What is a Lipid Panel? Normal Values & Results Interpretation

Lipid Panel

What is a Lipid Panel? Normal Values & Results Interpretation

Sources Used in Current Review

Baer, J. (2017 August 11). AACE and EAS Lipid Guidelines. American College of Cardiology. Available online at https://www.acc.org/latest-in-cardiology/articles/2017/08/11/08/35/aace-and-eas-lipid-guidelines. Accessed March 2019.

Nordestgaard, B. (2017). A Test in Context: Lipid Profile, Fasting Versus Nonfasting. Medscape from J Am Coll Cardiol. 2017;70(13):1637-1646. Available online at https://www.medscape.com/viewarticle/887480. Accessed March 2019.

Lozano, P. et. al. (2016 August 9). Lipid Screening in Childhood and Adolescence for Detection of Familial Hypercholesterolemia Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA. 2016;316 (6):645-655. Available online at https://jamanetwork.com/journals/jama/fullarticle/2542641. Accessed March 2019.

Bibbins-Domingo, K. et. al. (2016 November 15). Statin Use for the Primary Prevention of Cardiovascular Disease in Adults. US Preventive Services Task Force Recommendation Statement. JAMA. 2016; 316(19):1997-2007. Available online at https://jamanetwork.com/journals/jama/fullarticle/2584058. Accessed March 2019.

Genzen, J. (2018 August, Updated). Atherosclerotic Cardiovascular Disease (ASCVD) Traditional Risk Markers – Cardiovascular Disease Risk Markers (Traditional). ARUP Consult. Available online at https://arupconsult.com/content/cardiovascular-disease-traditional-risk-markers. Accessed March 2019.

Lloyd-Jones, D. et. al. (2017 October).

2017 Focused Update of the 2016 ACC Expert Consensus Decision Pathway on the Role of Non-Statin Therapies for LDL-Cholesterol Lowering in the Management of Atherosclerotic Cardiovascular Disease Risk, A Report of the American College of Cardiology Task Force on Expert Consensus Decision Pathways. JACC v 70 (14) October 2017. Available online at http://www.onlinejacc.org/content/70/14/1785. Accessed March 2019.

Pokharel, Y. et. al. (2017 April). Adoption of the 2013 American College of Cardiology/American Heart Association Cholesterol Management Guideline in Cardiology Practices Nationwide. JAMA Cardiol. 2017;2(4):361-369. Available online at https://jamanetwork.com/journals/jamacardiology/fullarticle/2606432. Accessed March 2019.

Jackson, E. (2017 September 5). 2017 ACC Recommendations for Non-Statin Therapy. American College of Cardiology. Available online at https://www.acc.org/latest-in-cardiology/ten-points-to-remember/2017/09/05/10/03/2017-focused-update-of-the-2016-acc-expert-consensus-nonstatin. Accessed March 2019.

Pallozola, V. et. al. (2018 April 24). Major Dyslipidemia Guidelines and Their Discrepancies: A Need for Consensus. American College of Cardiology. Available online at https://www.acc.org/latest-in-cardiology/articles/2018/04/24/08/56/major-dyslipidemia-guidelines-and-their-discrepancies. Accessed March 2019.

(2016 November, Updated). Final Recommendation Statement Statin Use for the Primary Prevention of Cardiovascular Disease in Adults: Preventive Medication. U.S. Preventive Services Task Force. Available online at https://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/statin-use-in-adults-preventive-medication1. Accessed March 2019.

(2017 October 31, Updated). Getting Your Cholesterol Checked. Centers for Disease Control and Prevention. Available online at https://www.cdc.gov/cholesterol/cholesterol_screening.htm. Accessed March 2019.

(2017 April 30, Updated). How To Get Your Cholesterol Tested. American Heart Association. Available online at https://www.heart.org/en/health-topics/cholesterol/how-to-get-your-cholesterol-tested. Accessed March 2019.

Sources Used in Previous Reviews

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) 285: 2486-2497.

(September 2002) National Heart, Lung, Blood Institute. National Cholesterol Education Program Guidelines, Cholesterol, ATP III. II.3-b, II.9-c. PDF available for download at http://www.nhlbi.nih.gov/guidelines/cholesterol/atp3full.pdf . Accessed June 2009.

American Heart Association. Guide to primary prevention of cardiovascular diseases: Risk intervention, Blood Lipid Management. Available online at http://www.americanheart.org/presenter.jhtml?identifier=4704. Accessed June 2009.

