scholarly journals Optimization of β-Quantification Methods for High-Throughput Applications

2001 ◽  
Vol 47 (4) ◽  
pp. 712-721 ◽  
Author(s):  
Thomas G Cole ◽  
Constance A Ferguson ◽  
David W Gibson ◽  
William L Nowatzke
Keyword(s):  
Ldl Cholesterol ◽  
Total Error ◽  
Hdl Cholesterol ◽  
Basic Research ◽  
Turnaround Time ◽  
Cholesterol Concentration ◽  
Target Values ◽  
Bottom Fraction ◽  
Clinically Significant ◽  
Method Accuracy

Abstract Background: Risk of cardiovascular disease is assessed, in part, by laboratory measurement of the concentrations of several lipoproteins. β-Quantification is a method of lipoprotein measurement that uses ultracentrifugation to partially separate lipoprotein classes. Although β-quantification is used largely in clinical and basic research, methods have not been described to allow the analysis of a large number of small-volume specimens with a short turnaround time. We report two variations of the traditional 5-mL method used by the Lipid Research Clinics Program that overcome these shortcomings. Methods: Two lower-volume modifications of the traditional 5-mL β-quantification method were developed. The methods used either 1 or 0.23 mL of specimen and required substantially less time for analysis (20 and 6 h, respectively) than the 5-mL method (2.5 days). The goal was to develop ultracentrifugation methods such that the concentration of cholesterol in the bottom fraction, from which LDL-cholesterol concentration is calculated, agreed with the 5-mL method. Fresh serum specimens (n = 45) were analyzed by the three methods to determine comparability of the methods based on the recovery of cholesterol in the bottom fraction after ultracentrifugation. To evaluate intrarun precision, replicate specimens (n = 17) were analyzed in a single run for each method. This experiment also evaluated how quickly the fractions would remix after separation by ultracentrifugation. For the 1-mL method, accuracy of the measurement of LDL- and HDL-cholesterol concentrations and the interrun precision were established by analysis of frozen serum specimens provided by the CDC, which established target values for the pools using reference methods. Results: No clinically significant differences in cholesterol concentrations in the bottom fraction were observed for the 1- and 0.23-mL methods, which had mean biases of 0.8% and 1.5% relative to the 5-mL method, respectively. Intra- and interrun variability was acceptable for each method, e.g., <1.8% for cholesterol in the bottom fraction. Ultracentrifuged specimens were stable for at least 4 h with no evidence of contamination of cholesterol in the bottom fraction. For comparison specimens provided by the CDC, the 1-mL method met the accuracy and precision goals of the National Cholesterol Education Program for the measurement of HDL- and LDL-cholesterol concentrations (goals: total error <13% and <12%, respectively), with total errors of 6.45% and 5.43%, respectively. Conclusions: Both the 1- and 0.23-mL β-quantification methods are suitable substitutes for the traditional 5-mL method for use in clinical and basic research for the determination of LDL-cholesterol concentration. Both methods provide much higher throughput and require substantially less specimen volume. The 0.23-mL method can be performed in 1 day, but it is slightly less precise than the 1-mL method. In our laboratory setting, as many as 80 specimens are routinely processed per day using the 1-mL method.

Comparison of test results obtained from lithium heparin gel tubes and serum gel tubes

2020 ◽  
Vol 45 (5) ◽  
pp. 575-586
Author(s):  
Şerif Ercan
Keyword(s):  
Ldl Cholesterol ◽  
Total Bilirubin ◽  
Clinical Chemistry ◽  
Total Error ◽  
Hdl Cholesterol ◽  
Turnaround Time ◽  
Test Results ◽  
Allowable Error ◽  
Clinically Significant ◽  
Clot Activator

AbstractObjectivesThere is currently trend that plasma might be alternative to serum due to some of its advantages. This study aimed to compare test results from heparinized plasma and serum.MethodsBlood samples from total of 40 participants (20 healthy, 20 hemodialysis patients) were drawn into serum gel tubes with clot activator and lithium heparin gel tubes. Twenty-eight clinical chemistry analytes were measured in serum and plasma samples. To determine whether difference between test results is clinically significant, total error (TE) was calculated and compared total allowable error (TEa) limits.ResultsTE of below 5% was calculated for amylase, AST, calcium, total cholesterol, chloride, CK, glucose, HDL-cholesterol, iron, LDH, LDL-cholesterol, magnesium, sodium, total bilirubin, uric acid and urea. Albumin, ALT, creatinine, CRP, lipase, phosphorus, potassium, total protein, and triglyceride had TE of 5–7%. TE of 7–10% were determined for ALP, direct bilirubin, and GGT. TE values were within TEa limits for all analytes.ConclusionsIt was concluded that results of 28 analytes measured in lithium heparin gel tubes are comparable to those of serum gel tubes. It is thought that several advantages including reduced turnaround time might be provided by using plasma instead of serum for these tests.

