Methods of low-density lipoprotein-cholesterol measurement: analytical and clinical applications

Among the five major classes of lipoprotein particles, low-density lipoprotein-cholesterol (LDL-C) is the primary lipoprotein risk factor for the development of cardiovascular diseases (CVD) through the promotion of atherosclerotic pathogenesis. Therefore, it is of paramount importance to accurately measure the plasma concentration of LDL-C using an appropriate method to examine the risk of CVD and determine the efficacy of therapeutic interventions to reduce the cholesterol level and examine the risk assessment strategy. At present, there is a wide variety of methods available for LDL-C measurement. In this review, we have outlined the commonly used methods of LDL-C measurement. These methods have been classified into non-automated analytical methods, calculation methods, and automated direct measurement of LDL-C. We have also described some recently proposed promising calculation methods which are being considered for clinical adoption. This current review could assist the clinicians to have a better understanding regarding the measurement techniques and comparative utilities of different methods of LDL-C measurement and guide them to select an appropriate method based on accuracy, turnaround time, and cost of test.