(Updated December 19, 2008) American Heart Association. What your Cholesterol Levels Mean. Available online at http://www.americanheart.org/presenter.jhtml?identifier=183#HDL. Accessed May 2009.

American Academy of Family Physicians. Cholesterol: What Your Level Means. (Updated October 2007). Available online at http://familydoctor.org/online/famdocen/home/common/heartdisease/risk/029.html. Accessed September 2008.

(May 12, 2008) MedlinePlus Medical Encyclopedia. Coronary Risk Profile. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/003491.htm. Accessed October 2008.

ARUP Consult. Physicians Guide. Lipid Panel, Extended. Available online at http://www.aruplab.com/guides/ug/tests/0020468.jsp. Accessed October 2008.

Clarke, W. and Dufour, D. R., Editors (2006). Contemporary Practice in Clinical Chemistry. AACC Press. Washington, DC. Pp 251-253.

Pagana K, Pagana T. Mosby's Manual of Diagnostic and Laboratory Tests. 3rd Edition, St. Louis: Mosby Elsevier; 2006. Pp 351-356.

Davidson M, et al. Clinical Utility of Inflammatory Markers and Advanced Lipid Testing: Advice from an Expert Panel of Lipid Specialists. Journal of Clinical Lipidology 2011 Sep; 5(5): 338-67.

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). Sep 2002. PDF available for download at http://www.nhlbi.nih.gov/guidelines/cholesterol/atp3full.pdf. Accessed October 2012.

(©2012) American Heart Association. Cholesterol Levels. Available online at http://www.heart.org/HEARTORG/Conditions/Cholesterol/Cholesterol_UCM_001089_SubHomePage.jsp. Accessed October 2012.

(November 2012) American Association of Family Physicians. High Cholesterol. Available online at http://familydoctor.org/familydoctor/en/diseases-conditions/high-cholesterol.html. Accessed October 2012.

Kavey R-EW, et al. Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents: Summary report. Pediatrics 2011; 128: DOI:10.1542/peds.2009-2107C. PDF available for download at http://pediatrics.aappublications.org/site/misc/2009-2107.pdf. Accessed October 2012.

KidsHealth.org. Cholesterol and Your Child. Available online at http://kidshealth.org/parent/medical/heart/cholesterol.html#. Accessed October 2012.

CDC. FASTSTATS – Leading Causes of Death (2009 data). Available online at http://www.cdc.gov/nchs/fastats/lcod.htm. Accessed October 2012.

KidsHealth.org. Cholesterol and Your Child. Available online at http://kidshealth.org/parent/medical/heart/cholesterol.html#. Accessed October 2012.

(2006) Sekar K. Increased Small Low-Density Lipoprotein Particle Number, A Prominent Feature of the Metabolic Syndrome in the Framingham Heart Study. Circulation. Available online at http://circ.ahajournals.org/content/113/1/20.full. Accessed October 2012.

(September 23, 2002) Blake G, et al. Low-Density Lipoprotein Particle Concentration and Size as Determined by Nuclear Magnetic Resonance Spectroscopy as Predictors of Cardiovascular Disease in Women. Circulation, Available online at http://circ.ahajournals.org/content/106/15/1930.full. Accessed October 2012.

Blakenstein R, et al. Predictors of Coronary Heart Disease Events Among Asymptomatic Persons With Low Low-Density Lipoprotein Cholesterol. Journal of the American College of Cardiology Volume 58, Issue 4, 19 July 2011, Pp 364–374.

Krauss R. Lipoprotein subfractions and cardiovascular disease risk. Curr Opin Lipidol 2010 Aug;21(4):305-11. Abstract available online at http://www.ncbi.nlm.nih.gov/pubmed/20531184. Accessed October 2012. 

Prado K, et al. Low-density lipoprotein particle number predicts coronary artery calcification in asymptomatic adults at intermediate risk of cardiovascular disease. J Clin Lipidol 2011 Sep-Oct;5(5):408-13. Abstract available online at http://www.ncbi.nlm.nih.gov/pubmed/21981843. Accessed October 2012.

(May 2012) Lavie C, et.al. To B or Not to B: Is Non–High-Density Lipoprotein Cholesterol an Adequate Surrogate for Apolipoprotein B? Mayo Clin Proc. 2010 May; 85(5): 446–450. Available online at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2861974/. Accessed October 2012.

Reviewer May 2015, Shannon Haymond, PhD, DABCC, FACB, Northwestern University Feinberg School of Medicine.