Platelet Aggregation and Plasma Lipoproteins in Alcoholics During Alcohol Withdrawal

1986 ◽  
Vol 55 (02) ◽  
pp. 173-177 ◽  
Author(s):  
K Desai ◽  
J S Owen ◽  
D T Wilson ◽  
R A Hutton
Keyword(s):  
Platelet Aggregation ◽  
Alcohol Withdrawal ◽  
Ldl Cholesterol ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Hdl Cholesterol ◽  
Plasma Lipoprotein ◽  
Cholesterol Concentration ◽  
Arachidonic Acid Content ◽  
Low Density

SummaryPlatelet aggregation, platelet lipid composition and plasma lipoprotein concentrations were measured each week in a group of seventeen alcoholics, without overt liver disease, for one month, following acute, total alcohol withdrawal. The platelets were initially hypoaggregable but, within 1-2 weeks of cessation of drinking, they became hyperaggregable and then gradually returned towards normal values. Hyperaggregability could not be explained by increases in either the cholesterol or the arachidonic acid content of the platelets. Plasma very-low-density lipoprotein cholesterol levels remained high throughout the study, but the initially raised levels of high-density lipoprotein (HDL) cholesterol fell by 26%. Low-density lipoprotein (LDL) cholesterol concentration rose by 10% after two weeks of withdrawal but then returned to about the starting level. The resulting changes in the plasma LDL-cholesterol: HDL-cholesterol ratio, which had increased by more than 50% after two weeks of abstinence, essentially paralleled the time course of enhanced platelet reactivity in all but four of the alcoholics. These findings suggest that alterations in plasma lipoprotein concentrations during acute alcohol withdrawal may be a contributory factor to the haemostatic disorders present in such patients.

Abstract 186: Reduction Of High density lipoprotein Cholesterol After Successfull Dietary Intervention Is Not Accompanied By A Change In Reverse Cholesterol Transport

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Rudolf Poledne
Keyword(s):  
Reverse Cholesterol Transport ◽  
Ldl Cholesterol ◽  
Dietary Cholesterol ◽  
Saturated Fat ◽  
Hdl Cholesterol ◽  
Cholesterol Concentration ◽  
Cholesterol Transport ◽  
High Cholesterol ◽  
Unsaturated Fat ◽  
Low Cholesterol

Substitution of dietary saturated fat by unsaturated fat and the reduction of dietary cholesterol intake leads to a decrease of LDL cholesterol concentration accompanied usually by a decrease of HDL cholesterol. Method: 18 young male volunteers were fed for 4 weeks either a high cholesterol saturated fat diet or low cholesterol and unsaturated fat diet in crossover design. At the end of both experimental periods, the lipoprotein concentration was determined. In addition, the reverse cholesterol transport from 14 C cholesterol labeled macrophages in tissue cultures was analyzed. Reverse cholesterol transport was calculated as the percentage of radioactivity released from pre-labeled cells to incubation media with serum of each individuals. Results: Highly significant decrease of LDL cholesterol after the unsaturated fat diet was accompanied by a significant decrease of the HDL cholesterol from 1.25 mmol/l to 1.05 mmol/l. Reverse cholesterol transport did not significantly change when the data of high cholesterol saturated fat diet (9.97 ± 1.45) and low cholesterol unsaturated fat diet (9.53 ± 1.41) were compared. There was no correlation between data of the decrease of HDL cholesterol concentration and change in reverse cholesterol transport. Conclusion: We conclude that dietary treatment by hypocholesterolemic diet accompanied by a reduction of HDL cholesterol does not lead to the decrease in reverse cholesterol transport.

