CONCORDANCE BETWEEN DIRECT MEASUREMENT OF LDL-C AND ESTIMATION BY THE EXTENDED MARTIN-HOPKINS EQUATION AT HIGH TRIGLYCERIDE

Mai Phùng Huyền My 1 , , Thái Hữu Khoa 1 , Cao Thị Vân 2
1 Pham Ngoc Thach University of Medicine image/svg+xml
2 Thong Nhat Hospital image/svg+xml
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DOI
10.63947/bvtn.v2i6.15
Published
2026-02-27
Issue Vol. 2 No. 6 (2026): Thách thức trong lão khoa 2026: Những giải pháp điều trị và chăm sóc toàn diện
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Original Research
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Research

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1.
My MPH, Khoa TH, Vân CT. CONCORDANCE BETWEEN DIRECT MEASUREMENT OF LDL-C AND ESTIMATION BY THE EXTENDED MARTIN-HOPKINS EQUATION AT HIGH TRIGLYCERIDE. JHA [Internet]. Vietnam; 2026 Feb. 27 [cited 2026 Mar. 15];2(6):101–107. https://tcsuckhoelaohoa.vn/bvtn/article/view/138 doi: 10.63947/bvtn.v2i6.15
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Abstract

Cardiovascular disease remains one of the leading causes of mortality worldwide, and LDL-C is a critical risk factor. Although direct measurement of LDL-C using homogeneous enzymatic assays provides high accuracy, it remains costly and time-consuming. The Friedewald equation, while widely applied, reduces accuracy in patients with elevated triglyceride, whereas the extended Martin-Hopkins (eMH) equation has been proposed to overcome this limitation. This cross-sectional study was conducted on 626 patients at Thong Nhat Hospital with TG levels ranging from 400-800 mg/dL. LDL-C concentrations were determined using a homogeneous enzymatic method and estimated using both the Friedewald and eMH equations. Accuracy was assessed by Pearson’s/Spearman’s correlation coefficient, mean absolute error (MAE), root mean square error (RMSE), and concordance rate for risk reclassification. The eMH equation demonstrated a higher correlation with direct measurement compared to Friedewald (0,74 > 0,70), lower MAE and RMSE values (20,6 mg/dL and 27,8 mg/dL vs 42,3 mg/dL and 52,2 mg/ dL), and a higher concordance rate (39% vs 29%). In conclusion, the eMH equation showed superior accuracy and concordance within the TG range of 400-800 mg/dL compared with the Friedewald equation. Nevertheless, further multicenter studies and comparisons with reference β-quantification methods are warranted before broad public implementation.

Keywords

LDL-C extended Martin-Hopkins Friedewald high TG homogenous enzymatic concordance MAE RMSE

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