Status of Lipid and Lipoprotein Standardization (Point) (Clinical Report‪)‬

The editorial in Clinical Chemistry by Sniderman and Cianflone [1] highlighted some of the potential advantages of measurement of apolipoproteins in clinical practice, most notably in its referral to the articles by Contois et al. on apolipoprotein (apo)11 A-I and apo B reference intervals [2, 3]. The improvements in apo A-I and apo B measurements in the past few years have been immense, thanks in great part to work by the IFCC Committee on Apolipoproteins, chaired by Santica Marcovina. This Committee developed World Health Organization (WHO)-IFCC International Reference Materials for apo A-I and apo B, which are now used internationally by manufacturers to set assay calibration [4-6]. The editorial by Sniderman and Cianflone, however, also indicated, mistakenly, that similar standardization of lipid and lipoprotein lipids does not exist. Although much has been written during the past few years regarding the progress in apolipoprotein measurement and standardization, it was clear from the editorial that public knowledge and understanding is lacking regarding international standardization of the lipid constituents of lipoproteins. In fact, the Lipid Standardization Program (LSP) of the Centers for Disease Control and Prevention-National Heart, Lung and Blood Institute (CDC-NHLBI) has provided standardization for lipid and lipoprotein cholesterol and triglyceride since 1957 in the US and in countries throughout the world [7]. So that all may have a complete understanding of the importance of the standardization programs that exist for the cholesterol and triglyceride constituents of lipoproteins, we describe here the programs that are available.