Complex lipid-lowering treatment options in patients with a history of acute coronary syndrome

2011 ◽  
Vol 152 (8) ◽  
pp. 296-302 ◽  
Author(s):  
Győző Dani ◽  
László Márk ◽  
András Katona
Keyword(s):  
Acute Coronary Syndrome ◽  
Serum Lipid ◽  
Ldl Cholesterol ◽  
Hdl Cholesterol ◽  
Lipid Lowering ◽  
Coronary Syndrome ◽  
Target Values ◽  
History Of ◽  
Lipid Parameters

Authors aimed to assess how target values in serum lipid concentrations (LDL- and HDL-cholesterol, triglyceride) can be achieved in patients with a history of acute coronary syndrome during follow up in an outpatient cardiology clinic. Methods: 201 patients with a history of acute coronary syndrome were included and were followed up between January 1 and May 31, 2007.Authors analyzed serum lipid parameters of the patients and the lipid-lowering medications at the time of the first meeting and during follow up lasting two years. Results: During the enrollment visit only 26.4% of the patients had serum LDL cholesterol at target level, whereas high triglycerides and low HDL cholesterol levels were observed in 40.3% and 33.3% of the patients, respectively. Only 22 patients (10.9%) achieved the target levels in all three lipid parameters. Of the 201 patients, 179 patients participated in the follow up, and data obtained from these patients were analyzed. There was a positive trend toward better lipid parameters; 42.5% of the patients reached the desired LDL-cholesterol target value and 17.3% of the patients had HDL-cholesterol and triglycerides target values. Conclusions: These findings are consistent with those published in the literature. Beside the currently used therapeutic options for achieving optimal LDL-cholesterol, efforts should be made to reduce the so-called “residual cardiovascular risk” with the use of a widespread application of combination therapy. Orv. Hetil., 2011, 152, 296–302.

scholarly journals Diabeteses dyslipidaemia és atherosclerosis

2016 ◽  
Vol 157 (19) ◽  
pp. 746-752 ◽  
Author(s):  
László Márk ◽  
Győző Dani
Keyword(s):  
Diabetes Mellitus ◽  
Myocardial Infarction ◽  
High Risk ◽  
Statin Therapy ◽  
Ldl Cholesterol ◽  
Hdl Cholesterol ◽  
Small Dense Ldl ◽  
Target Values ◽  
Postprandial Triglyceride ◽  
Low Hdl

The incidence and the public health importance of diabetes mellitus are growing continuously. Despite the improvement observed in the latest years, the leading cause of morbidity and mortality of diabetics are cardiovascular diseases. The diagnosis of diabetes mellitus constitutes such a high risk as the known presence of vascular disease. Diabetic dyslipidaemia is characterised by high fasting and postprandial triglyceride levels, low HDL level, and slightly elevated LDL-cholesterol with domination of atherogenic small dense LDL. These are not independent components of the atherogenic dyslipidaemia, but are closely linked to each other. Beside the known harmful effects of low HDL and small dense LDL, recent findings confirmed the atherogenicity of the triglyceride-rich lipoproteins and their remnants. It has been shown that the key of this process is the overproduction and delayed clearance of triglyceride-rich lipoproteins in the liver. In this metabolism the lipoprotein lipase has a determining role; its function is accelerated by ApoA5 and attenuated by ApoC3. The null mutations of the ApoC3 results in a reduced risk of myocardial infarction, the loss-of-function mutation of ApoA5 was associated with a 60% elevation of triglyceride level and 2.2-times increased risk of myocardial infarction. In case of diabetes mellitus, insulin resistance, obesity, metabolic syndrome and chronic kidney disease the non-HDL-cholesterol is a better marker of the risk than the LDL-cholesterol. Its value can be calculated by subtraction of HDL-cholesterol from total cholesterol. Target values of non-HDL-cholesterol can be obtained by adding 0.8 mmol/L to the LDL-cholesterol targets (this means 3.3 mmol/L in high, and 2.6 mmol/L in very high risk patients). The drugs of first choice in the treatment of diabetic dyslipidaemia are statins. Nevertheless, it is known that even if statin therapy is optimal (treated to target), a considerable residual (lipid) risk remains. For its reduction treatment of low HDL-cholesterol and high triglyceride levels is obvious by the administration of fibrates. In addition to statin therapy, fenofibrate can be recommended. Orv. Hetil., 2016, 157(19), 746–752.

