358 / Rubin et al.
D.A. Rubin and R.G. McMurray are with the Department of Exercise & Sport Science,
J.S. Harrell and B.W. Carlson are with the School of Nursing, and S. Bangdiwala is with the
Department of Biostatistics—all at the University of North Carolina, Chapel Hill, NC 27599-
8700.
358
Accuracy of Three D ry-Chemistry M ethods
for Lipid Profiling and Risk Factor Classification
Daniela A. Rubin, Robert G. McMurray, Joanne S. Harrell,
Barbara W. Carlson, and Shrikant Bangdiwala
The purpose of this project was to determine the accuracy in lipids measure-
ment and risk factor classification using Reflotron, Cholestech, and Ektachem
DT-60 dry-chemistry analyzers. Plasma and capillary venous blood from fast-
ing subjects (n = 47) were analyzed for total cholesterol (TC), high density
lipoprotein (HDL-C), and triglycerides (TG) using these analyzers and a CDC
certified laboratory. Accuracy was evaluated by comparing the results of each
portable analyzer against the CDC reference method. One-way ANOVAs were
performed for TC, HDL-C, and TG between all portable analyzers and the
reference method. Chi-square was used for risk classification (2001 NIH Guide-
lines). Compared to the reference method, the Ektachem and Reflotron pro-
vided significantly lower values for TC (p < .05). In addition, the Cholestech
and Ektachem values for HDL-C were higher than the CDC (p < .05). The
Reflotron and Cholestech provided higher values of TG than the CDC (p < .05).
Chi-squares analyses for risk classification were not significant (p > .45) be-
tween analyzers. According to these results, the Ektachem and Cholestech
analyzers met the current NCEP III guidelines for accuracy in measurement of
TC, while only Ektachem met guidelines for TG. All 3 analyzers provided a
good overall risk classification; however, values of HDL-C should be only used
for screening purposes.
Key Words: cholesterol, HDL-cholesterol, triglycerides, CHD-risk factors
Introduction
Studies have consistently found an association between coronary heart disease
(CHD) and elevated total cholesterol (TC), elevated low-density lipoprotein (LDL-
C), or low high-density lipoprotein (HDL-C; 8). In addition, elevated serum total
triglycerides (TG) are nowadays classified as an independent risk factor for CHD
(5). Because blood lipids can be improved by initiating therapeutic lifestyle changes
or medications that result in a reduction in heart disease (5), lipid profiling has
become even more important in the treatment and prevention of CHD. Guidelines
established in 2001 by the National Institutes of Health (NIH) suggested that adults
International Journal of Sport Nutrition and Exercise Metabolism, 2003, 13, 358-368
© 2003 Human Kinetics Publishers, Inc.