Stone NJ, Robinson JG, Lichtenstein AH, Bairey Merz CN, Blum CB, Eckel RH, Goldberg AC, Gordon D, Levy D, Lloyd-Jones DM, McBride P, Schwartz JS, Shero ST, Smith SC Jr, Watson K, Wilson PW; American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2014 Jul 1;63(25 Pt B):2889-934.

Source: https://labtestsonline.org/tests/lipid-panel

Understanding Your Cholesterol Report

What is a Lipid Panel? Normal Values & Results Interpretation

  • How to Read Your Lipid Panel
  • What's Your Goal?

A lipid profile is a blood test that measures the amount of cholesterol and fats called triglycerides in the blood.

These measurements give the doctor a quick snapshot of what's going on in your blood. Cholesterol and triglycerides in the blood can clog arteries, making you more ly to develop heart disease.

Thus, these tests can help predict your risk of heart disease and allow you to make early lifestyle changes that lower cholesterol and triglycerides.

A report typically contains the following items, in this order:

  • Total cholesterol: An estimate of all the cholesterol in the blood (good HDL plus bad LDL, for example). Thus, a higher total cholesterol may be due to high levels of HDL, which is good, or high levels of LDL, which is bad. So knowing the breakdown is important.
  • Triglycerides: A type of blood fat.
  • High-density lipoprotein (HDL): Good cholesterol that helps protect against heart disease.
  • Low-density lipoprotein (LDL): Bad cholesterol and a major contributor to clogged arteries.

Some reports also include:

  • Total cholesterol to HDL ratio: The amount of total cholesterol divided by HDL. This number is useful in helping doctors predict the risk of developing atherosclerosis (plaque build-up inside the arteries).
  • Very low-density lipoprotein (VLDL): Another type of bad cholesterol that builds up inside the arteries.

Total Blood (Serum) Cholesterol

In general, doctors recommend that you try to keep this number under 200 mg/dL. Levels over 200 mg/dL — depending on the breakdown of LDL versus HDL — may mean you are at higher risk for heart disease.

  • Desirable: Less than 200 mg/dL
  • Borderline high: 200-239 mg/dL
  • High: Over 240 mg/dL

Having a total cholesterol level over 240 mg/dL may double the risk of heart disease.

Low-density lipoprotein (LDL)

Low-density lipoprotein is bad cholesterol. Think of the “L” in LDL as “lousy.” High LDL levels increase the risk of heart disease.

Your actual LDL goal depends on whether or not you have existing risk factors for heart disease, such as diabetes or high blood pressure. But in general, LDL results are as follows:

  • Optimal: Less than 100 mg/dL
  • Near optimal: 100-129 mg/dL
  • Borderline high: 130-159 mg/dL
  • High: 160-189 mg/dL

your risk for heart disease, your doctor will discuss with you strategies for lowering your LDL by a certain percentage. Those strategies will include lifestyle changes — including dietary changes and exercise — as well as the use of cholesterol lowering medication. Together, you and your doctor will decide on the appropriate strategies for your particular situation.

High-Density Lipoprotein (HDL)

High-density lipoprotein (HDL) is good cholesterol. Think of the “H” in HDL as “healthy” to remember this cholesterol type as the good kind.

HDL helps carry bad cholesterol the bloodstream and arteries. It plays a very important role in preventing clogged arteries. So, the higher the HDL number, the better.

In general, HDL levels of 60 mg/dL or higher are considered to be good. wise, levels below 40 mg/dL are considered a risk factor for heart disease. But it's important to discuss with your doctor what level is best in your particular case.

Certain medications, including steroids, blood pressure drugs known as beta blockers, and some ‘water pills’ can interfere with HDL levels. Make sure your doctor always knows about all the medications you are taking.

Triglycerides

Triglycerides are a type of blood fat that has been linked to heart disease and diabetes. If you have high triglycerides, your total cholesterol and LDL levels may be high, as well.

  • Normal: less than 150 mg/dL
  • Borderline-High: 150-199 mg/dL
  • High: 200-499 mg/dL
  • Very High: 500 mg/dL

Lifestyle plays a large role in your triglyceride level. Smoking, excessive drinking, uncontrolled diabetes, and medications such as estrogen, steroids, and some acne treatments can contribute to high triglyceride levels. However, in some cases, genes or an underlying disease can be the cause.

Total Cholesterol to HDL Ratio

This number is not always listed on a cholesterol report. Some doctors use this instead of the total cholesterol level to help decide on an approach to lowering cholesterol. However, the American Heart Association recommends that focussing on actual values rather than ratios is more useful in determining treatment.

