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논문 기본 정보

자료유형
학술저널
저자정보
Jeong Yong Whi (Department of Biostatistics Graduate School Yonsei University Seoul Korea.) Koo Jun Hyuk (Yonsei University Wonju Industry-Academic Cooperation Foundation Wonju Korea.) Huh Ji Hye (Division of Endocrinology and Metabolism Department of Internal Medicine Hallym University Sacred Heart Hospital Anyang Korea.) Kim Young-Jin (Seoul Clinical Laboratories Biobank Yongin Korea.) Jeong Hoyeon (Department of Biostatistics Graduate School Yonsei University Seoul Korea.) Kim Eun Young (Department of Biomedical Laboratory Science Songho University Hoengseong Korea.) Kang Dae Ryong (Department of Precision Medicine Wonju College of Medicine Yonsei University Wonju Korea.)
저널정보
대한의학회 Journal of Korean Medical Science Journal of Korean Medical Science Vol.38 No.19
발행연도
2023.5
수록면
1 - 12 (12page)
DOI
10.3346/jkms.2023.38.e145

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Background: Low-density lipoprotein cholesterol is an important marker highly associated with cardiovascular disease. Since the direct measurement of it is inefficient in terms of cost and time, it is common to estimate through the Friedewald equation developed about 50 years ago. However, various limitations exist since the Friedewald equation was not designed for Koreans. This study proposes a new low-density lipoprotein cholesterol estimation equation for South Koreans using nationally approved statistical data. Methods: This study used data from the Korean National Health and Nutrition Examination Survey from 2009 to 2019. The 18,837 subjects were used to develop the equation for estimating low-density lipoprotein cholesterol. The subjects included individuals with low-density lipoprotein cholesterol levels directly measured among those with high-density lipoprotein cholesterol, triglycerides, and total cholesterol measured. We compared twelve equations developed in the previous studies and the newly proposed equation (model 1) developed in this study with the actual low-density lipoprotein cholesterol value in various ways. Results: The low-density lipoprotein cholesterol value estimated using the estimation formula and the actual low-density lipoprotein cholesterol value were compared using the root mean squared error. When the triglyceride level was less than 400 mg/dL, the root mean squared of the model 1 was 7.96, the lowest compared to other equations, and the model 2 was 7.82. The degree of misclassification was checked according to the NECP ATP III 6 categories. As a result, the misclassification rate of the model 1 was the lowest at 18.9%, and Weighted Kappa was the highest at 0.919 (0.003), which means it significantly reduced the underestimation rate shown in other existing estimation equations. Root mean square error was also compared according to the change in triglycerides level. As the triglycerides level increased, the root mean square error showed an increasing trend in all equations, but it was confirmed that the model 1 was the lowest compared to other equations. Conclusion: The newly proposed low-density lipoprotein cholesterol estimation equation showed significantly improved performance compared to the 12 existing estimation equations. The use of representative samples and external verification is required for more sophisticated estimates in the future.
#Low-Density Lipoprotein Cholesterol #Estimation Equation #Friedewald Equation #Triglycerides

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