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Volume 2014 (2014), Article ID 261878, 5 pages
Research Article

Validation of the Friedewald Formula in Patients with Metabolic Syndrome

Pontifícia Universidade Católica do Paraná, Rua Imaculada Conceição, Prado Velho, 1155 Curitiba, PR, Brazil

Received 16 September 2013; Revised 13 December 2013; Accepted 26 December 2013; Published 6 February 2014

Academic Editor: Gordon Ferns

Copyright © 2014 José Knopfholz et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Currently, the Friedewald formula (FF) is the main method for evaluating low-density lipoprotein cholesterol (LDL-c). Recently, many limitations have emerged regarding its use, including patients with triglyceride levels ≥400 mg/dL, diabetes mellitus, and kidney or hepatic chronic diseases. We analyzed the use of the FF in patients with metabolic syndrome. We selected patients with known metabolic syndrome that fulfilled the National Cholesterol Education Program Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) Final Report and excluded patients with triglyceride levels ≥400 mg/dL and chronic liver and/or kidney disease. Using direct assays, we measured total cholesterol, high-density lipoprotein cholesterol, triglycerides, and LDL-c. Then, LDL-c was estimated using the FF and compared with the LDL-c by direct assay. The sample size was 135 patients. Using the FF, the mean LDL-c value was  mg/dL; it was  mg/dL by direct assay. The correlation coefficient between these two methods was 0.89, with statistical significance . There were no significant differences between the patients with triglyceride levels >150 mg/dL . In conclusion, FF is a good method for estimating LDL-c in patients with metabolic syndrome.