scholarly journals Measurements for 8 Common Analytes in Native Sera Identify Inadequate Standardization among 6 Routine Laboratory Assays

2014 ◽  
Vol 60 (6) ◽  
pp. 855-863 ◽  
Author(s):  
Hedwig C M Stepman ◽  
Ulla Tiikkainen ◽  
Dietmar Stöckl ◽  
Hubert W Vesper ◽  
Selvin H Edwards ◽  
...  
Keyword(s):  
Uric Acid ◽  
Ldl Cholesterol ◽  
Peer Group ◽  
Clinical Chemistry ◽  
Total Error ◽  
Random Access ◽  
Reference Method ◽  
Hdl Cholesterol ◽  
Serum Samples ◽  
Fresh Frozen

Abstract BACKGROUND External quality assessment (EQA) with commutable samples is essential for assessing the quality of assays performed by laboratories, particularly when the emphasis is on their standardization status and interchangeability of results. METHODS We used a panel of 20 fresh-frozen single-donation serum samples to assess assays for the measurement of creatinine, glucose, phosphate, uric acid, total cholesterol, HDL cholesterol, LDL cholesterol, and triglycerides. The commercial random access platforms included: Abbott Architect, Beckman Coulter AU, Ortho Vitros, Roche Cobas, Siemens Advia, and Thermo Scientific Konelab. The assessment was done at the peer group level and by comparison against the all-method trimmed mean or reference method values, where available. The considered quality indicators were intraassay imprecision, combined imprecision (including sample–matrix interference), bias, and total error. Fail/pass decisions were based on limits reflecting state-of-the-art performance, but also limits related to biological variation. RESULTS Most assays showed excellent peer performance attributes, except for HDL- and LDL cholesterol. Cases in which individual assays had biases exceeding the used limits were the Siemens Advia creatinine (−4.2%), Ortho Vitros phosphate (8.9%), Beckman Coulter AU triglycerides (5.4%), and Thermo Scientific Konelab uric acid (6.4%), which lead to considerable interassay discrepancies. Additionally, large laboratory effects were observed that caused interlaboratory differences of >30%. CONCLUSIONS The design of the EQA study was well suited for monitoring different quality attributes of assays performed in daily laboratory practice. There is a need for improvement, even for simple clinical chemistry analytes. In particular, the interchangeability of results remains jeopardized both by assay standardization issues and individual laboratory effects.

scholarly journals Comparaison de six méthodes de dosage indirect du cholestérol LDL chez des personnes vivant avec le VIH à Libreville

2020 ◽  
Vol 14 (7) ◽  
pp. 2423-2433
Author(s):  
Rosalie Nikiema-Ndong ◽  
Aude Syntia Mbang Bengone ◽  
Alexandrine Nsi ◽  
Edwige Nnegue Edzo ◽  
Alvine Sibylle Batou ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Total Cholesterol ◽  
Indirect Method ◽  
Ldl Cholesterol ◽  
Hdl Cholesterol ◽  
Indirect Measurement ◽  
Cholesterol Concentration ◽  
People Living With Hiv ◽  
Étude Prospective ◽  
Living With Hiv

