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Lance, As well as Framingham and the other guidelines already mentioned see the results of PROCAM. Here patients were divided on the basis of a ratio of 5 or less and above 5 and the groups then subdivided into low (<2.3) and high Trigs. There was a 10-fold difference in CHD incidence between the low ratio / low trigs and high ratio / high trigs groups. Locally we report the ratio but no reference range - neither do we report ranges for Total, LDL or HDL cholesterol, though reports do state the NSF targets for Total and LDL. When we first started providing HDLs to GPs some ten years ago, we combined it with the introduction of guidelines, produced through the Health Authority, which stressed the incorporation of the ratio and other risk factors into risk prediction tables. Joe Begley Poole Hospital ----- Original Message ----- From: "Lance Sandle" <[log in to unmask]> To: <[log in to unmask]> Sent: Thursday, January 31, 2002 1:56 PM 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 > Consultant Chemical Pathologist > Department of Chemical Pathology > Trafford General Hospital, Moorside Road, Davyhulme > Manchester M41 5SL United Kingdom > Tel: +44(0)161 746 2473 Fax: +44(0)161 746 8545 > e-mail: [log in to unmask] > > __________________________________________________ > Do You Yahoo!? > Everything you'll ever need on one web page > from News and Sport to Email and Music Charts > http://uk.my.yahoo.com >