American Association for Clinical Chemistry
Better health through laboratory medicine
Division History

The Lipids and Lipoproteins Division: A Retrospective
Gerald R. Cooper M.D., Ph.D.

Division of Environmental Health Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia

* Italicized portions of this article are excerpts from an article, also by Gerald R. Cooper, published in the Summer 1992 issue of The Fats of Life.

In 1982, after the Council (now the AACC House of Delegates) of the American Association for Clinical Chemistry (AACC) endorsed authority for divisions to be organized, Russell Warnick telephoned Herbert Naito, Donald Wiebe, and Gerald Cooper to suggest that lipid investigators band together to form a division.* During 1983, this idea continued to be discussed among people interested in lipid research.

In 1984, a group of lipid investigators met at the AACC National Meeting to consider whether they would like to submit a petition to form a provisional AACC Lipids and Lipoproteins (L&LP) Division. This group, composed of Joe Artiss, Thom Cole, Gerald Cooper, Joan David, Ralph Ellefson, Neil Greenberg, David Hassemer, Judith McNamara, Herbert Naito, Howard Newman, Evan Stein, Russell Warnick, and Donald Wiebe, decided to begin developing the materials they would need in order to petition for provisional division status.

The Lipids and Lipoproteins Division has had enviable and outstanding leadership. Between 1984 and 1989, Russell Warnick served first as a leader of the Organizing Group and later as Chair during the provisional status period. The AACC stated that before permanent status could be granted, an elected Chairman must be chosen by members of the Provisional Division, and Russell Warnick was the first elected permanent Chair in 1989. Since then, the Chairs have been: 1990, Donald A. Wiebe: 1991, Gary L. Myers; 1992, W. Gregory Miller; 1993, Nader Rifai; 1994, Thomas G. Cole; 1995, Elizabeth Teng Leary; 1996, Judith R. McNamara; 1997, Herbert K. Naito; 1998, Kory M. Ward, and Ishwarlal Jialal as Chair-Elect for 1999. Outstanding secretaries have been: Donald Wiebe, Judith McNamara, Paula Steiner, and Wendy Taddei-Peters. Excellent treasurers have been Joseph Artiss, David Hassemer, Kimberly Markovich, and Richard Pearson.

In January 1987, the AACC House of Delegates granted provisional status to the L&LP Division, with Russell Warnick, chair, Donald Wiebe, secretary, and Joe Artiss, treasurer. By May, 206 people were members.

The membership of the Division grew rapidly during the first few years, and has remained fairly constant since 1992. In 1993, there were 696 members; 1994, 694; 1995, 648; 1996, 657; and in 1997, 713 (379 USA, 32 Canadian, and 302 international members). Current membership, in 1998, is 648 members as of May 14. The current Chair of the Membership Committee is Barbara Hill.

Educational Activities:
The members of the Lipids and Lipoproteins Division have contributed greatly to educational and information exchange activities in the AACC. The members of the Division have been active leaders and presenters at the annual meeting in selected topics sessions, workshops, round tables, and symposia each year.

Eastman Kodak, Boehringer-Mannheim, Beckman, DuPont, and Diagnostic Chemicals contributed valuable support to the various division events at the 1987 AACC Annual Meeting in San Francisco. At this meeting, Bruce Kottke and Wolfgang Patsch presented a workshop on apolipoproteins, and Thomas Innearity, Ernst Schaefer, Gerald Cooper, and Herbert Naito conducted a selected topic session on apolipoproteins. Eight roundtables on lipids and lipoproteins were presented by members of the division.

In 1998 the members will present 8 round tables, 1 Edutrak session, one workshop, and the Manufacturers Conference. The division membership has presented a number of posters at the AACC annual meeting each year; 59 will be presented in 1998. Since 1988, the Division has also held a reception each year at the annual meeting for members, especially for extending welcome to international members. For the past three years, the reception has been held jointly with the Nutrition Division.

