Le point sur les différentes méthodes pour déterminer le cholestérol-LDL

Direct methods for LDL-C measurement, based on different principles, are now available. These methods are satisfactory on the whole, but can be associated with biases compared to the reference method (β-quantification) and they do not allow a better evaluation of cardiovascular risk than the Friedewald formula for patients with a triglyceridemia between 2 and 4 g/L. In that regard, patients affected with type 2 diabetes may constitute an exception, but this conclusion has been drawn from small groups of patients and need further confirmation. These methods are particularly useful when the Friedewald formula can not be used due to triglycerides above 3.4 g/L. However when triglycerides further increase (above 7 g/L for some methods; above higher values for others), they also interfere with direct methods that can not be used anymore.