*Cholesterol *Triglycerides *HDL, Direct *LDL,Direct *VLDL, Calculated *Non HDL Cholesterol
Lipid Profile is a panel of blood tests that serves as an initial tool for abnormalities in lipid, such as cholesterol and triglycerides. The lipid panel is used as part of cardiac risk assessment to help determine your risk of heart disease and to make decisions about what treatment may be best if you have a borderline, intermediate or high risk.
The result of the lipid panel are considered along with other known risk factors of heart disease to develop a plan of treatment and follow up. Depending on the results ab dither risk factors, treatment options may be involve changes such as diet and exercise or medications that lower lipid level, typically statins.
Additionally a lipid panel may be used to monitor whether treatment has been effective in lowering levels.
It is recommended as a part of routine check-up for healthy adults. To detect various cardiac diseases, in patients with diabetes, obesity, in smokers, in coronary artery disease (CAD), heart attack, or stroke.
Non HDL-C (Calculated as total C-HDLC) represents the sum of cholesterol carried by all potentially atherogenic, apo B- containing lipoprotein particles, including LDL, LDL, Lp(a) VLDL (including VLDL remnants), and chylomicron particles and remnants.
An elevated level of cholesterol carried by circulating apolipoprotein (apo) B- containing lipoproteins (non-HDL-C & LDL-C, termed atherogenic cholesterol) is a root cause of atherosclerosis/ASCVD. HDL-C is responsible for lowering peripheral tissue cholesterol (reverse transport), in turn reducing risk of ASCVD.
Apolipoprotein B, hsCRP, Lp(a) and LP-PLA2 testing should be considered in patients with moderate risk of ASCDV.
In all adults. (>20 Years of age), a fasting or non-fasting lipid profile should be obtained at least every 5 years. At a minimum., this should include total cholesterol and HDL-C which allows calculation of NON-HDL-C (Total-C-HDL-C). If fasting (generally 9-12 hrs) the LDL-C Level may be calculated, provided that the triglyceride concentration is <400 mg/dl.
Apo B is considered as an optimal secondary target for treatment. Epidemiologic studies have generally shown that both apo B & non-HDL-C are better predictors of ASCVD risk than LDL-C. Apo B and non HDL-C share the advantage that neither requires fasting sample for accurate assessments
Elevated triglycerides level is not a target of therapy per se, except when very high (>500 mg/dL). When triglycerides are between 200 and 499 mg/dl, the target of therapy are non- HDL-C and LDL-C. When triglycerides are very high (>500 mg/dl, and especially if >1000 mg/dl). Reduction to <500 mg/dl to prevent pancreatitis becomes the primary goal of therapy.
Lifestyle therapies of ASCVD risk reduction generally includes intervention aimed at
Borderline High- 200-239
Borderline High 150- 199
Very High >500
|HDL Cholesterol||Mg/dl||Desirable: >60
Borderline High: 40-60
Low (High risk): <40
|LDL Cholesterol||Mg/dl||Optimal: <100
Near borderline: 100-129
Borderline high: 130-159
High: 160- 189
Very High: >190
|Total Cholesterol/HDLC ratio||0-4.5|