Lipid Profile With Non-HDL Cholesterol

TEST: 343925
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CPT: 80061
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Synonyms

  • LP
  • Non-HDL Cholesterol

Test Includes

Cholesterol, total; high-density lipoprotein (HDL) cholesterol; low-density lipoprotein (LDL) cholesterol (calculation); nonhigh-density lipoprotein (non-HDL) cholesterol (calculation = total cholesterol minus HDLC); triglycerides; very low-density lipoprotein (VLDL) cholesterol (calculation)

Special Instructions

State patient's age and sex on the request form.

Expected Turnaround Time

Within 1 day

Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary.

Related Documents

For more information, please view the literature below.

Spanning the Continuum of Cardiovascular Care

Clinical Lipid Panel Selection Table

Specimen Requirements

Specimen

Serum (preferred) or plasma

Volume

2 mL

Minimum Volume

0.7 mL (Note: This volume does not allow for repeat testing.)

Container

Red-top tube, gel-barrier tube, or green-top (lithium heparin) tube. Do not use oxalate, EDTA, or citrate plasma.

Collection

Separate serum from cells within 45 minutes of collection. Lipid panels are best avoided for up to three months following acute myocardial infarction, although cholesterol can be measured in the first 24 hours.

Storage Instructions

Maintain specimen at room temperature.

Stability Requirements

Temperature

Period

Room temperature

3 days

Refrigerated

14 days

Frozen

14 days

Freeze/thaw cycles

Stable x2

Patient Preparation

Patient should be on a stable diet, ideally for two to three weeks prior to collection of blood. Fasting is not necessary for this profile, however fasting for 12 to 14 hours prior to collection of the specimen is recommended where the triglyceride value provides a priori diagnostic information such as screening for familial hypercholesterolemia or early onset heart disease, pancreatitis, or confirming hypertriglyceridemia.

Causes for Rejection

Specimen with greatly elevated triglycerides (>400 mg/dL); improper specimen labeling

Test Details

Use

The Third Report of the National Cholesterol Education Program (NCEP) Expert Panel's revised guidelines1 for the treatment of cholesterol in adults called for increased attention to the metabolic syndrome and diabetes. These guidelines highlighted the increased inaccuracy of the LDL-C measurement in these patients because of elevated triglycerides. To overcome the inaccuracy of the calculated LDL-C method when triglycerides are elevated, measurement of nonhigh-density lipoprotein (non-HDL) was recommended as a better means to follow these patients toward their treatment goals. Non-HDL-C is a calculation (total cholesterol minus HDL-C), ie, the sum of the VLDL-C, LDL-C, and IDL-C. While LDL-C has long been the primary focus of cholesterol reduction efforts, researchers have identified several other lipoproteins that also affect cardiovascular health. The advantage of non-HDL-C measurement is that it accounts for cholesterol in the other potentially atherogenic lipoprotein particles, which include VLDL-C, IDL-C, LDL-C, and lipoprotein(a). Studies2,3 have shown that the measurement of non-HDL-C, rather than LDL-C, would be a better target for therapy, especially in persons with a triglyceride level >200 mg/dL. Cut-points for non-HDL-C are 30 mg/dL higher than the LCL-C cut-points (eg, if the patient's LDL-C goal is <160 mg/dL, the non-HDL-C goal should be <190 mg/dL).

Limitations

LDL cholesterol cannot be calculated if triglyceride is >800 mg/dL.

Methodology

See individual tests.

Footnotes

1. Executive Summary of The Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. JAMA. 2001 May 16; 285(19):2486-2497. 11368702
2. Lamarche B, Tchernof A, Moorjani S, et al. Small, dense low-density lipoprotein particles as a predictor of the risk of ischemic heart disease in men. Prospective results from the Québec Cardiovascular Study. Circulation.1997 Jan 7; 95(1):69-75.8994419
3. Ridker PM, Rifai N, Cook NR, Bradwin G, Buring JE. Non-HDL cholesterol, apolipoproteins A-1 and B100, standard lipid measures, lipid ratios, and CRP as risk factors for cardiovascular disease in women. JAMA. 2005 Jul 20; 294(3):326-333. 16030277

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
343925 LP+Non-HDL Cholesterol 001065 Cholesterol, Total mg/dL 2093-3
343925 LP+Non-HDL Cholesterol 001172 Triglycerides mg/dL 2571-8
343925 LP+Non-HDL Cholesterol 011817 HDL Cholesterol mg/dL 2085-9
343925 LP+Non-HDL Cholesterol 011919 VLDL Cholesterol Cal mg/dL 13458-5
343925 LP+Non-HDL Cholesterol 012059 LDL Chol Calc (NIH) mg/dL 13457-7
343925 LP+Non-HDL Cholesterol 011923 LDL Calc Comment: N/A
343925 LP+Non-HDL Cholesterol 011976 Non-HDL Cholesterol mg/dL 43396-1

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