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September 5, 1990

Portable Cholesterol Analyzers-Reply

JAMA. 1990;264(9):1102-1103. doi:10.1001/jama.1990.03450090037015

In Reply.—  Dr Massé makes a valid correction in the calculation of low-density lipoprotein cholesterol in SI units. In the study, we used conventional units and, for publication, converted all values to SI units. We did not report the correct calculation factor of low-density lipoprotein cholesterol in SI units, which is 2.18. Our results and discussion remain unaltered.Dr Massé's comment concerning the imprecision of the low-density lipoprotein calculation for specimens with triglyceride concentrations exceeding 4.52 mmol/L also is valid. Indeed, in our study we excluded all specimens with triglyceride concentrations equal to or exceeding 4.52 mmol/L, which is below the value generally associated with gross lipemia. We included in our evaluation only specimens within the range that is appropriate for low-density lipoprotein cholesterol calculation, according to the formula of Friedewald et al.Dr Nash's concern that cholesterol "screening programs" are simply for the separation of patients at low risk