Enzymic determination of free and esterified cholesterol in serum by microcalorimetry

Concentrations of free and esterified cholesterol in serum can be determined simultaneously by measuring, with a batch-type microcalorimeter, the heat released during the coupled cholesterol esterase/cholesterol oxidase/catalase enzymic reaction. To differentiate the two forms of cholesterol, we used kinetic calorimetry: the rate of heat output due to enzymic hydrolysis of esterified cholesterol (the rate-determining reaction) was subtracted from the measured heat, the difference being the heat released during the enzymic oxidation of free cholesterol (the fast reaction). Results obtained by the kinetic calorimetric method agreed with those obtained by separate sequential end-point calorimetric determinations of free and total cholesterol. We also compared the kinetic calorimetric method with the cholesterol method of Abell and Kendall and a continuous-flow modification of the Liebermann-Burchard method (Technicon SMAC). De-biased linear-regression analysis of the data indicates acceptable agreement between the calorimetric and the Abell-Kendall methods (y = 0.98x + 11.5). The correlation between results by calorimetric and SMAC methods shows a significant proportional error (y = 1.17x - 159.4). Bilirubin (up to 200 mg/L) does not interfere with the calorimetry.