A high LDL-C level is associated with an increased risk for coronary heart disease. It is considered the main risk factor in the lipid profile and is the primary target of therapy.1 However, the estimation of LDL-C has significant limitations in some groups, such as in individuals with hypertriglyceridemia or mixed hyperlipidemia or even in normolipidemic individuals with diabetes mellitus.2 These limitations are explained by the abnormal composition of the triglyceride-rich lipoproteins found in these conditions, which is not considered in the Friedewald formula.3 Some of the limitations of LDL-C could be overcome by using non–HDL-C.4 The recent article by Cui and coworkers5 demonstrates that non–HDL-C is a stronger predictor of CVD death than LDL-C in data derived from the Lipid Research Clinics Program Follow-up Study. Indeed, LDL-C level was the weakest lipid predictor of CVD death in men and women.
Aguilar-Salinas CA, Delgado A, Gómez-Pérez FJ. The Advantages of Using Non–HDL-C in the Diagnosis and Treatment of Dyslipidemia. Arch Intern Med. 2002;162(1):108-109. doi: