| For medical practitioners and the general public - Cholesterol Journal Article Catalog. |
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| Analysis of cholesterol and cholesteryl esters in human serum using capillary supercritical fluid chromatography Kim, D. H., K. J. Lee, et al. (1994), J Chromatogr B Biomed Appl 655(1): 1-8. Abstract: Capillary supercritical fluid chromatography (SFC) using carbon dioxide as a mobile phase was applied for the determination of free cholesterol and cholesteryl esters in human serum. Serum samples were extracted with methanol-chloroform (2:1, v/v), and the extracts were analyzed by pressure programmed capillary SFC-flame-ionization detection (FID) without thermal degradation and derivatization. The total cholesterol concentrations obtained from SFC analysis were compared with those from GC or enzymatic analysis. The capillary SFC-FID method having high resolution gave an acceptable average relative standard deviation of 2.6%, and a detection limit of 4-6 pg. The quantitative results were acceptable for the simultaneous analysis of cholesterol and its esters in biological fluids. The concentration profiles of each compound in various samples, normal Korean human serum, Western human serum, and from high-cholesterol patient plasma, have been compared with this method. |
| Analysis of cholesterol and desmosterol in cultured cells without organic solvent extraction Goh, E. H., D. K. Krauth, et al. (1990), Lipids 25(11): 738-41. Abstract: Cultured cell sterols such as cholesterol and desmosterol are usually extracted into organic solvents before they are quantified with cholesterol esterase and oxidase. A method to quantify these cultured cell sterols using cholesterol enzymes without prior organic solvent extraction is described. In this method, a suspension or monolayer of cultured L-M, U-937, or PC-12 cells is digested with 0.1% sodium dodecyl sulfate (SDS), and the digest treated with microbial cholesterol enzymes. The quantity of oxidized sterols produced by the reaction can be measured easily with high-pressure liquid chromatography, when a mixture of sterols is present, or by the production of hydrogen peroxide when only one sterol is present. This method is easier and safer to use than solvent extraction and can greatly expedite the quantitation of cultured cell sterols. Preliminary data show that other lipids such as choline phospholipids, triglycerides, and fatty acids can also be directly quantified in SDS cell digest by using specific enzymes to transform these lipids into hydrogen peroxides. |
| Analysis of cholesterol and phospholipid hydroperoxides by high-performance liquid chromatography with mercury drop electrochemical detection Korytowski, W., G. J. Bachowski, et al. (1993), Anal Biochem 213(1): 111-9. Abstract: High-performance liquid chromatography (HPLC) with reductive mode electrochemical detection on a mercury drop has been employed for the separation and determination of lipid hydroperoxides. Under the conditions used, baseline separation is achieved for three cholesterol hydroperoxide (ChOOH) standards, not only from one another, but also from two different phosphatidylcholine hydroperoxide (PCOOH) standards. Applying this method to a test system, photodynamically treated murine leukemia cells, we have identified and quantified a major family of overlapping PCOOHs and three ChOOHs, two of which are characteristic singlet oxygen adducts. In a typical separation, the detection limit is < 0.5 pmol for ChOOHs and < 50 pmol for more slowly eluting PCOOHs. In this respect, mercury drop detection outperforms all previously described electrochemical detection methods for lipid hydroperoxides and compares favorably with other HPLC-based approaches. However, in terms of equipment cost, relative simplicity of operation, and fewer potential artifacts, this method has a clear advantage over all other existing high-sensitivity methods. |
| Analysis of cholesterol ester accumulation in macrophages by the use of digital imaging fluorescence microscopy Koren, E., J. Franzen, et al. (1990), Atherosclerosis 85(2-3): 175-84. Abstract: Low density lipoprotein (LDL) induced accumulation of cholesterol esters was analyzed by the digital imaging fluorescence microscopy (DIFM) in murine tumor macrophages. To analyze cholesterol ester accumulation, P388D1 macrophages were incubated with increasing quantities of unmodified or acetylated human LDL, washed, and live stained with a lipophylic fluorescent dye Nile Red. The increase in fluorescence intensity was quantitatively determined by the interactive laser cytometer (ACAS 470) and compared with the accumulation of cellular cholesterol esters determined by the gas liquid chromatography. Correlation between the two methods was highly significant (r greater than 0.9, P less than 0.001). A good agreement between the two methods was also found in terms of sensitivity and reproducibility. With the use of 589 nm narrowband interference filter in the light path of emitted light the intensity of fluorescence correlated well with cellular cholesterol ester content even in the presence of relatively high concentrations of triglycerides. Therefore, digital imaging fluorescence microscopy appears to be a reliable method for quantification of cholesterol ester accumulation at the single cell level offering new possibilities of studying interactions between cells and cholesterol ester rich lipoproteins. |
| Analysis of cholesterol in all lipoprotein classes by single vertical ultracentrifugation of fingerstick blood and controlled-dispersion flow analysis Kulkarni, K. R., D. W. Garber, et al. (1992), Clin Chem 38(9): 1898-905. Abstract: This new, highly sensitive analytical system, based on controlled dispersion of the flowing sample, gives a rapid, continuous, and direct analysis for cholesterol in all lipoprotein classes, separated by single vertical-spin density-gradient ultracentrifugation. In this Vertical Auto Profile-II fingerstick system, designated VAP-IIfs, a narrow-bore Teflon coil serves as the reactor with no segmentation of the analytical stream by air bubbles, in contrast to the Technicon AutoAnalyzer used in the VAP-I method. Concentrations of high-, low-, intermediate-, and very-low-density lipoprotein cholesterol and lipoprotein(a) cholesterol are determined by decomposing the spectrophotometric absorbance curve for the continuous analysis of the centrifuged sample, with use of software developed in this laboratory. Total cholesterol is determined from the total area under the absorbance curve. For assaying total cholesterol, the CV between aliquots within a rotor ranged from 1.35% to 3.15%; the CV between rotors was 2.45%. Because only 18 microL of sample is required, VAP-IIfs can be readily adapted to analysis for lipoprotein cholesterol profiles in capillary blood samples. Total cholesterol values by VAP-IIfs for fingerstick and venous samples from 23 subjects agreed well: slope = 1.01 (SD 0.03), intercept = -21 (SD 51) mg/L, Sy/x = 50 mg/L, and r = 0.992. Results by VAP-IIfs also correlated highly with results for duplicate samples analyzed at the Northwest Lipid Research Laboratories. |
| Analysis of cholesterol oxidation products in biological samples Diczfalusy, U. (2004), J AOAC Int 87(2): 467-73. Abstract: Cholesterol oxidation products, or oxysterols, have gained increased attention since it was suggested that they participate in cell signaling as ligands for the nuclear receptors liver X receptor alpha and beta. In addition, oxysterols serve as important intermediates in bile acid biosynthesis and are also involved in cholesterol transport. Several studies have suggested that certain oxysterols may be used as markers for oxidative stress, and still other oxysterols may be of use in diagnosing neurological diseases. This broad spectrum of functions in health and disease has created a demand for accurate and reliable methods to measure oxysterols in complex biological matrixes. At present, the most reliable and sensitive method for oxysterol determination in biological materials is isotope-dilution gas chromatography-mass spectrometry using deuterium-labeled internal standards. With this technique, the major oxysterols in human blood plasma and atherosclerotic plaques have been carefully determined. The knowledge of oxysterol contents in other tissues and organs is still very scarce. As oxysterols are found to participate in an increasing number of cellular events, it is obvious that improved methods are needed for their analysis to understand their roles in the living cell. |
| Analysis of cholesterol oxides in egg yolk and turkey meat Ahn, D. U., J. I. Lee, et al. (1999), Poult Sci 78(7): 1060-4. Abstract: A study was conducted to develop a solvent system that will clean egg yolk samples and concentrate cholesterol oxides effectively before analysis. Cholesterol oxide standards or lipid samples (0.2 g) loaded onto a silicic column were washed with a portion of Solvent I (hexane/diethyl ether, 9:1, vol/vol) and then with Solvent II. Four different Solvent II preparations (Solvent IIa, hexane:ethyl acetate = 4:1; Solvent IIb, hexane:ethyl acetate = 1:1; Solvent IIc, hexane:ethyl acetate:diethyl ether = 2:1:1; Solvent IId, hexane:ethyl acetate:diethyl ether = 4:1:2, vol/vol/vol) were prepared and the purification efficiencies of Solvent II solutions for neutral lipids, cholesterol, and phospholipids in the column were compared. Yield study using cholesterol oxide standards showed that one or more of the cholesterol oxide standards were eluted by the Solvent IIb and Solvent IIc, but Solvent IIa and Solvent IId did not elute any of the cholesterol oxides during washing. Egg samples prepared with Solvent IIa showed greater amount of cholesterol oxides than those prepared with Solvent IId, probably due to incomplete purifying of phospholipids and interference. However, the amounts of cholesterol oxides in cooked meat prepared with the two purification solvents were not different. Because egg yolk contains very large amounts of phospholipids and cholesterol compared with other foods, at least twice as much Solvent IIa as Solvent IId was required to properly clean egg yolk samples. It was concluded that purification solvents should be selected by sample types, and Solvent IId (hexane:ethyl acetate:diethyl ether = 4:1: 2) was superior to Solvent IIa (hexane:ethyl acetate = 4: 1) for egg yolk samples. |
| Analysis of micellar and vesicular lecithin and cholesterol in model bile using 1H- and 31P-NMR de Graaf, M. P., A. K. Groen, et al. (1995), Magma 3(2): 67-75. Abstract: The distribution of phospholipid and cholesterol between the vesicular and micellar phases in bile plays an important role in the formation of cholesterol gallstones. Conventional analytical procedures to determine the distribution are potentially unreliable because they disturb the distribution of these compounds between the two phases. In this work, we circumvent this problem by using NMR. 31P-NMR is used to quantify directly the micellar and the vesicular amount of lecithin. The previously described 1H-NMR method to determine directly the micellar lecithin (Groen et al., J Lipid Res 31: 1315-1321) has been optimized by the implementation of a spectral quantification method. The agreement between the 31P and 1H methods was excellent. In our hands, the method of Ellul et al. (FEBS Lett 300: 30-32) did not allow quantification of micellar cholesterol, although our fitting procedure offered the possibility of quantifying overlapping spectral peaks by the use of prior knowledge about all the parameters of the compounds visible in the spectrum. The micellar cholesterol concentration was so low compared to the overlapping lecithin peaks that no reliable quantification was possible. The same problem was encountered when using other characteristic cholesterol resonances for quantification. Our data suggest that cholesterol present in the vesicular phases is too immobile to give rise to high-resolution peaks and the amount of cholesterol present in the micellar phase is too low to allow quantitation by NMR. We conclude that 1H-NMR can be used to determine micellar lecithin, and 31P-NMR to determine micellar as well as vesicular lecithin in model bile. |
| Analysis of plant sterol and stanol esters in cholesterol-lowering spreads and beverages using high-performance liquid chromatography-atmospheric pressure chemical ionization-mass spectroscopy Mezine, I., H. Zhang, et al. (2003), J Agric Food Chem 51(19): 5639-46. Abstract: Plant sterol and stanol esters were separated on a Luna hexyl-phenyl column using a gradient of acetonitrile (90-100%) in water. The eluted compounds were detected by atmospheric pressure chemical ionization (APCI)-mass spectroscopy (MS) in the positive mode. Sterol and stanol esters produced M + H - HOOCR(+) ions. Application of the hyphenated technique-LC-MS-allowed differentiation between a number of esters of sitosterol, campesterol, stigmasterol, and (tentatively) avenasterol, as well as sitostanol and campestanol esters. With cholesteryl decanoate used as the internal standard, the method showed good linearity, precision, and reproducibility. The method required minimal sample pretreatment and can be applied to samples with high water content (juices) as well as samples with high oil content (margarine spreads). The method could be useful for the analysis of sterol and stanol esters in fortified food products. |
| Analysis of plasma cholesterol oxidation products using gas- and high-performance liquid chromatography/mass spectrometry Sevanian, A., R. Seraglia, et al. (1994), Free Radic Biol Med 17(5): 397-409. Abstract: The application of gas chromatography and high-pressure liquid chromatography/mass spectrometry techniques for analysis of plasma cholesterol oxidation products is described. Cholesterol oxides that are widely identified in biological samples were subjected to gas (GC) and high-pressure liquid chromatographic (HPLC) separations, and their detection and characterization by mass spectrometry (MS) were compared. Analysis of cholesterol oxides from plasma samples revealed distinct advantages for each method according to the specific cholesterol oxide in question. Whereas HPLC/MS analysis of cholesterol oxides provided less resolution and lower sensitivity as compared to GC/MS, a distinct advantage was evident for direct measurements of cholesterol-7-hydroperoxides and 7-ketocholesterol. These two cholesterol oxides are particularly sensitive to storage in solvents, derivatization procedures, and analytical conditions used for GC analysis, which are minimized or avoided using the HPLC/MS conditions described. Analysis of human and rabbit plasma samples identified cholest-5-ene-3 beta, 7 beta-diol (7 beta-hydroxycholesterol); 5,6 alpha-epoxy-5 alpha-cholestan-3 beta-ol (cholesterol-5 alpha, 6 alpha-epoxide); 5 alpha-cholestane-3 beta, 5,6 beta-triol (cholestanetriol); 3 beta-hydroxycholest-5-ene-7-one (7-ketocholesterol); and 5,6 beta-epoxy-5 beta-cholestan-3 beta-ol (cholesterol-5 beta,6 beta-epoxide) as commonly occurring components (trivial names indicated in parentheses). The latter two compounds were dramatically increased in hypercholesterolemic samples and were found in approximately equal amounts in the free cholesterol and cholesteryl ester fractions. Although most of the plasma cholesterol oxides are found in the dietary cholesterol, others are not, particularly cholesterol-5 beta,6 beta-epoxide, suggesting that at least some of these compounds are formed by in vivo oxidation of cholesterol. Despite the readily measurable levels of the above cholesterol oxides, as well as other less prominent oxides, there was no evidence of cholesterol-7-hydroperoxides associated with plasma free cholesterol. Although several of the plasma cholesterol oxides may derive from cholesterol-7-hydroperoxides, it appears that the latter are either unstable and decompose in plasma, are metabolized to other cholesterol oxidation products, or break down during their isolation. |
| Analysis of plasma remnant lipoprotein cholesterol Shirai, K. (2001), Nippon Rinsho 59 Suppl 2: 802-5. |
| Analysis of the distribution of HDL-cholesterol and (VLDL + LDL)-cholesterol in hepatic and intestinal disorders Remy-Heintz, N., G. Cassanas, et al. (1990), Ann Biol Clin (Paris) 48(4): 259-62. Abstract: Total cholesterol (Ch-T), HDL cholesterol (Ch-HDL) and (VLDL + HDL) cholesterol (Ch-(VLDL + LDL) were evaluated in 78 cases of various hepatodigestive diseases (11 icterus, 14 hepatitis, 30 chronic alcoholisms, 8 Crohn's diseases and 15 haemorragic rectocolitis (RCH, and in 76 control subjects. High cholesterol levels were found in icterus, but its distribution between lipoproteic fractions remained unchanged. In the group of hepatitis, a deficit in Ch-(VLDL + LDL) was elicited by a significant decrease of Ch-(VLDL + LDL)/Ch-T ratio. The same was observed in chronic alcoholism. In Crohn's disease the levels of every cholesterol fraction were low, while in RCH they were not significantly different from those of the control group. But, in RCH, the Ch-HDL/Ch-T ratios showed significant low values with concommitant higher values of Ch-(VLDL + LDL)/Ch-HDL ratios, suggesting that, in RCH, the metabolism of cholesterol is unbalanced with a deficit of Ch-HDL. In conclusion, the evaluation of cholesterol in lipoproteic fractions by a simple assay may contribute to specify the diagnostic of these disorders. |
| Analysis of the effect of intestinal resection on rat ileal bile Acid transporter expression and on bile Acid and cholesterol homeostasis Al-Ansari, N., G. Xu, et al. (2002), Pediatr Res 52(2): 286-91. Abstract: Ileal reclamation of bile salts is mediated in large part by an apical sodium-dependent bile acid transporter (ASBT) located in the terminal ileum. The following studies were performed to elucidate the adaptive response of ASBT to intestinal resection. Two separate series of intestinal resections were performed: 1) limited (25%) ileal and 2) massive (70%) intestinal resection. The boundaries of the resections were varied to examine differences in compensation when variable amounts of endogenous transporter activity were resected. Previously demonstrated supraphysiologic expression of ASBT, which was seen after proximal ileal resection, led to a contraction in the bile acid pool size and a paradoxical reduction in bile acid (cholesterol 7alpha-hydroxylase and sterol 27-hydroxylase) and cholesterol (hydroxymethylglutaryl coenzyme A reductase) biosynthetic enzyme activities. Massive intestinal resection resulted in ileal hypertrophy and an apparently maladaptive specific down-regulation in ASBT protein expression. In this model bile acid pool size correlated with the amount of residual ASBT-expressing terminal ileum. Cholesterol and bile acid biosynthetic enzyme activities were inversely related to bile acid pool size. Adaptive changes in ASBT expression and alterations in bile acid and cholesterol homeostasis are dependent on the type and location of intestinal resection. |
| Analytic accuracy of calculated low-density lipoprotein cholesterol concentrations Demacker, P. N. and A. H. Stalenhoef (1999), Diabetes Care 22(2): 371-3. |
| Analytic and clinical performance of two compact cholesterol-testing devices Volles, D. F., J. M. McKenney, et al. (1998), Pharmacotherapy 18(1): 184-92. Abstract: Several relatively inexpensive compact analyzers for measuring cholesterol are available for use outside of the clinical laboratory. We evaluated the analytic and clinical performance of total cholesterol assayed with the AccuMeter (ChemTrak) and the LDX (Cholestech). Accuracy of both devices was evaluated by collecting capillary and venous whole blood from 100 subjects and assaying for total cholesterol. Results were compared with the Centers for Disease Control standardized reference laboratory method. Mean percent bias, mean absolute percent bias, and percentage of subjects with total error above +/- 8.9% were calculated and results were compared with recommendations from National Cholesterol Education Program (NCEP) for total cholesterol measurements. Precision was evaluated by assay of three pooled serum samples with both devices in duplicate in two runs/day for 20 days. The CV for each serum pool for each device was calculated and compared with NCEP recommendations for precision for total cholesterol measurements. Results with the two devices were compared. The total cholesterol mean percent bias for capillary samples was 2.1% for the LDX and -1.0% for the AccuMeter (p<0.01), and for venous samples 1.6 and -2.0%, respectively (p<0.001). The mean absolute percent bias for capillary samples was 5.4 and 5.2%, respectively (p=0.29), and for venous samples was 5.0 and 5.7% (p=0.79). Each device had an excessive number (12-22%) of individual results that exceeded NCEP recommended total error for a single cholesterol measurement (+/- 8.9%). In the precision analysis the average CV from all three serum pools was 4.0% and 5.3% for the LDX and AccuMeter, respectively (p<0.05). Thus both devices failed to meet the NCEP recommendation for precision of 3% CV. They both provided total cholesterol results that correctly classified individual patients into appropriate risk groups 95% of the time or better if values within +/- 8.9% of NCEP cut points for risk classification were ignored. Both devices met the NCEP +/- 3% requirement for total cholesterol mean percent bias but did not meet the +/- 3% requirement for CV as a measure of precision. Because of the variability in results, both devices had excessive numbers of individual subjects with total cholesterol results greater than the recommended total error limit of +/- 8.9% difference from the standardized method. Despite variability in some individual results, the rate of clinical misclassifications for coronary heart disease risk was relatively low for both devices if results near the NCEP cut points were repeated. |
| Analytical and clinical evaluation of two homogeneous assays for LDL-cholesterol in hyperlipidemic patients Esteban-Salan, M., A. Guimon-Bardesi, et al. (2000), Clin Chem 46(8 Pt 1): 1121-31. Abstract: BACKGROUND: LDL-cholesterol (LDL-C) concentrations are the primary basis for treatment guidelines established for hyperlipidemic patients. LDL-C concentrations are commonly monitored by means of the Friedewald formula, which provides a relative estimation of LDL-C concentration when the triglyceride concentration is <2000 mg/L and there are no abnormal lipids. The Friedewald formula has several limitations and may not meet the current total error requirement of <12% in LDL-C measurements. METHODS: We evaluated the analytical and clinical performance of two direct methods (Roche and Wako) by analyzing 313 fresh serum samples obtained from dyslipidemic patients in a lipid clinic and comparing them with modified beta-quantification. RESULTS: Both homogeneous assays displayed excellent precision (CV <2%). The Roche method showed a mean total error of 7.72%, and the Wako method showed a mean total error of 4.46% over a wide range of LDL-C concentrations. The Roche method correlated highly with the modified beta-quantification assay (r = 0.929; y = 1.052x - 168 mg/L; n = 166) and showed a bias of -4. 5% as a result of the assigned standard value. The Wako method also correlated highly with beta-quantification (r = 0.966; y = 0.9125x + 104.8 mg/L; n = 145) without significant bias. The Roche method correctly classified 97% of patients with triglycerides <2000 mg/L, 75% of patients with type IIb hyperlipemia (HPL), and 84% of patients with type IV HPL based on the cutpoints of 1300 and 1600 mg/L, compared with 98%, 78.4%, and 89%, respectively, for the Wako method. In dysbetalipoproteinemic patients, both methods have a 30% mean positive bias compared with beta-quantification. CONCLUSIONS: Both direct methods can be a useful alternative when ultracentrifugation is not available for the diagnosis and control of lipid-lowering medication for patients with mixed HPL, but not for patients with type III hyperlipidemia. |
| Analytical and clinical performance of a detergent-based homogeneous LDL-cholesterol assay: a multicenter evaluation Nauck, M., M. S. Graziani, et al. (2000), Clin Chem 46(4): 506-14. Abstract: BACKGROUND: LDL-cholesterol (LDL-C) concentrations currently are determined in most clinical laboratories using the Friedewald calculation. This approach has several limitations and may not always meet the current total error recommendation in LDL-C measurement of |
| Analytical and clinical performance of a homogeneous enzymatic LDL-cholesterol assay compared with the ultracentrifugation-dextran sulfate-Mg2+ method Rifai, N., E. Iannotti, et al. (1998), Clin Chem 44(6 Pt 1): 1242-50. Abstract: LDL-cholesterol (LDL-C) concentration is currently determined in most clinical laboratories by the Friedewald calculation. This approach has several limitations and may not meet the current total error requirement in LDL-C measurement of < or = 12%. We evaluated the analytical and clinical performance of the direct N-geneous LDL-C assay (Equal Diagnostics). The N-geneous method correlated highly with the modified beta-quantification assay (r = 0.95; y = 0.91x + 70.6 mg/L; n = 199), showed no significant effect of increased triglyceride or other common interferants, and performed adequately in serum samples from nonfasting individuals. This assay demonstrated a mean total error of 6.75% over a wide range of LDL-C concentrations. In addition, at the medical decision cutoff points, this LDL-C assay showed positive predictive values of 78-95% and negative predictive values of 84-99%. We conclude that the N-geneous LDL-C meets the currently established analytical performance goals and appears to have a role in the diagnosis and management of hypercholesterolemic patients. |
| Analytical and clinical performance of two homogeneous assays for measuring of LDL-cholesterol Leowattana, W., S. Narkrung, et al. (2000), J Med Assoc Thai 83 Suppl 2: S6-12. Abstract: A clinical laboratory currently estimates LDL-Cholesterol (LDL-C) concentration using the Friedewald calculation, which requires fasting specimens and is subject to error with increasing triglycerides levels. We evaluated the analytical and clinical performance of the direct LDL-C assay from two companies, Roche Diagnostics (LDL-C(Roche)) and Wako Pure Chemical (LDL-C(Wako)). Both methods meet current guidelines for precision with within-run coefficients of variation less than 3 per cent. The LDL-C(Roche) assay correlated well with the LDL-C from the Friedewald equation (LDL-C(Fried), r = 0.958, y = 0.85x + 17.08 mg/dL, n = 422). The LDL-C(Wako) assay also correlated with the LDL-C(Fried) (r = 0.946, y = 0.86x + 7.81 mg/dL, n = 422). In addition, at the medical decision cutoff points, LDL-C(Roche) assay and LDL-C(Wako) showed positive predictive values of 87.44 per cent and 69.67 per cent respectively. We conclude that the LDL-C(Roche) assay meets the currently established analytical and clinical performance, but LDL-C(Wako) assay meets only analytical performance. Clinical performance needs further evaluation. |
| Analytical performance and clinical efficacy of three routine procedures for LDL cholesterol measurement compared with the ultracentrifugation-dextran sulfate-Mg(2+) method Nauck, M. and N. Rifai (2000), Clin Chim Acta 294(1-2): 77-92. Abstract: The diagnosis and management of adults with hypercholesterolemia in the US are largely based on low-density lipoprotein cholesterol (LDL-C) concentration. In order to classify someone correctly into the National Cholesterol Education Program cut-points, LDL-C must be measured with a total error of |