The Lipids and Lipoproteins Division, in cooperation with the Centers for Disease Control and Prevention and the American Heart Association, presented highly successful conferences in 1993 and 1996 entitled "Frontiers in Lipid and Lipoprotein Research: Basic Science, Analytical, Clinical, and Public Health Applications." The 1993 conference was co-chaired by Gary Myers and Nader Rifai and the 1996 conference by Ishwarlal Jialal, Mary M. Kimberly, and Martin H. Kroll. The Frontiers Conference planned for January 2000 will be chaired by Thomas Cole. The major objective of the Frontiers Conference is to integrate relevant recent advances in cardiovascular research to define the state of the art in pathophysiology of lipid and lipoprotein diseases.

An outstanding and highly comprehensive contribution has been the publication of three serially related books on lipid and lipoprotein laboratory measurements. In 1991, the first edition was edited by Nader Rifai and Russell Warnick and entitled "Methods for Clinical Laboratory Measurement of Lipid and Lipoprotein Risk Factors." In 1994, the second edition, also edited by Nader Rifai and Russell Warnick, was entitled "Laboratory Measurement of Lipids, Lipoproteins, and Apolipoproteins." The most recent edition, published in 1997 and entitled "Handbook of Lipoprotein Testing", was edited by Nader Rifai, Russell Warnick, and Marek Dominiczak. These books have been widely distributed and are recognized as excellent references for the laboratory bench worker, supervisor, and director. The 1997 edition contains 31 chapters written by 59 contributors. Up-to-date information is presented on current knowledge of lipoprotein metabolism, the effect of clinical lipid disorders on the cardiovascular system, methods for and importance of measuring traditional lipid risk factors, consideration of preanalytical variables and matrix effects on measurements, importance and process of standardization of lipid measurements, and the influence of non-lipid risk factors on lipid risk factors for coronary heart disease. The 1994 edition has been translated into Russian and is being used in Moscow as a text for medical and laboratory students.

The Fats of Life Newsletter:
The Lipids and Lipoproteins Division has produced an outstanding and highly acclaimed quarterly newsletter called The Fats of Life since June 1987. Donald Wiebe was the first editor in 1987-88; then Nader Rifai in 1989; and Russell Warnick has been editor since 1990. Members and invited lipid scientists have published reports on up-to-date and developing new lipid concepts and informative reviews for each issue. Dr. Marek Dominiczak has submitted mini-literature reviews for each issue since 1987. A division feature in 1993 was the publication of the apolipoprotein debate on "What is the clinical utility of apolipoprotein A-1 and B in coronary heart disease risk assessment?" Pro-speakers were James Maciejko and Allen Sniderman and con-speakers were Henry Ginsberg and Ernst Schaefer. The minutes of Management Team meetings are also reported to the membership in the newsletter.

National Cholesterol Education Program (NCEP) Activities:
The Lipids and Lipoproteins Division, in the early years, formed ad hoc committees to evaluate and make recommendations about traditional lipid and lipoprotein analytical methods. These findings were a major part of the basis for the reports on status and recommendations of the later NCEP laboratory committees. The members of the Lipids and Lipoproteins Division played a major role in the early deliberations and publications on NCEP laboratory aspects.

When the Matrix problems that could exist in an instrument-reagent cholesterol analytical system became recognized, the members of the Division along with the staff of the CDC Lipid Standardization Program recommended the establishment of a Cholesterol Reference Method Laboratory Network (CRMLN) to offer evaluation of cholesterol diagnostic products of manufacturers with fresh subject serum specimens. This CRMLN service has provided assurance to manufacturers that their calibration materials and diagnostic products can produce accurate values in the clinical laboratories and thus permit them to meet the recommended analytical performance needed for accurate classification of patients on the basis of a cholesterol reported value.

Manufacturers Conference:
Particularly successful has been the Manufacturers Conference that is usually held on Sunday afternoon before the AACC National Meeting. The first Manufacturers Conference was held before the San Francisco AACC meeting on Sunday, July 19, 1987. The early division workshops (1987-92) were designed to bring diagnostics manufacturers and lipoprotein laboratory specialists together to encourage communication as lipoprotein assays and analytical systems were being developed and standardized. This first Conference featured recommendations and issues of the National Cholesterol Education Program, and focused on "Issues of Lipid Standardization and Reference Materials". Herbert Naito reported on the National Cholesterol Education Program; Raymond Vanderline on Cholesterol National Reference System; Gary Myers on CDC Lipid Standardization Program; Russell Warnick on Reference Materials Criteria; and Al Hartman on CAP lipid improvement programs. Members of the industry were invited to make comments: Nathan Gochman, Beckman; Wendell O'Neal, DuPont; Jack Levine and Janet Carrubba, Technicon; Robert Bodden, American Dade; and Neil Greenberg, Eastman Kodak.

