Original Article

Ann Lab Med 2017; 37(1): 1-8

Published online January 1, 2017

Copyright © Korean Society for Laboratory Medicine.

Calibration of High-Density Lipoprotein Cholesterol Values From the Korea National Health and Nutrition Examination Survey Data, 2008 to 2015

Yeo-Min Yun, M.D.1, Junghan Song, M.D.2, Misuk Ji, M.D.3, Jeong-Ho Kim, M.D.4, Yongkang Kim, M.S.5, Taesung Park, Ph.D.5,6, Sang Hoon Song, M.D.7, Seungman Park, M.D.8, Min Jin Kim, M.D.9, Sun Jin Nho, M.S.10, and Kyung Won Oh, Ph.D.10

Department of Laboratory Medicine1, Konkuk University School of Medicine, Seoul; Department of Laboratory Medicine2, Seoul National University Bundang Hospital, Seongnam; Department of Laboratory Medicine3, Veterans Health Service Medical Center, Seoul; Department of Laboratory Medicine4, Yonsei University College of Medicine, Seoul; Department of Statistics5, Seoul National University, Seoul; Interdisciplinary Program in Bioinformatics6, Seoul National University, Seoul; Department of Laboratory Medicine7, Seoul National University Hospital, Seoul; Green Cross Laboratories8, Yongin; Seegene Medical Foundation9, Seoul; Division of Health and Nutrition Survey10, Centers for Disease Control and Prevention, Cheongju, Korea

Correspondence to: Junghan Song
Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 82, Gumi-ro 173beon-gil, Bundang-gu, Seongnam 13620, Korea
Tel: +82-31-787-7691 E-mail:

Received: July 5, 2016; Revised: September 5, 2016; Accepted: October 18, 2016

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background: For correct interpretation of the high-density lipoprotein cholesterol (HDL-C) data from the Korea National Health and Nutrition Examination Survey (KNHANES), the values should be comparable to reference values. We aimed to suggest a way to calibrate KNHANES HDL-C data from 2008 to 2015 to the Centers for Disease Control and Prevention (CDC) reference method values.
Methods: We derived three calibration equations based on comparisons between the HDL-C values of the KNHANES laboratory and the CDC reference method values in 2009, 2012, and 2015 using commutable frozen serum samples. The selection of calibration equation for correcting KNHANES HDL-C in each year was determined by the accuracy-based external quality assurance results of the KNHANES laboratory.
Results: Significant positive biases of HDL-C values were observed in all years (2.85-9.40%). We created the following calibration equations: standard HDL-C=0.872×[original KNHANES HDL-C]+2.460 for 2008, 2009, and 2010; standard HDL-C=0.952×[original KNHANES HDL-C]+1.096 for 2012, 2013, and 2014; and standard HDL-C=1.01×[original KNHANES HDL-C]-3.172 for 2011 and 2015. We calibrated the biases of KNHANES HDL-C data using the calibration equations.
Conclusions: Since the KNHANES HDL-C values (2008-2015) showed substantial positive biases compared with the CDC reference method values, we suggested using calibration equations to correct KNHANES data from these years. Since the necessity for correcting the biases depends on the characteristics of research topics, each researcher should determine whether to calibrate KNHANES HDL-C data or not for each study.

Keywords: HDL cholesterol, Korea National Health and Nutrition Examination Survey, Calibration