Test Catalog

Test Id : CHLE

Cholesteryl Esters, Serum

Useful For
Suggests clinical disorders or settings where the test may be helpful

Establishing a diagnosis of lecithin-cholesterol acyltransferase deficiency


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

Method Name
A short description of the method used to perform the test

Enzymatic Colorimetric

NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.


Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test

Cholesteryl Esters, S

Lists additional common names for a test, as an aid in searching

Cholesterol Esters

Specimen Type
Describes the specimen type validated for testing


Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing

Collection Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Submission Container/Tube: Plastic vial

Specimen Volume: 1 mL

Collection Instructions: Centrifuge and aliquot serum into plastic vial. Send refrigerated.


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

Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the Testing Laboratory

0.5 mL

Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected

Gross hemolysis Reject
Gross lipemia OK
Gross icterus Reject

Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included

Specimen Type Temperature Time Special Container
Serum Refrigerated (preferred) 7 days
Frozen 60 days
Ambient 24 hours

Useful For
Suggests clinical disorders or settings where the test may be helpful

Establishing a diagnosis of lecithin-cholesterol acyltransferase deficiency


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

Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

Cholesterol in the blood serum is normally 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.


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 serum 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, an acquired LCAT deficiency and reduced cholesterol ester concentration.

Reference Values
Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

> or =18 years: 60-80% of total cholesterol

Reference values have not been established for patients who are less than 18 years of age.

Provides information to assist in interpretation of the test results

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.

Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

In a severe form, cholesteryl ester storage disease can be fatal before the age of 1 year (Wolman's disease) and, in some less severe form cases, may be undetected until adulthood. This defect is caused by a deficiency of a lysosomal enzyme, acid cholesteryl ester hydrolase (also known as acid lipase). It causes accumulation of cholesteryl esters in tissues, but it has no effect on the percentage of cholesterol that circulates in esterified form in the blood serum. Detection of the defect requires careful evaluation of the cholesteryl ester hydrolase activity and cholesteryl ester content of leukocytes, cultured fibroblasts, and liver biopsy.


Result can be falsely decreased in patients with elevated levels of N-acetyl-p-benzoquinone imine (NAPQI)-a metabolite of acetaminophen, N-acetylcysteine (NAC), and metamizole.

Clinical Reference
Recommendations for in-depth reading of a clinical nature

1. Meikle PJ, Mundra PA, Wong G, et al: Circulating lipids are associated with alcoholic liver cirrhosis and represent potential biomarkers for risk assessment. PLoS One. 2015 Jun 24;10(6):e0130346. doi: 10.1371/journal.pone.0130346

2. Leach NV, Dronca E, Vesa SC, et al: Serum homocysteine levels, oxidative stress and cardiovascular risk in non-alcoholic steatohepatitis. Eur J Intern Med. 2014 Oct;25(8):762-767. doi: 10.1016/j.ejim.2014.09.007

3. Santamarina-Fojo S, Hoeg JM, Assmann G, Brewer B: Lecithin cholesterol acyltransferase deficiency and fish eye disease. In: Valle DL, Antonarakis S, Ballabio A, Beaudet AL, Mitchell GA. eds. The Online Metabolic and Molecular Bases of Inherited Disease. McGraw-Hill; 2019. Accessed June 8, 2021. Available at https://ommbid.mhmedical.com/content.aspx?sectionid=225539713&bookid=2709

Method Description
Describes how the test is performed and provides a method-specific reference

Free cholesterol reacts with cholesterol oxidase to generate hydrogen peroxide which reacts with 3,5-dimethoxy-N-(2-hydroxy-3-sulfopropyl) aniline sodium (DAOS) and 4-aminoantipyrene to produce a blue pigment. The product is proportional to the serum free cholesterol concentration.(Fujifilm Free Cholesterol E. Fujifilm Wako Pure Chemical Corporation; 04/01/2018)

PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information


Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.

Monday through Friday

Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.

1 to 3 days

Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded

7 days

Performing Laboratory Location
Indicates the location of the laboratory that performs the test


Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.

  • Authorized users can sign in to Test Prices for detailed fee information.
  • Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
  • Prospective clients should contact their Regional Manager. For assistance, contact Customer Service.

Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.

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 US Food and Drug Administration.

CPT Code Information
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.

CPT codes are provided by the performing laboratory.


LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.

Test Id Test Order Name Order LOINC Value
CHLE Cholesteryl Esters, S 21197-9
Result Id Test Result Name Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
CHLES Cholesteryl Esters, S 21197-9

Test Setup Resources

Setup Files
Test setup information contains test file definition details to support order and result interfacing between Mayo Clinic Laboratories and your Laboratory Information System.

Excel | Pdf

Sample Reports
Normal and Abnormal sample reports are provided as references for report appearance.

Normal Reports | Abnormal Reports

SI Sample Reports
International System (SI) of Unit reports are provided for a limited number of tests. These reports are intended for international account use and are only available through MayoLINK accounts that have been defined to receive them.

SI Normal Reports | SI Abnormal Reports