Jump to ContentJump to Main Navigation

Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

Editor-in-Chief: Plebani, Mario

Ed. by Gillery, Philippe / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Schlattmann, Peter / Tate, Jillian R. / Tsongalis, Gregory J.

12 Issues per year

IMPACT FACTOR 2014: 2.707
Rank 6 out of 30 in category Medical Laboratory Technology in the 2014 Thomson Reuters Journal Citation Report/Science Edition

SCImago Journal Rank (SJR) 2014: 0.741
Source Normalized Impact per Paper (SNIP) 2014: 1.011
Impact per Publication (IPP) 2014: 2.310



The Friedewald Formula Underestimates LDL Cholesterol at low Concentrations

Hubert Scharnagl / Matthias Nauck / Heinrich Wieland / Winfried März

Citation Information: Clinical Chemistry and Laboratory Medicine. Volume 39, Issue 5, Pages 426–431, ISSN (Print) 1434-6621, DOI: 10.1515/CCLM.2001.068, June 2005

Publication History

Published Online:


Due to recent advances in the treatment of hypercholesterolemia, low density lipoprotein (LDL) cholesterol concentrations below 2.6 mmol/l have become attainable. In general, LDL cholesterol is determined indirectly according to Friedewald. We examined the performance of the Friedewald formula at low concentrations of LDL cholesterol in comparison with a β-quantification method. We analyzed 176 samples from individuals treated by LDL apheresis with a mean LDL cholesterol concentration of 3.07 mmol/l and found that the Friedewald formula underestimated LDL cholesterol with a bias of −18.5%, −14.5%, −7.3%, and −3.8% at mean LDL cholesterol levels of 1.58, 2.4, 3.49, and 4.67 mmol/l, respectively. Thus, the lower the LDL cholesterol concentration was, the greater the negative bias. We conclude that the Friedewald formula may not be reliable at low LDL cholesterol concentrations produced by LDL apheresis. This finding may also be of relevance to the monitoring of patients being treated with lipid lowering drugs.

Citing Articles

Here you can find all Crossref-listed publications in which this article is cited. If you would like to receive automatic email messages as soon as this article is cited in other publications, simply activate the “Citation Alert” on the top of this page.

