The ratio of free to esterified cholesterol in serum. A new discriminant in correlating lipid metabolism with disease state.

A normal range has been established for the ratio of free to esterified cholesterol in serum. It has been observed that whereas this ratio remains constant in clinically healthy subjects and is not influenced by sex or age, it is markedly altered in certain disease states. The present study is concerned with the correlation of the normal free:esterified cholesterol ratio with ratios determined for 148 patients hospitalized for various reasons. This study has allowed correlations to be made with respect to various groups of diseases, such as cardiac disease and cancer. Changes in the free:esterified cholesterol ratios offer a new and incisive discriminant in correlating the relationships between cholesterol and various diseases. The methods used were gas-liquid chromatography for determination of "free" and "total" cholesterol and the new enzymatic methods for "free" and "total" cholesterol.