stofk. (beregnet): 4,5 mmol/1. Det fremhreves ,
at grrensevrerdier ikke kan sidestilles med in–
terventionsvrerdier, men reprresenterer sig–
nalvrerdier, der afhrengig af den kliniske situa–
tion kan udl0se intervention.
SUMMARY
J0rn Dyerberg, Steen Stender, Gunnar Eg An–
dersen , Ole Frergeman, Torben Haghfelt, Tor–
sten Hviid , Tonny J. Jensen, Arne Leth, Bjar–
ne Sigurd
&
Flemming Skovby (The lipid
group within the Danish Society for Cardiolo–
gy, the section for preventive cardiology): Re–
commendations for clinical chemical depart–
ments: Lipid and lipopartein measurements.
Ugeskr Lreger 1990; 152: 1434- 7.
The section for preventive cardiology with–
in the Danish Society for Cardiology has es–
tablished a lipid group with representatives
from The Danish Society for Clinical Chem–
istry, The Danish Society for Interna! Medi–
cine, The Danish Society for Cardiology, The
Danish Society of Hypertension, The Danish
College of General Practitioners, and The
Danish Paediatric Society. The lipid group
has elaborated recommendations for clinical
chemical departments regarding lipid and
lipoprotein analyses. The group suggests that
doctors ordering lipid and lipoprotein analy–
ses are offered the following: S-Cholesterol
(total), substance conc., (fPt)S-Triglycerides,
substance conc., S-HDL-cholesterol, substan–
ce conc. , and (fPt)S-LDL-cholesterol , substan–
ce conc. (calculated).
It
is recommended that
the biological variation be minimized by
sampling in a sitting position after a 15 minu–
tes' rest and by basing the clinical decision on
a minimum of 2-3 determinations with an
interval of about one month. The analytical
variations should be reduced to below 3%
(calculated as the variation coefficient), and it
is recommended that laboratories participate
in externa! quality control systems at least
10
four times annually by reporting at !east two
human reference materials with different con–
centrations. As the use of reference intervals
dependent on age and sex, based on random
samplings of the background population, are
less informative, it is recommended to refer to
cutoff values for the clinical decision. The fol–
lowing cutoff -values are recommended: S–
Cholesterol (total), substance conc.: 6 mmol/1,
(fPt)S-Triglycerides, substance conc.; 2.5
mmol/1, S-HDL-cholesterol, substance conc. :
0.9 mmol/1 , (fPt)-LDL-cholesterol, substance
conc. (calculated): 4.5 mmol/1.
It
is empha–
sized that cutoff values cannot be compared
with intervention values, but represent signal
values which, depending on the clinical situa–
tion, might release intervention.
LITTERATUR
l.
Cooper GR, Myers GL, Smith SJ, Sampson EJ.
Standardization of lipid, lipoprotein and apali–
poprotein measurement. Clin Chem 1988; 34:
B95-B105.
2. Schaffer R. Current status of blood cholesterol
measurement in clinical laboratories in the
United States: a report from the laboratory stan–
dardization panel of the national cholesterol
education program. Clin Chem 1988; 34:
193-201.
3. Report from the National Cholesterol Education
Program Expert Panel on detection, evaluation,
and treatment of high blood cholesterol in
adults. From the National Cholesterol Education
Program, National Heart, Lung, and Blood Insti–
tute, Bethesda, Md. Arch Intern Med 1988; 148:
36-69.
4. Study group, European Atherosclerosis Society.
Strategies for the prevention of coronary heart
disease: a policy statement of the European
Atherosclerosis Society. Eur Heart J 1987; 8: 77- 88.
5. Fa:rgemann O, Hansen JF, Hilden T, Olesen ES,
Strunge P. Hyperlipida:mi: retningslinier for
unders0gelser og behandling. Fra en arbejds–
gruppe nedsat af Dansk Selskab for Intern Medi–
cin. 1985.
6. Behandling av hyperlipidemi. Information från
Socialstyrelsens läkemedelsavdeling 1988; 5:
152-7.
Klinisk kemi
i
Norden
