LIPID TESTING FOR THE YEAR-2000 AND BEYOND

Lipid testing has progressed from early measurements of total lipid by extraction and weighing to assess the fat content of the specimen. Th is nonspecific approach to lipid testing has been replaced in clinical laboratories by automated and quantitative procedures that avoid the extraction process. Instead, selective enzymes are utilized in reactio n schemes to quantitate the individual lipid classes present in patien t specimens. For example, cholesterol esterase and oxidase are used on a routine basis to measure total cholesterol in plasma and serum spec imens. Similar use of other enzyme systems has permitted triglycerides and phospholipids to be measured by clinical laboratories. Lipid and lipoprotein measurements have advanced considerably from the early non specific extraction and gravimetric analysis schemes to the specific a utomated procedures that are commonly used today. However, as lipids a nd lipoproteins increased in their clinical usefulness as cardiovascul ar risk assessment tools, the search intensified for newer approaches to measure these entities more easily and more accurately. The influen ce of National Cholesterol Education Program has played a key role in highlighting the importance of lipids and lipoprotein analysis. Today, lipid testing is available outside the traditional laboratory environ ments - drugstores sell units that individuals can use at home to asse ss cholesterol levels. Lipid testing has come a long way, and we have only begun to experience some of the remarkable changes for the future .