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Test ID: CHLE Cholesteryl Esters, Serum

Reporting Name

Cholesteryl Esters, S

Useful For

Establishing a diagnosis of lecithin-cholesterol acyltransferase deficiency


Evaluating the extent of metabolic disturbance by bile stasis or liver disease

Clinical Information

Cholesterol in the blood serum normally is 60% to 80% esterified with fatty acids, largely as a result of the action of the enzyme lecithin-cholesterol acyltransferase (LCAT), which circulates in the blood in association with the high-density lipoproteins. LCAT transfers an acyl group for lecithin to cholesterol.


Familial deficiency of LCAT is uncommon, usually occurring individuals of northern Europe descent, and is associated with erythrocyte abnormalities (target cells) and decreased (20% or less) esterification of plasma cholesterol. This is associated with early atherosclerosis, corneal opacification, hyperlipidemia, and mild hemolytic anemia.


Persons with liver disease may have impaired formation of LCAT and, therefore, a secondary deficiency of this enzyme and of esterified plasma cholesterol.


In patients with lecithin-cholesterol acyltransferase deficiency, the concentration of unesterified cholesterol in serum may increase 2 to 5 times the normal value, resulting in a decrease in esterified serum cholesterol to 20% or less of the total serum cholesterol.

Analytic Time

Same day/1 day

Day(s) and Time(s) Performed

Monday through Friday; Continuously

Clinical Reference

Glomset JA, Assmann G, Gjone E, Norum KR: Lecithin: cholesterol acyltransferase deficiency and fish eye disease. In The Metabolic Basis of Inherited Disease. Seventh edition. Edited by CR Scriver, AL Beaudet, WS Sly, D Valle. New York, McGraw-Hill Book Company, 1995, pp 1933-1951

Method Name

Enzymatic Colorimetric

Specimen Type


Specimen Required

Patient Preparation:

1. Fasting-overnight (12-14 hours).

2. Patient must not consume any alcohol for 24 hours before the specimen is drawn.

Collection Container/Tube:

Preferred: Red top

Acceptable: Serum gel

Submission Container/Tube: Plastic vial

Specimen Volume: 1 mL

Specimen Minimum Volume

0.5 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Serum Refrigerated (preferred) 7 days
  Frozen  90 days

Reference Values

60-80% of total cholesterol

Reference values have not been established for patients that are <16 years of age.

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.

CPT Code Information


LOINC Code Information

Test ID Test Order Name Order LOINC Value
CHLE Cholesteryl Esters, S 21197-9


Result ID Test Result Name Result LOINC Value
CHLES Cholesteryl Esters, S 21197-9


If not ordering electronically, complete, print, and send a Cardiovascular Test Request Form (T724) with the specimen.

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