Homogeneous Assays for LDL-C and HDL-C are Reliable in Both the Postprandial and Fasting State

Most epidemiological and clinical studies calculated low-density lipoprotein-cholesterol (LDL-C) by Friedewald's formula which cannot be used in the postprandial samples. Although the homogeneous assays with poor analytical performance were withdrawn from the market, it remained unclear whether the currently available reagents for LDL-C and high-density lipoprotein-cholesterol (HDL-C) are as accurate for postprandial samples as for fasting samples.

Fresh blood samples were collected from 59 non-diseased and 109 diseased subjects. Postprandial samples constituted 72.9% and 39.4% of these samples. LDL-C and HDL-C concentrations were measured using the homogeneous assays of four manufacturers (Denka Seiken, Wako, Kyowa Medex, and Sekisui Medical). Simultaneously, LDL-C and HDL-C concentrations were determined using the reference measurement procedures (RMPs) of the Centers for Disease Control and Prevention (CDC). Total errors were calculated using a routine method (TE_com) and via error component analysis (TE_ECA).

All homogeneous assays for LDL-C and HDL-C met the National Cholesterol Education Program (NCEP) requirements in terms of coefficient of variation, and TE_com in both non-diseased and diseased subjects. LDL-C and HDL-C values measured by the homogeneous assays were in good agreement with those measured by the RMPs in both fasting and postprandial samples. The TE_com and TE_ECA values of the postprandial samples were similar to those of fasting samples, although the TE_ECA values were up to 4.4-fold greater than the TE_com values.

In both non-diseased and diseased subjects, the homogeneous assays for LDL-C and HDL-C of four manufacturers are as accurate for postprandial samples as for fasting samples.