Reliability of lipid, lipoprotein, and apolipoprotein measurements.

The National Heart, Lung, and Blood Institute national awareness program on cholesterol and heart disease has placed new demands on laboratorians to utilize and perform more reliable measurements of lipids, lipoproteins, and apolipoproteins. The general public's awareness and the clinicians' concerns about the reliability of laboratory testing make it paramount that the analytical problems and issues are identified and solutions are provided to increase the current state of reliability of the measurement of these blood constituents. To accomplish this, the initial step is to assess the current state of reliability of lipid, lipoprotein, and apolipoprotein measurements in the clinical laboratories. Accuracy and precision of measurements of total cholesterol, triglycerides, high-density lipoprotein cholesterol, and apolipoproteins A-I and B are extensively discussed, and general as well as some specific recommendations are provided for some of the apparent problems.