以新公式取代Friedewald公式估算台灣成年人低密度脂蛋白膽固醇

Estimating Low Density Lipoprotein-cholesterol by a New Formula Instead of the Friedewald Formula in Adult Taiwanese

蔡崇煌(Chung-Huang Tsai)；蘇家龍(Jia-Lung Su)；吳敏華(Min-Hua Wu)；黃青真(Cheng-Jang Huang)；林俊隆(Jiunn-Lung Lin)

low density lipoprotein-cholesterol ； residual cholesterol ； triglyceride,training data ； testing data

台灣家庭醫學雜誌

23卷1期（2013 / 03 / 01）

1 - 14

繁體中文

背景及目的：過去研究發現 Friedewald formula（FF）之不準確性，本研究使用迴歸模型建構另一推估公式。方法：收集中部某區域醫院 2006年1月至 2011年12月於健康檢查，禁食8小時以上且有完整血脂肪檢查者共14405個案，年齡為20∼96歲，男性佔8816人（61.2%）。檢驗項目包括總膽固醇（total cholesterol, TC）、高密度脂蛋白膽固醇 （high density lipoprotein-cholesterol, HDL-C）、低密度脂蛋白膽固醇（low density lipoprotein-cholesterol, LDL-C）及三酸甘油酯（triglyceride, TG）。以其中2006年1月至2010年12月之數據為訓練資料，2011年1月至 12月數據為測試資料。定義殘餘膽固醇（residual cholesterol, Rc）為TC-（LDL-C）-（HDL-C），以SAS 9.2軟體分析資料。結果：由Rc與實測TG值求算迴歸，可得TG之新迴歸係數為1/8，由此與FF之 TG 係數（1/5）做比較，結果達統計學上顯著差異（p＜0.05）。之後以2011年1月至 12月個案數值做測試，結果顯示估計LDL-C的準確性與精密度皆比FF高。結論：FF有其不準確性，以新公式推估 LDL-C有較好的效果，此或可資國人臨床上之應用。

Background: The Friedewald formula (FF) is of doubtful accuracy and precision; therefore, a new formula for the estimation of low density lipoprotein-cholesterol (LDL-C) is proposed, based on the data from a large Taiwanese population.Methods: Data from a total of 14,405 physical checkups where the patients had fasted for more than 8 hours, were aged 20-96 and 61.2% male, were collected from January 2006 to December 2011 at a Taichung regional hospital. The data from 2006 to 2010 was selected as the training data set, while that from 2011 served as the testing data set. Total cholesterol (TC), high density lipoprotein-cholesterol (HDL-C), LDL-C and triglycerides (TG) were determined by enzymatic colorimetric methods. Residual cholesterol (Rc) was defined as TC- (LDL-C) - (HDL-C). SAS 9.2 was employed to perform the statistical analysis.Results: A new coefficient (1/8) for TG was obtained via simple linear regression analysis of the training data. A significant difference between the TG coefficient (1/5) for FF and 1/8 was noted. The new formula (Tsai formula; TF) performed much better than did FF in predicting LDL-C when they were compared using the testing data.Conclusions: TF was more accurate and precise in estimating LDL-C and may be used to estimate LDL-C concentration in adult Taiwanese.

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