Machine learning predictive models of LDL-C in the population of eastern India and its comparison with directly measured and calculated LDL-C

BACKGROUND: LDL-C is a strong risk factor for cardiovascular disorders. The formulas used to calculate LDL-C showed varying performance in different populations. Machine learning models can study complex interactions between the variables and can be used to predict outcomes more accurately. The current study evaluated the predictive performance of three machine learning models-random forests, XGBoost, and support vector Rregression (SVR) to predict LDL-C from total cholesterol, triglyceride, and HDL-C in comparison to linear regression model and some existing formulas for LDL-C calculation, in eastern Indian population. METHODS: The lipid profiles performed in the clinical biochemistry laboratory of AIIMS Bhubaneswar during 2019-2021, a total of 13,391 samples were included in the study. Laboratory results were collected from the laboratory database. 70% of data were classified as train set and used to develop the three machine learning models and linear regression formula. These models were tested in the rest 30% of the data (test set) for validation. Performance of models was evaluated in comparison to best six existing LDL-C calculating formulas. RESULTS: LDL-C predicted by XGBoost and random forests models showed a strong correlation with directly estimated LDL-C (r = 0.98). Two machine learning models performed superior to the six existing and commonly used LDL-C calculating formulas like Friedewald in the study population. When compared in different triglycerides strata also, these two models outperformed the other methods used. CONCLUSION: Machine learning models like XGBoost and random forests can be used to predict LDL-C with more accuracy comparing to conventional linear regression LDL-C formulas.