Total cholesterol in serum determined by isotope dilution/mass spectrometry, with liquid-chromatographic separation

We describe an accurate, precise method for determination of total serum cholesterol by isotope dilution/mass spectrometry (IDMS) with liquid-chromatographic separation. After adding [3,4-13C]cholesterol to serum and hydrolyzing the cholesterol esters, we extract the total cholesterol. "High-performance" liquid chromatography (HPLC) is used to separate the extracted cholesterol for measurement by electron-impact mass spectrometry with use of a direct-insertion device. To evaluate the specificity and the accuracy of this method, we also studied the conventional IDMS method, which involves converting cholesterol to the trimethylsilyl ether and assay by gas chromatography-mass spectrometry with use of a capillary column. The coefficient of variation for the HPLC method was a little larger than that for the conventional method, but mean values by each method agreed within 1% for all sera tested.