Accuracy of low-density lipoprotein cholesterol estimation equations according to drinking status: A cross-sectional study
Year: 2026
Type: preprint
Abstract: High low-density lipoprotein cholesterol (LDL-C) and triglyceride (TG) levels are associated with heavy alcohol consumption, but the accuracy of LDL-C estimation equations according to drinking status remains unclear. We analyzed direct LDL-C and drinking-status data from 28,882 participants in the Korea National Health and Nutrition Examination Survey, classified as non/ex-drinkers, moderate drinkers, or binge drinkers. Mean absolute deviation (MAD) was calculated for the Friedewald, Martin-Hopkins, and Sampson equations relative to directly measured LDL-C, and 95% confidence intervals for the median absolute deviation (MeAD) were determined by TG level. Estimation error increased with heavier alcohol consumption and higher TG level. In binge drinkers, all three equations underestimated LDL-C, with the largest deviation at higher TG levels. The Sampson equation showed the lowest MAD and MeAD across drinking categories and TG strata and was most accurate at a TG level of 150–400 mg/dL, whereas the Martin-Hopkins equation was more accurate at TG levels of ≥400 mg/dL. The Sampson or Martin-Hopkins equation estimates LDL-C more accurately than the Friedewald equation regardless of drinking status and should be preferred, with the choice further individualized by TG level in heavy drinkers.
Source: medRxiv
Authors: Jae Yong Lee, Hae Won Jung, Seung-Pyo Hong, Han-Joon Bae
Institution: Daegu Catholic University Medical Center
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
Funder: Catholic University of Daegu
OpenAlex ID: W7216378410