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It also underestimates LDL-C in patients with low LDL-C (< 25 mg/dL or 0.6 mmol/L). It does not take into account intermediate-density lipoprotein. [1] A "Martin/Hopkins" variation that takes into how triglycerides-to-VLDL ratio tends to vary with other parameters appears more reliable and accurate. [11] [12] [13]
LDL particles carry many fat molecules (typically 3,000 to 6,000 fat molecules per LDL particle); this includes cholesterol, triglycerides, phospholipids and others. Thus even if the hundreds to thousands of cholesterol molecules within an average LDL particle were measured, this does not reflect the other fat molecules or even the number of ...
In routine cholesterol testing, LDL-cholesterol (LDL-C) is not directly measured, rather it is estimated using the Friedewald equation, is generally inaccurate when patients are not fasting because of its dependence on triglycerides levels in the calculation. Also, estimated LDL-C is falsely low when directly measured LDL-C is < 100 mg/dL or ...
VLDL is a large, triglyceride-rich lipoprotein secreted by the liver that transports triglyceride to adipose tissue and muscle. The triglycerides in VLDL are removed in capillaries by the enzyme lipoprotein lipase , and the VLDL returns to the circulation as a smaller particle with a new name, intermediate-density lipoprotein (IDL).
Remnant cholesterol is the cholesterol content of triglyceride-rich lipoproteins, which consist of very low-density lipoproteins and intermediate-density lipoproteins with chylomicron remnants. [2] [5] Remnant cholesterol is primarily chylomicron and VLDL, and each remnant particle contains about 40 times more cholesterol than LDL. [6]
That estimate is typically obtained by measuring triglyceride levels after at least eight hours of fasting, when chylomicrons have been totally removed from the blood by the liver. In the absence of chylomicrons, triglyceride levels have a much larger correlation with risk of cardiovascular diseases than total LDL levels.