Cholesterol test
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Advances in Cholesterol Testing: Methods and Technologies
Automated Enzymic Measurement of Total Cholesterol
The automated enzymic system for measuring total cholesterol in serum has revolutionized clinical diagnostics. This system, utilized by Du Pont's Automatic Clinical Analyzer, involves a series of enzymatic reactions where cholesterol oxidase oxidizes free cholesterol, producing cholest-4-en-3-one and hydrogen peroxide. The hydrogen peroxide then reacts with N,N-Diethylaniline hydrochloride and 4-aminoantipyrine to form a quinoneimine dye, which is measured at 553 nm. This method ensures high reagent efficiency and reliable analytical performance.
Evaluation of Cholesterol Test Systems Using ID GS-MS
A comprehensive evaluation of four frequently used cholesterol test systems—Beckman, Boehringer Mannheim, Merck, and Johnson & Johnson Clinical Diagnostics—was conducted using isotope dilution gas chromatography-mass spectrometry (ID GS-MS) as a reference. The results demonstrated excellent correlation and state-of-the-art performance across these systems, with high correlation coefficients and minimal dispersion, indicating their reliability for clinical use.
Noninstrumented Quantitative Cholesterol Test
A novel noninstrumented technology has been developed for quantifying cholesterol in whole blood. This method uses a test strip where enzymatic action on cholesterol produces hydrogen peroxide, which is then quantified through a redox-coupled indicator system. The height of the color band formed is directly proportional to the cholesterol concentration. This user-friendly test is completed in less than 15 minutes and correlates well with established methods, making it accessible for non-technically trained users.
Point of Care Testing (POCT) via Electrophoresis Titration
A portable point of care testing (POCT) method for cholesterol in blood serum has been developed using a moving reaction boundary electrophoresis titration chip. This method integrates a selective enzymatic reaction with an electrophoresis titration chip, allowing for visual and portable quantification of cholesterol. The device shows high selectivity, portability, and visuality, with a sensitivity limit of 5 µM and good linearity, making it a promising tool for rapid cholesterol testing.
Triple Lipid Screening Test
The triple lipid screening (TLS) test is an automated single-tube assay that measures HDL-cholesterol, total cholesterol, and triglycerides without specimen pretreatment. This homogeneous assay uses either an anti-apolipoprotein B antibody or a polyanion to block the enzymatic measurement of non-HDL cholesterol. The TLS test has shown acceptable analytic performance and compares favorably with standard tests, providing a simple and efficient method for detecting hyperlipidemia.
Whole-Blood Test for Total Cholesterol
A disposable device for whole-blood cholesterol testing has been developed, which meters the sample, separates plasma from erythrocytes, and times plasma flow into reagent compartments. The test results are displayed as a color bar, with a quality-control window ensuring the integrity of the test components. Clinical studies have shown this device to have high precision and accuracy, making it a reliable tool for cholesterol measurement.
Plasma Total Cholesterol as a Screening Test
The use of plasma total cholesterol as a screening test for elevated low-density lipoprotein cholesterol (type IIa hyperlipoproteinemia) in young subjects has been assessed. The study found that using the 95th percentile as a cutpoint resulted in a significant number of false positives and negatives. Adjusting the cutpoint affected the balance between false positives and negatives, highlighting the need for careful consideration in screening protocols.
Simplified Method for Estimating Total Cholesterol
A simplified method for estimating total cholesterol in serum involves treating the serum with alcoholic potassium hydroxide, extracting cholesterol into petroleum ether, and measuring it using the Liebermann-Burchard color reaction. This method has been shown to be specific and reliable, making it suitable for both clinical and research laboratories.
Cholesterol Testing on Smartphones
A smartphone accessory and software application have been developed to quantify cholesterol levels in blood using standard test strips. This system allows for accurate cholesterol measurement within 60 seconds and improves measurement sensitivity and reproducibility across different smartphones. This innovation has the potential to make cholesterol monitoring more accessible and widespread, enhancing preventive care for cardiovascular disease.
Performance of Commercially-Available Cholesterol Self-Tests
An assessment of five commercially-available cholesterol self-tests revealed varying levels of accuracy and diagnostic performance. The Roche Accutrend Plus showed the best performance with high sensitivity and specificity, while other tests demonstrated poor accuracy. This highlights the need for better regulation and standardization of cholesterol self-tests to ensure reliable results.
Conclusion
The advancements in cholesterol testing methods and technologies have significantly improved the accuracy, efficiency, and accessibility of cholesterol measurement. From automated enzymic systems to smartphone-based applications, these innovations are paving the way for better diagnostic and preventive care in cardiovascular health. However, the variability in performance among commercially-available self-tests underscores the importance of continued efforts in standardization and quality control.
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