L’objectif de cette étude était, de comparer six méthodes de dosage indirect du cholestérol LDL en vue de mettre en place une méthode plus pertinente dans le suivi des modifications cardiométaboliques chez les personnes vivant avec le VIH (PVVIH) sous traitements. Il s’agissait d’une étude prospective descriptive et analytique chez des PVVIH sous antirétroviraux à Libreville, allant du 13 août au 30 novembre 2018. Les patients de plus de 15 ans ont été inclus après avoir donné leurs consentements. Le dosage du cholestérol total, cholestérol HDL, cholestérol LDL et triglycérides a requis un automate multi analyseur (BS 200 de Mindray®) ainsi que des kits « BIOLABO ». La régression linéaire était utilisée pour rechercher les différentes corrélations. Les valeurs de triglycérides <150mg/dL étaient retrouvées chez 96% de la population et 52% avait une concentration de cholestérol HDL <40mg/dL. Les différentes formules de calcul de la concentration du cholestérol LDL par rapport aux  concentrations de LDL cholestérol direct ont montré que le carré du coefficient de corrélation linéaire r était plus élevé pour la formule  d’Anandaraja (r2 = 0,83), suivi de celle de Friedewald avec r2 = 0,72. Un palliatif au dosage direct pourrait être l’utilisation de la formule d’Anandaraja dans notre contexte d’étude.Mots clés : Cholestérol LDL, Cholestérol total, Méthode indirecte, VIH, Anandaraja, Friedewald. Comparison of six indirect LDL cholesterol methods among HIV patients in Libreville   The objective of this study was to compare six methods of indirect measurement of LDL cholesterol for setting a more relevant method of monitoring cardiometabolic changes in people living with HIV under treatment. This was a prospective descriptive and analytic study among people living with HIV and under antiretroviral therapy in Libreville, from 13 August to 30 November 2018. Patients over 15 years of age were included after giving their consent. The dosage total of cholesterol, HDL cholesterol, LDL cholesterol and triglycerides required a multi analyzer BS 200 of Mindray® and reagents kits from BIOLABO. Linear regression was used to found different correlations. Triglyceride values below 150 mg/dL were found among 96% of the population and 52% had HDL cholesterol concentration below 40 mg/dL. The different formulas for calculating the LDL cholesterol concentration relative to the direct LDL cholesterol concentrations show that the square of the linear correlation coefficient r is higher for the Anandaraja formula (r2 = 0.83) followed by that of Friedewald with r2 = 0.72. A palliative method to the direct assay could be the use of Anandaraja's formula in our context.Keywords: LDL cholesterol, Total cholesterol, Indirect method, HIV, Anandaraja, Friedewald.

Abstract 492: Atherogenic Dyslipidemia in Patients with Transient Ischemic Attack

2015 ◽  
Vol 35 (suppl_1) ◽  
Author(s):  
Hye-Yeon Choi
Keyword(s):  
Transient Ischemic Attack ◽  
Ldl Cholesterol ◽  
Recurrent Stroke ◽  
Density Lipoprotein ◽  
Hdl Cholesterol ◽  
Vascular Lesion ◽  
Vascular Lesions ◽  
Cholesterol Concentration ◽  
Atherogenic Dyslipidemia ◽  
Ischemic Attack

Background: The risk of recurrent stroke following transient ischemic attack (TIA) is reported up to 15% at 90 days after the attack. Urgent assessment and combined use of preventive treatments in appropriate patients can reduce this risk significantly. The atherogenic dyslipidemia in patients with TIA may be associated with intracranial artery stenosis and higher risk of early recurrent stroke. This study was aimed to investigate if dyslipidemia was related to atherosclerotic vascular lesions in the TIA patients. Methods: Patients with TIA who admitted to single hospital were included. TIA was defined as an acute loss of focal cerebral function, lasting fewer than 24 hours. If brain magnetic resonance imaging scans showed acute infarction, the patient was judged to have a TIA with a new lesion; if not, the event was classified as TIA without a new lesion. Radiologic findings were reviewed retrospectively. Association between presence of atherosclerotic vascular lesions and lipid profile were examined. Atherogenic dyslipidemia was defined as high density lipoprotein (HDL) cholesterol ≤ 40 mg/dL and triglycerides ≥ 150 mg/dL. Level of non-HDL cholesterol was calculated as total cholesterol concentration minus HDL cholesterol concentration. Presence of classic risk factors of atherosclerosis and vascular disease were also reviewed. Results: Among 117 TIA patients, 106 patients who had available results were included to the analysis. Mean age was 64 years (± 13), and 48 were men (42.1%). Atherosclerotic vascular lesion was shown in 56 patients (52.8%). Presence of atherosclerotic vascular lesions was associated with age, diabetes, low density lipoprotein (LDL) cholesterol concentrations, and level of CRP. Atherogenic dyslipidemia was not related to vascular lesions. Among 106 patients, only 18 patients (17.0%) were diagnosed as TIA with a new lesion. Presence of acute cerebral infarction was associated with presence of atherosclerosis. Diabetes and current smoking were associated with new ischemic lesion related TIA. Conclusions: In TIA patients, concentrations of LDL cholesterol were related atherosclerotic vascular lesion which is known to be associated with recurrent stroke after TIA. It might be helpful to screen high risk TIA patient.

