Lakhasly

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(HDL).and the American
Heart Association and American College of Cardiology.[52] There are several
limitations of the Friedewalk equation as follows o The estimated LDL-C level is not accurate in patients with
hypertriglyceridemia(up to 4.5mmol/l or 400 mg/dL) - such a setting warrants
ultracentrifugal single spin analysis or immunoprecipitation technique
o There is an underestimation of LDL-C level in patients with lower LDL-C (less
than 25 mg/dL or 0.6 mmol/L)
o There is an underestimation of intermediate-density lipoprotein(IDL), and some
VLDL remnants which are considered atherogenicFirst developed in the
1960s, Friedewald equation has been used widely to estimate LDL-C which is (total
cholesterol) - (high-density lipoprotein cholesterol [HDL-C]) - (triglycerides/5) in
mg/dL for research as well as clinical purpose.Generally, a lipid profile or lipid
panel consists of the following
o Total cholesterol
o High-density lipoprotein (HDL) cholesterol
o Low-density lipoprotein (LDL) cholesterol
o Triglycerides
Cholesterol level measurement is from serum.


Original text

(HDL). Each of these classes of lipoproteins transports cholesterol and triglyceride to 
its designated destinations [49].
The level of cholesterol plays a vital role in cardiovascular diseases process. A high 
level of lipids, including cholesterol and triglycerides in the serum, which also termed 
as hyperlipidemia, leads to a higher risk of developing atherosclerotic cardiovascular 
disease (CVD). Clinically, obtaining a lipid profile assists in the screening, diagnosing, 
and managing diseases. Here, we will discuss the indications for testing, the role 
of lipid profiles, and the relevant health care issues. Generally, a lipid profile or lipid 
panel consists of the following
• Total cholesterol
• High-density lipoprotein (HDL) cholesterol
• Low-density lipoprotein (LDL) cholesterol
• Triglycerides
Cholesterol level measurement is from serum. A non-fasting lipid test can be done 
anytime without fasting; a fasting lipid test requires a 12-hour fast except for water. 
Total and HDL cholesterol are measured directly from serum. First developed in the 
1960s, Friedewald equation has been used widely to estimate LDL-C which is (total 
cholesterol) – (high-density lipoprotein cholesterol [HDL-C]) – (triglycerides/5) in 
mg/dL for research as well as clinical purpose. A fixed factor of 5 for the ratio of 
fasting triglyceride level(up to 4.5mmol/l ) to very low-density lipoprotein 
cholesterol(TG: VLDL-C) is the assumption from the equation [50]. Optimizing 
LDL-C level has been the main target for current guidelines, including the European 
Society of Cardiology, European Atherosclerosis Society, [51]. and the American 
Heart Association and American College of Cardiology.[52] There are several 
limitations of the Friedewalk equation as follows • The estimated LDL-C level is not accurate in patients with
hypertriglyceridemia(up to 4.5mmol/l or 400 mg/dL) - such a setting warrants
ultracentrifugal single spin analysis or immunoprecipitation technique
• There is an underestimation of LDL-C level in patients with lower LDL-C (less
than 25 mg/dL or 0.6 mmol/L)
• There is an underestimation of intermediate-density lipoprotein(IDL), and some
VLDL remnants which are considered atherogenic


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