{"id":"697bdc2e1421","type":"article","url":"https://hartvaat.nl/2026/01/27/lp-a-verstoort-de-ldl-cholesterolberekening-welke-formule-is-het-meest-betrouwba/","title":"Lp(a) verstoort de LDL-cholesterolberekening: welke formule is het meest betrouwbaar?","title_en":"Lipoprotein(a) Concentration and Achieving Target Values of Low-Density Lipoprotein Cholesterol Calculated by Different Equations.","category":"cholesterol","category_label":"Cholesterol","professions":["apotheker","internist"],"tags":["dyslipidemie","ezetimibe","ldl-cholesterol","lipide-aferese","lipidenverlaging","lipoproteïne-a","lipoproteïne-a-therapeutisch-doel","pelacarsen","statines"],"journal":"Diseases (Basel, Switzerland)","doi":"10.3390/diseases14020041","source_url":"https://doi.org/10.3390/diseases14020041","authors":["Olga I Afanasieva","Alexandra V Tyurina","Elena A Klesareva","Marat V Ezhov","Sergei N Pokrovsky"],"significance":3,"published":"2026-01-27","source_date":"2026-01-27","image":"","kennis":["https://hartvaat.nl/kennis/lipiden/lpa-meten-wanneer-waarom/","https://hartvaat.nl/kennis/lipiden/ldl-cholesterol-mechanisme/"],"congress":"","summary_en":"This study demonstrates that lipoprotein(a) cholesterol contributes to overestimation of \"true\" LDL-C in standard calculations. Correction for Lp(a)-cholesterol significantly improves lipid profile accuracy in patients with elevated Lp(a).","created":"2026-07-03T10:24:56Z","updated":"2026-07-03T13:24:24Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Lipoproteïne(a) bevat cholesterol dat meegerekend wordt in standaard LDL-C-berekeningen, wat leidt tot overschatting van het 'echte' LDL-C bij patiënten met verhoogd Lp(a). Deze studie vergelijkt verschillende berekeningsformules en laat zien dat correctie voor Lp(a)-cholesterol de nauwkeurigheid van het lipidenprofiel significant verbetert.","abstract_original":"BACKGROUND: Low-density lipoprotein cholesterol (LDL-C) is a major cardiovascular risk factor and an indicator of hypolipidemic therapy effectiveness. However, direct and calculated methods for determining \"LDL-C\" present the sum of the cholesterol in all apoB-containing lipoproteins, including lipoprotein(a) [Lp(a)]. There has been an ongoing debate about the correctness of LDL-C in patients with elevated Lp(a) concentrations up to now. The aim of this study was to evaluate the effect of Lp(a) concentration on the LDL-C calculated by different equations. METHODS: The study included the results of fasting lipids and Lp(a) concentration of 566 measurements from 283 patients (before and after lipid-lowering therapy prescribing, after exclusion of 17 patients with incomplete data). LDL-C and LDL-C corrected for Lp(a)-cholesterol (LDL-Ccorr) were calculated by Friedewald, Martin-Hopkins, and Sampson equations. RESULTS: We assessed 566 measurements of lipids and Lp(a). The number of values reclassified to a higher risk category was 10% and 13% with Martin-Hopkins and Sampson equations compared to the Friedewald formula. The percentage of Lp(a)-cholesterol (Lp(a)-C) in the LDL-C calculated by three formulas was up to 90% or more depending on the concentration of LDL-C and Lp(a). When stratified by clinically significant LDL-C thresholds, the proportion of values LDL-Ccorr reclassified to a lower risk category ranged from 30 to 59%. CONCLUSION: Comparison of LDL-C concentrations calculated by Friedewald, Martin-Hopkins, and Sampson equations showed high consistency in patients without elevated triglycerides. The LDLcorr is reasonable to use in patients with Lp(a) concentration ≥ 30 and ≥41 mg/dL when using the Martin-Hopkins and Sampson equations, respectively. These data may help clinicians interpret LDL-C goal attainment in patients with elevated Lp(a) and avoid misclassification driven by the Lp(a)-cholesterol component."}