HDL-cholesterol or apolipoprotein AI: How to choose?

The French Consensus for cholesterol, established by ARCOL in 1989, recommends the use of HDL-cholesterol and apolipoprotein Al as additional parameters. The present study was undertaken to establish the correlation between these Two parameters and to determine the limit value for apolipoprotein AI, based on the recommended limit of 0.90 mmol/L for HDL-cholesterol established by ARCOL. The correlation between HDL-cholesterol analysed by precipitation, and apolipoprotein AI analysed by immunonephelemetry on the day of blood drawing, determined on 1980 samples, raised a r value of 0.89. Using the regression line equation (y = 0.602 x + 0.629), the apoliporotein AI value corresponding to the recommended HDL-cholesterol limit (0.90 mmol/L) was found to be 1.17 g/L, while the limit value established by ARCOL was 1.20 g/L. Using the HDL-cholesterol value of 0.90 mmol/L, the population was divided into a high risk group and a low risk group. With the limit value of 1.20 g/L for apolipoprotein AI, 89.2% of the subjects would be correctly classified. This percentage would be raised to 90.65% using the value (1.17 g/L) established in our study. Our conclusion is that apolipoprotein AI as well as HDL-cholesterol represent good markers for atherosclerosis in the clinical practice. The advantage of HDL-cholesterol is that the determination of this parameter allows the calculation of LDL-cholesterol which is used in all consensus, while the advantage of apolipoprotein AI is that it may be analysed automatically.