Within-person variation in serum lipids: implications for clinical trials

M.A. Pereira, R.M. Weggemans, D.R. Jacobs, P.J. Hannan, P.L. Zock, J.M. Ordovas, M.B. Katan

Research output: Contribution to journalArticleAcademicpeer-review

30 Citations (Scopus)


Background Little is known about the degree to which behavioural, biological, and genetic traits contribute to within-person variation in serum cholesterol. Materials and Methods The authors studied within-person variation in serum total and high density lipoprotein (HDL) cholesterol in 458 participants of 27 dietary intervention studies in Wageningen, The Netherlands, from 1976 to 1995. Results For a median of 4 days between blood draws, the geometric mean of the within-person standard deviation was 0.13 mmol/l (similar to5 mg/dl, coefficient of variation = 3.0%) for total cholesterol and 0.04 mmol/l (similar to1.5 mg/dl, coefficient of variation = 3.0%) for HDL cholesterol. In mixed-model linear regressions using within-person variance as the dependent variable and including lipid concentration and covariates listed below, within-person variance of both total cholesterol and HDL cholesterol was higher for greater number of days between blood draws and for self-selected diet rather than investigator-controlled diet. Within-person variance of total cholesterol only was higher for non-standardized versus standardized phlebotomy protocol and for female sex. The authors found evidence that the APOA4 -347 (12/22 genotype) and MTP -493 (11 genotype) polymorphisms may increase the within-person variation in total cholesterol. Conclusion Under certain study design (self-selected diet, use of non-standardized phlebotomy protocol) or participant characteristics (female, certain polymorphisms) within-person lipid variance is increased and required sample size will be greater. These findings may have important implications for the time and cost of such interventions.
Original languageEnglish
Pages (from-to)534-541
JournalInternational Journal of Epidemiology
Publication statusPublished - 2004


  • density-lipoprotein cholesterol
  • apolipoprotein-a-iv
  • dna polymorphisms
  • dietary-changes
  • plasma
  • gene
  • substitution
  • standardization
  • amplification
  • triglyceride


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