Lipid Profile, Nonfasting, Pediatric

CPT: 82465; 83718
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Test Details

Test Includes

Cholesterol, total; high-density lipoprotein (HDL); non-HDL cholesterol (calculated as total cholesterol minus HDL)

Use

Assessment of cardiovascular health and risk stratification in pediatric, adolescent, and young adult populations.

Limitations

Patients with obstructive liver disease may develop lipoprotein abnormalities.

Methodology

Enzymatic

Additional Information

Atherosclerosis begins in youth, and this process, from its earliest phases, is related to the presence and intensity of the known cardiovascular risk factors. Clinical events such as myocardial infarction, stroke, peripheral arterial disease, and ruptured aortic aneurysm are the culmination of the lifelong vascular process of atherosclerosis. The most important evidence relating risk in youth to clinical CVD is the observed association of risk factors for atherosclerosis to clinically manifest cardiovascular conditions. Genetic disorders related to high cholesterol are the biological model for risk-factor impact on the atherosclerotic process. Combined evidence from autopsy studies, vascular studies, and cohort studies strongly indicates that abnormal lipid levels in childhood are associated with increased evidence of atherosclerosis. The evidence review supports the concept that early identification and control of dyslipidemia throughout youth and into adulthood will substantially reduce clinical CVD risk beginning in young adult life. Significant evidence exists to indicate that using family history of premature CVD or cholesterol disorders as the primary factor in determining lipid screening for children misses ~30% to 60% of children with dyslipidemias, and accurate and reliable measures of family history are not available. In the absence of a clinical or historic marker, identification of children with lipid disorders that predispose them to accelerated atherosclerosis requires universal lipid assessment. Non-HDL cholesterol level has been identified as a significant predictor of the presence of atherosclerosis, as powerful as any other lipoprotein cholesterol measure in children and adolescents. For both children and adults, non-HDL cholesterol level seems to be more predictive of persistent dyslipidemia and, therefore, atherosclerosis and future events than TC, LDL cholesterol, or HDL cholesterol levels alone. A major advantage of non-HDL cholesterol is that it can be accurately calculated in a nonfasting state and is, therefore, practical to obtain in clinical practice.1

Specimen Requirements

Specimen

Serum (preferred) or plasma

Volume

2 mL

Minimum Volume

0.5 mL

Container

Gel-barrier tube, green-top (heparin) tube, or lavender-top (EDTA) tube

Patient Preparation

Nonfasting

Collection

Separate serum or plasma or from cells within 45 minutes of collection.

Storage Instructions

Maintain specimen at room temperature. Stable at room temperature, refrigerated or frozen for seven days.

Causes for Rejection

Hemolysis

Clinical Information

Special Instructions

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

Footnotes

1. Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents: Summary report. Pediatrics. 2011 Dec; 128(Suppl 5):S213-S256.22084329

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
373634 Ped Lipid Panel, Non-Fasting 001065 Cholesterol, Total mg/dL 2093-3
373634 Ped Lipid Panel, Non-Fasting 011817 HDL Cholesterol mg/dL 2085-9
373634 Ped Lipid Panel, Non-Fasting 011976 Non-HDL Cholesterol mg/dL 43396-1
373634 Ped Lipid Panel, Non-Fasting 011824 Comment: 77202-0
373634 Ped Lipid Panel, Non-Fasting 012029 Comment 77202-0

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