Six methods for isolating high-density lipoprotein compared, with use of the reference method for quantifying cholesterol in serum.

Using 90 serum specimens, we compared six routine procedures for high-density lipoprotein (HDL) isolation to determine the biases, if any, of each. Use of the Reference Method for cholesterol (Duncan et al., Centers for Disease Control, Atlanta, GA) and automated dispensing equipment helped ensure the accuracy of the cholesterol measurements and minimized errors from sample and reagent manipulations. Regression analysis of the results showed significant differences between most HDL isolation methods, except for those involving precipitation with heparin-MnCl2 (1.0 mol/L) or polyethylene glycol 6000, which yielded comparable results with a slope close to one and a zero intercept. The dextran sulfate (Mr 500 000)-MgCl2 method had the largest proportional and constant bias with respect to those two methods. All the methods produced comparable results in the clinically important low HDL-cholesterol range (250 to 350 mg/L), but biases were significant at high concentrations. We conclude that these increased biases in the upper ranges of HDL-cholesterol concentrations are the result of increased heterogeneity of HDL and the different mechanisms involved in forming the insoluble complexes between lipoproteins and the various precipitation reagents.