International quality assurance schemes for cholesterol

Lipid disorders rank high among the risk factors known to be associated with development of cardiovascular diseases which constitute a great socio-economic problem in many countries. Blood lipid lipoprotein and apolipoprotein measurements belong in all types of medical services to the most important ones not only because of their diagnostic but also of predictive value. Especially the measurement of blood cholesterol concentration is used in different studies and population screenings as an aid in establishing the degree of the risk of the development of cardiovascular disease. Accurate methods and uniform decision cut-points are needed for identifying individuals at high risk for comparability among results from different places and for preventing false diagnostic decisions based on inaccurate measurements. International Reference and/or Standardization Centres are of utmost importance helping to bring methods into uniform accuracy and precision limits everywhere. Local reference and standardization centres can be created with their assistance. Using the example of control of total cholesterol methods this paper describes some of the activities of the WHO Lipid Reference Centre at the Institute for Clinical and Experimental Medicine (IKEM) in Prague Czechoslovakia which shows comparability to the Centres for Disease Control (CDC Atlanta) standardization basis and mentions several other standardization centres in different countries.