Cholesterol, clinical diagnostics

Clinical/diagnostics For clinical diagnostics, a lot of sensors have been developed for medical diagnosis of various analytes in blood samples like glucose, cholesterol, urea, lactate, uric acid, creatinine, both qualitatively and quantitatively. To detect... 

Solberg and co-workers have applied discriminate analysis of clinical laboratory tests combined with careful clinical and anatomic diagnoses of liver disease in order to determine which combinations of the many dozen liver diagnostic tests available are the bes t ( ). These authors found that the measurement of GPT, GMT, GOT, ALP and ceruloplasmin were the most useful enzymatic tests, when combined with other non-enzymatic tests such as the measurement of bilirubin, cholesterol, hepatitis-B associated Australian antigen, etc. Another group of highly useful enzymes, not discussed in this review, are those clotting factors and the enzyme cholinesterase which are synthesized by the liver cells. 

Based on the clinical suspicion of a cholesterol biosynthesis defect, the first line of diagnosis for these various defects often involves sterol analysis in patient material where detection of a specific sterol intermediate is indicative for the respective defect. Confirmative diagnostic procedures involve enzymatic assays and/or molecular testing. 

The remaining six disorders are due to defects of enzymes involved specifically in the synthesis of cholesterol (Fig. 5.1.2). The detection of specific intermediate sterol species in cells, tissues, and/or body fluids of patients suspected to suffer from a defect in cholesterol biosynthesis based on their clinical presentation is often the first line of diagnosis, which can then be followed by enzyme and/or molecular diagnostic testing [9]. 

In a study from the Mayo Clinic (M4), a group of male patients undergoing diagnostic coronary angiography for chest pain or suspected coronary artery disease had plasma cholesterol and triglyceride, HDL cholesterol, and apoA-I concentrations measured. Whereas HDL cholesterol discriminated to some extent between those with and those without important coronary artery disease (and total cholesterol and triglyceride did not discriminate at all), apoA-I levels provided an almost perfect prediction of obstructive coronary artery disease. Some caveats on the interpretation of apoA-I levels in this and other studies have been noted by Blackburn (B34). 

Disruption of lipid metabolism as the cause of respiratory distress syndrome and Tay-Sachs disease Section 26.1.6 Diagnostic use of blood cholesterol levels Section 26.3.2 Hypercholesteremia and atherosclerosis Section 26.3.5 Clinical management of cholesterol levels Section 26.3.6... 

Free and esterified cholesterol can be measured during the determination of a total lipid profile by the methods described in Chapter 8 (Section I). On the other hand, so important is the absolute concentration of cholesterol in plasma as a diagnostic marker in disease states believed to be that a number of methods have been developed for the rapid determination of cholesterol alone by various means. For routine clinical applications, all such methods, including GC, should be capable of a high degree of automation. The procedures available have been reviewed and compared elsewhere [336,659, 1011], Enzymatic and colorimetric methods appear to be favoured in most routine clinical applications... 

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