Jeffrey W. Meeusen, Christine L. Snozek, Nikola A. Baumann, Allan S. Jaffe, and Amy K. Saenger
The American Journal of Cardiology, 2015
Laszlo Mark, Antonio J. Vallejo-Vaz, Istvan Reiber, György Paragh, Sreenivasa Rao Kondapally Seshasai, and Kausik K. Ray
Atherosclerosis, 2015, Volume 241, Number 1, Page 62
Christie M. Ballantyne, Joel Neutel, Anne Cropp, William Duggan, Ellen Q. Wang, David Plowchalk, Kevin Sweeney, Nitin Kaila, John Vincent, and Harold Bays
The American Journal of Cardiology, 2015, Volume 115, Number 9, Page 1212
J. Martins, S.A.S. Olorunju, L.M. Murray, and T.S. Pillay
Clinica Chimica Acta, 2015, Volume 444, Page 137
Razvan T. Dadu and Christie M. Ballantyne
Nature Reviews Cardiology, 2014, Volume 11, Number 10, Page 563
Evan A. Stein and Frederick J. Raal
Best Practice & Research Clinical Endocrinology & Metabolism, 2014, Volume 28, Number 3, Page 309
Seth S. Martin, Michael J. Blaha, Mohamed B. Elshazly, Eliot A. Brinton, Peter P. Toth, John W. McEvoy, Parag H. Joshi, Krishnaji R. Kulkarni, Patrick D. Mize, Peter O. Kwiterovich, Andrew P. DeFilippis, Roger S. Blumenthal, and Steven R. Jones
Journal of the American College of Cardiology, 2013, Volume 62, Number 8, Page 732
Evan A. Stein and Gary D. Swergold
Current Atherosclerosis Reports, 2013, Volume 15, Number 3
Allan D Sniderman
The American Journal of Cardiology, 2002, Volume 90, Number 8, Page 48
Seth S. Martin, Thomas S. Metkus, Aaron Horne, Michael J. Blaha, Rani Hasan, Catherine Y. Campbell, Omair Yousuf, Parag Joshi, Sanjay Kaul, Michael Miller, Erin D. Michos, Steven R. Jones, Ty J. Gluckman, Christopher P. Cannon, Laurence S. Sperling, and Roger S. Blumenthal
The American Journal of Cardiology, 2012, Volume 110, Number 2, Page 307
Murat Can, Serefden Acikgoz, Gorkem Mungan, Ebru Ugurbas, Handan Ankarali, Vildan Sumbuloglu, Selda Demirtas, and Levent Karaca
International Journal of Cardiology, 2010, Volume 142, Number 1, Page 105
Vladimir Masin, Milan Blaha, Pravoslav Stransky, Vladimir Blaha, Melanie Cermanova, Radovan Maly, and Jiri Zajic
Transfusion and Apheresis Science, 2007, Volume 36, Number 1, Page 39
Krishnaji R. Kulkarni
Clinics in Laboratory Medicine, 2006, Volume 26, Number 4, Page 787
Genovefa Kolovou, Georgios Hatzigeorgiou, Constantinos Mihas, Nikos Gontoras, Panagiotis Litras, Dimitris Devekousos, Panagiota Kontodima, Constantina Sorontila, Helen Bilianou, and Sophie Mavrogeni
Cholesterol, 2012, Volume 2012, Page 1
Tessa N. van den Kommer, Miranda G. Dik, Hannie C. Comijs, Cees Jonker, and Dorly J.H. Deeg
Neurobiology of Aging, 2012, Volume 33, Number 1, Page 196.e1
Eduardo Paz, Jesús Hermida, Lorena Bouzas, Julio Brenlla, and J. Carlos Tutor
Clinical Biochemistry, 2008, Volume 41, Number 12, Page 1002
Ana María Wägner, Edgar Zapico, Rosa Bonet, Antonio Pérez, and Jordi Ordóñez-Llanos
Clinical Biochemistry, 2003, Volume 36, Number 3, Page 177
J.A. Díaz, M. Castro, and A. Liem
Clínica e Investigación en Arteriosclerosis, 2005, Volume 17, Number 3, Page 142
James O. Mudd, Barry A. Borlaug, Peter V. Johnston, Brian G. Kral, Rosanne Rouf, Roger S. Blumenthal, and Peter O. Kwiterovich
Journal of the American College of Cardiology, 2007, Volume 50, Number 18, Page 1735
Gilbert R. Thompson, M. Barbir, D. Davies, P. Dobral, M. Gesinde, M. Livingston, P. Mandry, A.D. Marais, S. Matthews, C. Neuwirth, A. Pottle, C. le Roux, D. Scullard, C. Tyler, and S. Watkins
Atherosclerosis, 2010, Volume 208, Number 2, Page 317
Maria Claudia Peixoto Cenci, Flávia Lúcia Conceição, Débora Vieira Soares, Luciana Diniz Carneiro Spina, Rosane Resende de Lima Oliveira Brasil, Priscila Marise Lobo, Eduardo Michmacher, and Mario Vaisman
Metabolism, 2008, Volume 57, Number 1, Page 121
Vimal Ramjee, Laurence S. Sperling, and Terry A. Jacobson
Journal of the American College of Cardiology, 2011, Volume 58, Number 5, Page 457
John H. Contois, G. Russell Warnick, and Allan D. Sniderman
Journal of Clinical Lipidology, 2011, Volume 5, Number 4, Page 264
G.P. Carnevale Schianca, R. Pedrazzoli, S. Onolfo, E. Colli, E. Cornetti, L. Bergamasco, G.P. Fra, and E. Bartoli
Nutrition, Metabolism and Cardiovascular Diseases, 2011, Volume 21, Number 6, Page 406
Venkata M. Alla, Manu Kaushik, and Aryan Mooss
Southern Medical Journal, 2010, Volume 103, Number 5, Page 434
W. März and A. von Eckardstein
LaboratoriumsMedizin, 2001, Volume 25, Number 11-12, Page 433
Ntei Abudu and Stanley S. Levinson
Clinical Chemical Laboratory Medicine, 2007, Volume 45, Number 10
Bas van den Bogaard, Bert-Jan H. van den Born, Rana Fayyad, David D. Waters, David A. DeMicco, John C. LaRosa, John J. P. Kastelein, and Ingar Holme
European Journal of Clinical Investigation, 2011, Volume 41, Number 2, Page 134
M. Andrikoula and I. F. W. McDowell
Diabetes, Obesity and Metabolism, 2008, Volume 10, Number 4, Page 271
Dean G. Karalis
Preventive Cardiology, 2007, Volume 10, Number 4, Page 228
T. Wendler, R. Schilling, A. Lennertz, K. Sodemann, W. Kleophas, H. Me�ner, G. Riechers, J. Wagner, C. Keller, and T. Bosch
Journal of Clinical Apheresis, 2003, Volume 18, Number 4, Page 157

Comments (0)

Please log in or register to comment.