Dear Lance Sandle,
Our local Professor of Cardiology expressly asked us firstly to add this
TC:HDL-C ratio to our lipid profile, and secondly to completely stop quoting
any of the reference data we used to append to each lipid report.
He said all of the GPs, Cardiologists, and others now know and follow the
official UK NSF (National Services Framework) recommendations.
And this does seem to be the case.
We agree to compromise by mentioning the NSF and the BNF on our lipid
reports instead of reference data. That's what we do now.
Yours,
Les Culank
Consultant Chemical Pathologist, Addenbrooke's
Dear Lance
The BNF (in the UK) provide Coronary Risk Predication Charts produced by the
Joint British Societies. These tables are use to classify patients into
various CHD risks. So there is no actual total: HDL cholesterol cut-off
value. We have started reporting this ratio on our reports, and they are
very much liked by the GPs.
Avril Owen
Principal Biochemist
> From: Lance Sandle <[log in to unmask]>
> Subject: Total to HDL cholesterol ratio
>
> Dear Colleagues
>
> Total:HDL ratio appears on various risk prediction
> charts and in the literature. Though not at present
> under pressure to provide this derived parameter on
> lab reports, I would have to be confident that it has
> been validated before doing so. Obviously I'm happy to
> report total and HDL cholesterol, leaving those still
> capable of long division to work out the ratio for
> themselves. What I'm not happy to do is take
> responsibility for a derived result of dubious
> scientific provenance.
>
> I've seen cut-off values of 4.0 and 4.5 quoted -
> sometimes by the same author, hence my scepticism!
>
> Has anyone got hard evidence of its validity?
>
> Dr Lance N Sandle
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