.884 non HDL-C LDL-C r=0.990 TC non HDL-C r=0.875 VLDL-C %r=0.903ldl-c non HDL VLDL-C TG TG5 3TG FTG 1/4 1/4.5 1/5 1/5.5 1/6 5 F LDL-CLDL-C LDL-C FLDL-C LDL-C % % TG 1/4.5 1/6 TG 10 TG TG 3 TG 4 TG VLDL-C ± SD TG ± 61.2 VLDL-C 16.2 ± CI TC HDL-C TG LDL-C TC+ HDL-C+ TG 62 ( 732 ) Vol.27 No

5 5 TG TG 6 TG TC<220mg/dL TG<150mg/dL F TG TG3 1 FVLDL-C TG VLDL-C TG TG 1/82 FTC HDL-C TG LDL-C TC HDL-C TG /10 non HDL-C 3 F TG TC HDL-C LDL-C TG LDL-CLDL-C TG ± 0.161± TG TG TGTG TG5 TG 5 TG 50mg/dL 50 99mg/dL TG mg/dL mg/dL TG F TC 220mg/dL TG 150mg/dL 6 TG LDL-C F BQ 5,8 LDL-C BQ F LDL-C Vol.27 No ( 733 )

6 TC non HDL-C TG TG LDL-C LDL TCTG 9 TC HDL-C LDL-C VLDL-CTG HDL-C LDL-C VLDL-C 35.2% 59.2% 5.3% VLDL-C TG9/78= /8 LDL-C VLDL-C TCHDL-CLDL-C HDL-C LDL-C VLDL-C Friedewald TypeVLDL-C TC 28.2 normal type VLDL-C VLDL-C TC TG VLD-C LDL-C F ± 5.40 SD 3 TG F LDL-C TG TG FVLDL-C TG 1 5 TG VLDL-C TG r=0.850 TG0.12 1/6 VLDL-C 95% TG VLDL-C % TG 1LDL-C = TC TC HDL-C HDL-C TG TG TC HDL-C non HDL TG Ahmadi 10 TC HDL-C TG 3 LDL-C TG 100mg/dL TC 250mg/dL F LDL-C=TC/1.19+TG/1.9 HDL-C/ TG F TG = TCHDL-CLDL-C TG VLDL-CTG TG /6 ±0.062 SD CV =0.062/ =38.5% 3 TG VLDL-C TG TG VLDL-C TG ( 734 ) Vol.27 No

7 Friedewald 1/5 TG TG TGLDL-C F VLDL-C TG TG TGTG TG TG TG1/4 TG 11 Delong 12 k=1/6 13,14 Friedewald F TG1/4 1/8 LDL-C% TG TG TG LDL-C TC TGTG TC 15,16 TG TG LDL-C LDL-C 66.6 Miller NCEP 12% 5 8 BQ F r=0.986 LDL-C S =0.975 LDL-C F LDL-C BQ -BQ =3.1 mean ± 7.1 mg/dl SD IDL small dense LDL BQ LDL-C LDL-C F TC TG non HDL-C 10 LDL-C LDL-C F TG 400mg/dL non HDL-C 19 TG 400mg/dL TG mg/dL TG F LDL-C F F TG LDL-C Vol.27 No ( 735 )

