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Lipid panel; total cholesterol:HDL ratio
Evaluation of hyperlipidemia as an index to coronary artery disease. Investigation of serum lipids is indicated in those with coronary and other arterial disease, especially when it is premature, and in those with family history of atherosclerosis or of hyperlipidemia. In this sense, the expression “premature” is mostly used to include those younger than 40 years of age.
Patients with obstructive liver disease may develop lipoprotein abnormalities. Serum lipid factors have not been demonstrated to have a strong influence on recurrent stenosis following coronary angioplasty, the pathogenesis of which is presently not well understood. Low-density lipoprotein cholesterol (LDL-C) cannot be calculated if triglyceride is >400 mg/dL.
Patients with xanthomas should be worked up with lipid panels, but not those with xanthelasmas or xanthofibromas in the sense of dermatofibromas. Those whose fasting serum is lipemic should have a lipid panel, but the serum of a subject with high cholesterol (but normal triglyceride) is not milky in appearance. The patient with high cholesterol (>240 mg/dL) should have a lipid panel. Patients with cholesterol levels between 200−240 mg/dL plus two other coronary heart disease risk factors should also have a lipid panel.1 In addition to application in screening programs for evaluation of risk factors for coronary arterial disease, lipid profiling may lead to detection of some cases of hypothyroidism.
Primary hyperlipoproteinemia includes hypercholesterolemia, a direct risk factor for coronary heart disease.
Secondary hyperlipoproteinemia includes nephrosis, renal failure, obesity, diabetes mellitus, alcoholism, primary biliary cirrhosis, and other types of cholestasis. Decreased lipids are found with some cases of malabsorption, malnutrition, and advanced liver disease. In abetalipoproteinemia, cholesterol is <70 mg/dL.
Serum (preferred) or plasma
Red-top tube, gel-barrier tube, green-top (heparin) tube, or lavender-top (EDTA) tube
Patient should be on a stable diet, ideally for two to three weeks prior to collection of blood, and should fast for 12 to 14 hours before collection of the specimen.
Separate serum or plasma from cells within 45 minutes of collection. Lipid panels are best avoided for three months following acute myocardial infarction, although cholesterol can be measured in the first 24 hours.
Room temperature; if arrival at lab will extend beyond three days, then refrigerate.
Causes for Rejection
Specimen with greatly elevated triglycerides (>400 mg/dL); improper specimen labeling
State the patient's age and sex on the test request form.
|Order Code||Order Code Name||Order Loinc||Result Code||Result Code Name||UofM||Result LOINC|
|221010||Lipid Panel w/ Chol/HDL Ratio||001065||Cholesterol, Total||mg/dL||2093-3|
|221010||Lipid Panel w/ Chol/HDL Ratio||001172||Triglycerides||mg/dL||2571-8|
|221010||Lipid Panel w/ Chol/HDL Ratio||011817||HDL Cholesterol||mg/dL||2085-9|
|221010||Lipid Panel w/ Chol/HDL Ratio||011916||VLDL Cholesterol Cal||mg/dL||13458-5|
|221010||Lipid Panel w/ Chol/HDL Ratio||012054||LDL Cholesterol Calc||mg/dL||13457-7|
|221010||Lipid Panel w/ Chol/HDL Ratio||011824||Comment:||77202-0|
|221010||Lipid Panel w/ Chol/HDL Ratio||100065||T. Chol/HDL Ratio||ratio||9830-1|