Lipid Profile

Profiles

Lipid Profile

The lipid profile includes cholesterol, triglycerides, high-density lipoprotein (HDL), very low-density lipoprotein (VLDL), low-density lipoprotein (LDL) and various risk classifications for coronary heart disease (CHD), cholesterol to HDL ratio, and LDL to HDL ratio.

  • Turn-around time = 5 to 7 days
  • Specimen is fasting serum

Cholesterol

Total cholesterol is used to measure lipid status and metabolic disorders. Cholesterol is necessary for life, but is also associated with atherosclerosis. It is used to make hormones, vitamin D, and cell membranes. About two-thirds of the body’s cholesterol is made by the liver and one-third obtained through the diet. Increased cholesterol is found in high fat diets, primary hypercholesterolemia, the nephritic syndrome, hypothyroidism, primary biliary cirrhosis and in some cases of diabetes. Low levels have been found in malnutrition, malabsorption, severe liver disease, polycythemia vera, etc.

The method is by spectrophotometry.

Normal values are based on age. The "normal or reference ranges" has been lowered in recent years to combat the rapid increase in heart disease. In people under 19 years of age, the normal value is less than 170 mg/dL. In people over 19 years of age, the normal value is less than 200 mg/dL.

Triglycerides

Like cholesterol, triglycerides (TG) are used to measure lipid status and metabolic disorders. A patient must absolutely be fasting for an accurate measurement. Triglycerides are the major component of chylomicrons and VLDL, two types of lipoproteins. They may be elevated in hypothyroidism, diabetes, chronic liver and kidney diseases, pancreatitis, some genetic types of hyperlipidemia, alcohol abuse, estrogen (pregnancy or oral contraceptive pills), and certain medications (thiazide diuretics). The triglyceride level is used to calculate the LDL, however, to get a correct answer, the TG must be 400 mg/dL or less. A turbid serum specimen indicates a TG level of around 400 mg/dL.

The method is by spectrophotometry.

The ATP III guidelines recommends:
Unit (mg/dL) 
< 150 normal
150 - 199 borderline-high
200 - 499 high
> 500 very high

HDL (High-Density Lipoprotein)

HDL is called the "good cholesterol". It tends to carry cholesterol away from tissues. All other risk factors considered, a high HDL is a good risk factor.

The method is by spectrophotometry.

The ATP III guideline recommends:
Unit (mg/dL) 
< 40 low
> 60 high

LDL (Low-Density Lipoprotein)-Calculated

LDL cholesterol is called the "bad cholesterol". It is part of the lipid profile and is one of the more important “risk factors” for atherosclerotic (CHD) disease. LDL is the cholesterol component that binds to liver receptors and tends to control the formation of cholesterol.

The method is by calculation using the Friedewald formula. The formula can only be used when the TG are less than 400 mg/dL. LDL core lipids contains about 10% TG and 45% cholesterol.

The ATP III Guidelines recommend:
Unit (mg/dL) 
< 100 optimal
100 - 129 near optimal
130 - 159 borderline high
160 - 189 high
> 190 very high

Very Low Density Lipoprotein (VLDL)

VLDL is a type of lipoprotein and helps carry triglycerides to the liver and other parts of the body. Density refers to the amount of lipids per lipoprotein versus proteins. Core lipids in chylomicrons contain about 85% triglycerides and 5% cholesterol, VLDL contains about 60% TG and 15% cholesterol. Elevated VLDL levels are found in Type IV hyperlipidemias.

Cholesterol to HDL Ratio

The Cholesterol to HDL ratio is a calculation of your risk for heart disease. It is optimal to have a low ratio. A low ratio indicates that total cholesterol is comprised mostly of HDL particles. This ratio is considered the most important indicator for atherosclerosis.

Risk Classification Male Female
1/2 Average Risk < 3.4 < 3.3
Average Risk 3.4 - 5.0 3.3 - 4.4
2 Times Average Risk 5.1 - 9.6 4.5 - 7.1
3 Times Average Risk 9.7 - 23.0 7.2 - 11.0

LDL to HDL Ratio

The LDL to HDL ratio is also a heart disease risk indicator. It is best to have a low ratio as this indicates there is sufficient HDL in relation to LDL to aid in prevention of atherosclerosis. Excessively high or low levels can indicate a problem. It is best to maintain these in proper balance to HDL.

Risk Classification Male Female
1/2 Average Risk < 1.0 < 1.5
Average Risk 1.0 - 3.6 1.5 - 3.2
2 Times Average Risk 3.7 - 6.3 3.3 - 5.0
3 Times Average Risk 6.4 - 8.0 5.1 - 6.1

Selected References:

  1. NIH Publication No. 01-3305, JAMA, 285:2486-97, May, 2001.
  2. Report of the National Cholesterol Treatment Program Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults. Arch Intern Med,1988, 148:36-9.
  3. Vance, D.E., Vance, J.E. Biochemistry of Lipids, Lipoproteins, and Membranes. New York, Elsevier Science, 1996.

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