The second Manufacturers Meeting, expanded to a full day, was held Sunday, July 24, 1988 in New Orleans on "Cholesterol Methods - Today's Needs", "Reference Materials - Tomorrow's Accuracy", and "Past, Present, Future of Lipid Standardization". Joachim Ziegenhorn spoke on the "History of Cholesterol Methods"; Joseph Artiss on "Enzymatic Methods"; Herbert Naito on "LDL and HDL Cholesterol Methods"; Michael Welch reported on "Reference Materials Criteria"; Don Schap on "CAP Reference Materials"; Gary Myers on "CDC-CAP Cholesterol Materials Study"; Donald Wiebe on "Wisconsin Serum Pools"; David Hassemer on "Wisconsin Cholesterol Study"; Gregory Tetrault on "Medical College of Virginia Cholesterol Study"; and Russell Warnick on "Seattle Cholesterol Study". A panel discussion was led by George Bowers.

The Manufacturers Conference has continued to be a main feature of the Lipids and Lipoproteins Division at the AACC National Meeting. During recent years, for instance, in 1994 an outstanding program was presented under the title "Concepts in Lipid Measurements - Today's Challenges Highlighting Point-of-Care Testing". In 1995, the program was entitled "Concepts in Lipid Measurements: Updates and Innovations". In 1996 and 1997, a Sunday afternoon program was presented with the manufacturers of lipid diagnostic products entitled "Lipid and Lipoprotein Testing: Issues, Progress and Solutions". The 1996 Manufacturers workshop was planned and coordinated by Herbert Naito, Greg Miller, Gary Myers, Marty Kroll, and Kory Ward. The 1997 workshop was conducted by Kory Ward, Herbert Naito, Thomas Cole, Elizabeth Leary, and Judy McNamara. In 1998, this workshop on Sunday afternoon will be entitled "Remnant Lipoproteins and Atherosclerosis", organized by Ken Jialal and Herb Naito.

In 1990 the Lipids and Lipoproteins Division initiated the first of two prestigious awards to recognize exceptional contributions to service and research in the field of lipids and lipoproteins. The Zak Award for Research was first presented to Dr. Bennie Zak, for whom the award was named, in 1990. Subsequent recipients of the research award have been Russell Warnick in 1993, Santica Marcovina in 1995, and Sigrid Klotzsch in 1997. The Cooper Award for Service was instituted in 1992, and Dr. Gerald Cooper was its first recipient. Since then, recipients for this award have been Nader Rifai in 1994 and Gary Myers in 1996. The two awards are presented in alternate years at the division mixer at the Annual Meeting.

The Division also initiated an International Travel Award in 1995, to bring international lipid scientists to the AACC Annual Meeting. Awardees are selected by the AACC Awards Committee and funded by the division. The first award was presented to Dr. Vladimir Dvorkin from Russia in 1995. Subsequently, the award has gone to Dr. Margarita Iturriza of Venezuela in 1996, and to Dr. Mosaad Alunen Abou-Seif from Egypt in 1997.

All of these highlights of division activities remind all members that the Division has come a long way since Russell Warnick in 1982 made a hurried telephone call to Gerald Cooper suggesting the formation of a Lipids and Lipoproteins Division. We owe much to Russ Warnick, who assumed leadership in organizing and promoting the division. Gerald Cooper, at that time, was President-elect of the AACC. The Lipids and Lipoproteins is serving a great need to stimulate and maintain great interest in lipids, lipoproteins, and apolipoproteins by improving measurements, gaining better understanding of pathophysiologic and clinical aspects, and serving collaboratively with other health-related disciplines to provide excellent health care for the population.