Non-HDL Cholesterol Profile

CPT: 82465; 83718
Updated on 1/30/2018
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Test Details

Synonyms

  • LP
  • Non-HDL Cholesterol

Test Includes

Cholesterol, total; high-density lipoprotein (HDL) cholesterol; non-HDL cholesterol (calculation)

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 non-high-density lipoprotein (non-LDL-C) 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. Cutpoints for non-HDL-C are 30 mg/dL higher than the LCL-C cutpoint (eg, if the patient's LDL-C goal is <160 mg/dL, the non-HDL-C goal should be <190 mg/dL).

Methodology

See individual tests.

Specimen Requirements

Specimen

Serum

Volume

2 mL

Minimum Volume

1 mL

Container

Red-top tube or gel-barrier tube

Patient Preparation

Patient should be on a stable diet, ideally for two to three weeks prior to collection of the specimen.

Collection

Separate serum from cells within 45 minutes of venipuncture. Lipid profiles are best avoided following acute myocardial infarct, for up to three months, 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

Temperature

Period

Room temperature

3 days

Refrigerated

3 days

Frozen

14 days

Freeze/thaw cycles

Stable x2

Temperature

Period

Room temperature

3 days

Refrigerated

14 days

Frozen

14 days

Freeze/thaw cycles

Stable x2

Causes for Rejection

Improperly labeled specimen

Clinical Information

Special Instructions

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

Footnotes

1. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. 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). 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 Quebec 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
344265 Non-HDL Cholesterol Panel 001065 Cholesterol, Total mg/dL 2093-3
344265 Non-HDL Cholesterol Panel 011817 HDL Cholesterol mg/dL 2085-9
344265 Non-HDL Cholesterol Panel 011976 Non-HDL Cholesterol mg/dL 43396-1
344265 Non-HDL Cholesterol Panel 011824 Comment: N/A

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The LOINC® codes are copyright © 1994-2018, Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee. Permission is granted in perpetuity, without payment of license fees or royalties, to use, copy, or distribute the LOINC® codes for any commercial or non-commercial purpose, subject to the terms under the license agreement found at https://loinc.org/license/. Additional information regarding LOINC® codes can be found at LOINC.org, including the LOINC Manual, which can be downloaded at LOINC.org/downloads/files/LOINCManual.pdf