8 LDL-C F TG 400mg/dL TG VLDL-C TG /8 TC HDL-C TG 1F TG / /6 F TG F LDL-C TC F non HDL-C 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: Bachorik PS, Ross JW: National Cholesterol Education Program recommendations for measurement of lowdensity lipoprotein cholesterol: executive summary. The National Cholesterol Education Program Working Group on Lipoprotein Measurement. Clin Chem 1995; 41: Nau c k M, War n i c k G R, R i f ai N : Me t h o d s for measurement of LDL-cholesterol: a critical assessment of direct measurement by homogeneous assays versus calculation. Clin Chem 2002; 48: Sugiuchi H, Irie T, Uji Y, et al: Homogeneous assay for measuring low-density lipoprotein cholesterol in serum with triblock copolymer and α -cyclodextrin sulfate. Clin Chem 1998; 44: Chen Y, Zhang X, Pan B, et al: A modified formula for calculating low-density lipoprotein cholesterol values. Lipids Health Dis 2010; 9: LDL-C Yamashita S, Kawase R, Nakaoka H, et al: Differential reactivities of four homogeneous assays for LDLcholesterol in serum to intermediate-density lipoproteins and small dense LDL: comparisons with the Friedewald equation. Clin Chim Acta 2009; 410: HDL Ahmadi SA, Boroumand MA, Gohari-Moghaddam K, et al: The impact of low serum triglyceride on LDL-cholesterol estimation. Arch Iran Med 2008; 11: Hata Y, Nakajima K: Application of Friedewald's LDLcholesterol estimation formula to serum lipids in the Japanese population. Jpn Circ J 1986; 50: DeLong DM, DeLong ER, Wood PD, et al: A comparison of methods for the estimation of plasma low- and very low-density lipoprotein cholesterol. The Lipid Research Clinics Prevalence Study. JAMA 1986; 256: Nakanishi N, Matsuo Y,Yoneda H, et al: Validity of the Conventional Indirect Methods Including Friedewald Method for Determining Serum Low-Density Lipoprotein Cholesterol Level: Comparison with the Direct Homogeneous Enzymatic Analysis. J Occup Health 2000; 42: Friedewald LDL Rungtanapirom S, Ongphiphadhanakul B, Kiatbamrungpunt T, et al: Comparative study of direct-measured and calculated LDL in clinical use. J Med Assoc Thai 2008; 91: Vujovic A, Kotur-Stevuljevic J, Spasic S, et al: Evaluation of different formulas for LDL-C calculation. Lipids Health Dis 2010; 9: Nakamura M, Koyama I, Iso H, et al: Ten-year evaluation of homogeneous low-density lipoprotein cholesterol methods developed by Japanese manufacturers. Application of the Centers for Disease Control and Prevention/Cholesterol Reference Method Laboratory Network lipid standardization protocol. J Atheroscler Thromb 2010; 17: Miller WG, Myers GL, Sakurabayashi I, et al: Seven direct methods for measuring HDL and LDL cholesterol compared with ultracentrifugation reference measurement procedures. Clin Chem 2010; 56: ( 736 ) Vol.27 No

9 Evaluation of Dyslipidemia Using LDL-C (Direct Method and Friedewald Formula) in Health Check-ups Tadayoshi Takegoshi, Narisato Kimura, Seitaroh Okamura, Makoto Yamamoto Fukui Kosei Hospital Abstract Objective: We compared LDL-C measurement by direct assay with LDL-C calculated by Friedewald s formula (FF) in health check-ups. Methods: Our subjects were 3,545 people (males: 3,545, females: 1,399,mean age:50.9 ± 6.7)who came to our health check-up center. We evaluated the TG coefficient using statistical analysis. Results: The Student s paired t-test showed that values measured by D-LDL-C (Direct assay) were significantly higher than those calculated by F-LDL-C (Friedewald s formula). Regression analysis revealed a strong correlation between calculated and measured LDL-C. D-LDL-C was strongly correlated with TC and non-hdl-c. The percentage difference between calculated and measured values [(F-LDL-C - D-LDL-C)/ (D-LDL-C) x 100] was significantly correlated with TG, showing a downward deviation with increasing TG levels. The TG coefficient calculated by FF was 0.16 ± 0.06 (SD) and 0.1 calculated by a multiple regression equation from TC, HDL-C and TG values. It was 0.12 from a scatter plot of TG vs. VLDL-C. Statistical analysis showed that when TG was low, the TG coefficient varied widely, whereas when TG was between 100 and 350mg/dL, no significant difference between calculated and measured LDL-C values was observed. Conclusion: D-LDL-C was highly correlated with F-LDL-C, and D-LDL-C tended to be higher than F-LDL-C with increasing TG levels. The TG coefficient varied widely according to TG levels. Therefore, the calculation of TC using FF should be restored for lipid metabolism management in health check-ups. Keywords: LDL-C (direct method and Friedewald formula), health check-up Vol.27 No ( 737 )

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