Faculty of Medicine

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    Item type:Publication,
    COMPARATIVE ACCURACY OF LDL-CHOLESTEROL ESTIMATION: OMPARATIVE ACCURACY OF LDL-CHOLESTEROL ESTIMATION: A META-ANALYSIS OF THE FRIEDEWALD AND MARTIN-HOPKINS EQUATION META-ANALYSIS OF THE FRIEDEWALD AND MARTIN-HOPKINS EQUATION
    (Bulgarian Society of Cardiology and Pensoft Publishers, 2025-12-04)
    Kostovska, Irena
    ;
    Introduction: Low-density lipoprotein cholesterol (LDL-C) is a cornerstone biomarker for cardiovascular risk. The Friedewald formula has long been the standard for estimating LDL-C, however, it has limitations, particularly in patients with hypertriglyceridemia or low LDL-C levels. Several alternative equations, including the Martin–Hopkins (M/H) and Sampson formulas, have been developed to improve accuracy. Among them, M/H has gained recognition for its performance in specific populations, but it represents only one of several refined methods used across professional communities. This study aimed to perform a meta-analysis comparing the accuracy and precision of the Friedewald and M/H formulas in diverse populations, acknowledging that other approaches also exist. Methods: A systematic review of articles published between 2018 and 2024 was conducted using PubMed, Embase, Scopus (Elsevier), and Web of Science-eligible studies directly compared both formulas against direct LDL-C measurement in adult populations. A random-effects model was used to pool mean absolute errors (MAEs), root mean square errors (RMSEs), correlation coefficients, and p-values. Heterogeneity was assessed using the I² statistic. Results: Eight novel studies, involving a total of 192,094 participants, were included. The M/H formula showed significantly lower MAE (3.6 mg/dL vs. 8.4 mg/dL, p < 0.001), lower RMSE (5.1 mg/ dL vs. 9.8 mg/dL, p < 0.001), and a stronger correlation with direct LDL-C (r = 0.92 vs. r = 0.84) compared to the Friedewald formula. The superiority of the M/H formula was especially evident in patients with triglycerides >200 mg/dL or LDL-C <70 mg/dL. Conclusion: The M/H formula provides more accurate and precise LDL-C estimation than Friedewald, particularly in clinically vulnerable groups. However, it should be considered one of several improved approaches, alongside other equations such as Sampson, which may perform better in certain populations. M/H can be recommended as a strong option, but is not the sole alternative for routine lipid profiling.
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    Hyperbilirubinemia is a predictor of appendiceal perforation in children: A meta-analysis
    (2023-04)
    Mustafa Azizoğlu
    ;
    Mehmet Hanifi Okur
    ;
    Bahattin Aydoğdu
    ;
    Tuğçe Merve Orbay
    ;
    Ayten Ceren Bakir
    Objective: In this meta-analysis, our goal was to examine the diagnostic utility of bilirubin in identifying complicated from uncomplicated pediatric appendicitis. Materials and methods: Using the databases Embase, PubMed, Scopus, and Cochrane, we carried out a thorough literature search up to 2022. Studies comparing complicated appendicitis (CA) and simple appendicitis (SA) in terms of hyperbilirubinemia in the pediatric population were included. Results: A total of 5 studies with 2740 acute appendicitis patients (1097 complicated appendicitis and 1643 simple appendicitis) were included in this meta-analysis. Five studies have discussed the diagnostic value of total bilirubin (TB). When compared to simple appendicitis, complicated appendicitis had a significantly higher TB count (I2=94%), (WMD=0.18, 95% CI -0.00 to 0.37; P=0.05), DB count (I2=0%), (WMD=0.11, 95% CI 0.04 to 0.18; P=0.002), and IB count (I2= not applicable), (WMD=0.04, 95% CI 0.01 to 0.07; P=0.02). Conclusions: In conclusion, in this meta-analysis, total bilirubin, direct bilirubin, and indirect bilirubin values were higher in complicated appendicitis compared to simple appendicitis. Both total bilirubin and direct bilirubin can be used as diagnostic parameters in childhood appendicitis to differentiate complicated appendicitis from simple appendicitis.