scholarly journals Milk minerals modify the effect of fat intake on serum lipid profile: results from an animal and a human short-term study

2013 ◽  
Vol 111 (8) ◽  
pp. 1412-1420 ◽  
Author(s):  
Janne K. Lorenzen ◽  
Søren K. Jensen ◽  
Arne Astrup
Keyword(s):  
Total Cholesterol ◽  
High Fat Diet ◽  
Ldl Cholesterol ◽  
Control Period ◽  
Saturated Fat ◽  
Hdl Cholesterol ◽  
Cholesterol Concentration ◽  
Control Group ◽  
High Fat ◽  
Milk Minerals

Despite a high content of saturated fat, evidence from observational studies indicates that the consumption of dairy products may have a neutral effect or may be inversely associated with the risk of CVD. We aimed to examine whether milk minerals modify the effect of saturated fat on serum lipid profile. We present data from two studies. Study I had a randomised, blinded, parallel design (n 24 pigs) with a 10 d adaptation period during which a high-fat diet was fed to the pigs and a 14 d intervention period during which the same diet either enriched with milk minerals (MM group) or placebo (control group) was fed to the pigs. Study II had a randomised cross-over design (n 9 men) where the subjects were fed either a high-fat diet enriched with milk minerals (MM period) or a regular diet (control period). In both the studies, blood variables were measured before and after the intervention and faecal and urine samples were collected at the end of the dietary periods. The increase in plasma total cholesterol and LDL-cholesterol concentrations but not in HDL-cholesterol concentration was markedly lowered by milk minerals in both the studies. In the animal study, baseline adjusted total cholesterol and LDL-cholesterol concentrations in the MM group were 11 % (P= 0·004) and 13 % (P= 0·03) lower compared with those in the control group after the intervention. Similarly in the human study, baseline adjusted total cholesterol and LDL-cholesterol concentrations were 6 % (P= 0·002) and 9 % (P= 0·03) lower after the MM period compared with those in the control period. HDL-cholesterol concentration was not lowered by milk minerals. These short-term studies indicate that the addition of milk minerals to a high-fat diet to some extent attenuates the increase in total cholesterol and LDL-cholesterol concentrations, without affecting HDL-cholesterol concentration.

Inverse Relationship in Jamaica between Plasma High-Density Lipoprotein Cholesterol Concentration and Coronary-Disease Risk as Predicted by Multiple Risk-Factor Status

1976 ◽  
Vol 51 (5) ◽  
pp. 475-482 ◽  
Author(s):  
G. J. Miller ◽  
N. E. Miller ◽  
M. T. Ashcroft
Keyword(s):  
Blood Pressure ◽  
Risk Factor ◽  
Ldl Cholesterol ◽  
Density Lipoprotein ◽  
Hdl Cholesterol ◽  
Cholesterol Concentration ◽  
Multiple Risk Factor ◽  
Coronary Risk ◽  
Plasma High Density ◽  
Risk Factor Status

1. The relation between plasma high-density lipoprotein (HDL) cholesterol concentration and multiple coronary-risk factor status has been assessed in fifty-two middle-aged clinically healthy men from urban and rural Jamaica. 2. Rural hill-farmers had a superior exercise performance (assessed by the responses to submaximal test exercise), less body fat, and lower fasting levels for plasma total cholesterol, low-density lipoprotein (LDL) cholesterol, total triglyceride and blood glucose than urban businessmen. Mean plasma HDL cholesterol was considerably higher in farmers then businessmen. 3. Multilinear regression analysis showed HDL cholesterol concentration to be independently and inversely correlated with plasma triglyceride, LDL cholesterol and diastolic blood pressure and that these relationships applied across the urban and rural sub-groups. There was also some evidence that HDL cholesterol concentration increased with stature. When these factors were taken into account, age, ethnic group, adiposity, weight, exercise performance, smoking history and blood glucose made no further significant contribution to the prediction of HDL cholesterol concentration. 4. Thus plasma HDL cholesterol concentration was highest in those subjects with the lowest coronary-risk as predicted by their multiple risk-factor status, an observation which supported other evidence that coronary-risk is inversely related to plasma HDL concentration. 5. The results raise the possibility that coronary-risk can be more simply estimated from the plasma HDL cholesterol concentration than from a consideration of other major lipid risk factors and blood pressure.

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