Standardization of measurements for cholesterol, triglycerides, and major lipoproteins

This review evaluates the status of standardization of lipids and lipoproteins. Prerequisites and some basic principles for standardization are provided. The reference systems for cholesterol, HDL cholesterol (HDL-C), LDL cholesterol (LDL-C), triglycerides (TG), apolipoprotein A-I (apoA-I), apolipoprotein B (apoB), and lipoprotein(a) (Lp[a]) are described. Brief descriptions of the standardization programs available for each of these analytes are also provided. Finally, the review addresses some of the challenges in standardizing these markers of cardiovascular disease (CVD). The standardization programs described have contributed to improvements in laboratory measurements of lipids and lipoproteins. Our intention is that clinical laboratory professionals and manufacturers of in vitro diagnostics will use these resources to standardize lipid and lipoprotein measurements. Manufacturers must take the initiative to thoroughly evaluate their products and ensure traceability to the reference systems.