A Comparison Study between Martin/Hopkin’s and Sampson’s Equations and the Traditionally used Friedewald’s Equation for more Accurate Estimation of Low-Density Lipoprotein Cholesterol

Background and Study Aim: Cardiovascular disease (CVD) is considered the leading cause of death worldwide, with atherosclerosis being its primary driver. Low density lipoprotein cholesterol (LDL-C) is as a key factor in atherosclerotic cardiovascular disease, making its accurate measurement essential for assessing CVD risk. This study aims to evaluate the performance of two novel low-density lipoprotein cholesterol assessment methods, the Martin-Hopkins and Sampson equations, by comparing their accuracy to the Friedewald equation and direct low-density lipoprotein cholesterol assessment.Materials and Methods: The study involved 1000 participants who underwent complete lipid profile analysis at Ain Shams University Hospitals. LDL-C concentrations were determined utilizing Sampson, Friedewald, and Martin equations and were also directly measured using enzymatic colorimetric method. The results were compared for accuracy using concordance and reclassification analyses. Scatterplots with calculation of Pearson’s correlation coefficient (r) were used to assess the correlation between different LDL-C equations and direct measurement.Results: Both Martin and Sampson equations resulted in 4% more patients being reclassified to greater LDL-C categories than Friedewald’s equation. The discrepancies between the different low-density lipoprotein cholesterol evaluations were more marked in cases with increased triglyceride levels. In individuals with triglyceride levels ranging from 200 to 399 milligram per deciliters, up to 25% were reclassified to greater LDL-C categories by Sampson compared to Friedewald, 41.6% by Martin versus Friedewald, and 22.6% by Martin versus Sampson. Furthermore, the Martin equation showed the highest concordance with direct LDL-C measurement (88.6%), followed by Sampson (88.3%) and Friedewald (87.1%).Conclusion: The Sampson equation demonstrated acceptable accuracy compared to both Friedewald and Martin equations, and it can be effectively utilized in cases with triglyceride concentrations up to 800 milligram per deciliters.