Very Low-Density Lipoprotein (VLDL)

This is a type of bad cholesterol that contains the highest amount of triglycerides. The higher your VLDL level, the more ly you are to have a heart attack or stroke.

The VLDL level is not always included in cholesterol reports. There is no simple or direct way to measure VLDL. Most labs estimate it by dividing the triglyceride level by 5. However, this is not valid if the triglyceride level is over 400.

Normal VLDL levels range from 5 – 40 mg/dL.

Keep in mind your cholesterol report offers a general guideline only. What's normal for you may not be OK for someone else. Your doctor will look at all your cholesterol numbers together with your other risk factors to develop a specific strategy for you.

Your goal depends on your age, family history of heart disease, and whether or not you have other risk factors for heart disease, such as diabetes, high blood pressure, and weight problems. Results may even vary depending on the lab a doctor uses. Always ask your doctor to help you interpret test results.

Adults aged 20 and older should have their cholesterol and triglyceride levels checked once every five years. However, your doctor may suggest doing this more often if you have certain risk factors such as diabetes, high blood pressure, obesity, or a family history of heart disease.

SOURCES:

Lab Tests Online: “Cholesterol: The Test.”

National Cholesterol Education Program: “High Blood Cholesterol, What You Need to Know.”

National Heart, Lung, and Blood Institute: “What is High Blood Cholesterol?”

American Heart Association: “What Your Cholesterol Levels Mean.”

© 2018 WebMD, LLC. All rights reserved.

Source: https://www.webmd.com/cholesterol-management/understanding-your-cholesterol-report

Cholesterol test: Uses, what to expect, results

What is a Lipid Panel? Normal Values & Results Interpretation

High cholesterol levels cause plaque to build up, which can block or narrow arteries, leading to heart attacks and other major health issues.

Testing cholesterol is an easy way to check a person’s risk for developing heart disease.

Share on Pinterest A lipid panel or lipid profile measures the amount of cholesterol in the blood.

A cholesterol test is also called a lipid panel or a lipid profile. This blood test measures the amount of cholesterol and triglycerides in the blood.

The amount of cholesterol and triglycerides in the blood can help doctors determine whether or not plaque has built up in a person’s arteries.

A complete cholesterol test measures the following four types of fats in the blood:

  • Total cholesterol level: The total amount of cholesterol in a person’s blood.
  • Low-density lipoprotein (LDL) cholesterol: Often referred to as “bad cholesterol,” this is the cholesterol that can build up in the arteries, raising the risk of heart attack and stroke.
  • High-density lipoprotein (HDL) cholesterol: This cholesterol is called “good cholesterol” because it helps keep the arteries clear of LDL cholesterol.
  • Triglycerides: These are fats in the bloodstream that give the body energy. When these fats don’t get used, the body stores them. Too many of these fats can be indicators of health problems including heart disease.

Risks of untreated high cholesterol

High cholesterol often has no signs and symptoms but can have devastating health consequences. When there is too much cholesterol in the blood, it builds up in the arteries and can harden. This buildup of plaque narrows the arteries and reduces and slows the blood flow to the heart. If the blood supply to any part of the heart is totally blocked, a heart attack occurs.

What is a cholesterol test used for?

A cholesterol test is a useful tool to assess the risk of heart disease including heart attack and stroke.

The test is used to measure and analyze the amount of fats in the blood. If there is too much cholesterol in the blood, treatment can be started to lower cholesterol levels and reduce the risk of heart disease.

Who should get one? How often?

Everyone should get their cholesterol checked regularly. How often depends on age and certain health risk factors.

An adult with average risk of heart disease should get their cholesterol checked every 4 to 6 years starting at age 20.

Some adults need to test their cholesterol more regularly. Those adults include the following individuals:

  • those with a family history of heart disease or high cholesterol
  • anyone with a previously high cholesterol test
  • people with diabetes
  • obese or overweight individuals
  • inactive people
  • people who eat a high-fat diet
  • men over the age of 45
  • women over the age of 55
  • smokers

Additionally, children should have their cholesterol tested. The Centers for Disease Control and Prevention (CDC) recommend testing a child’s cholesterol levels once between the ages of 9 and 11 and again between the ages of 17 and 21.

Cholesterol testing is generally avoided during puberty because hormones can alter the results of the tests.

Share on PinterestA cholesterol blood test is similar to other blood tests and may involve a 12-hour fast period prior to the procedure.

Most of the time, cholesterol tests require fasting, which means no food or drink other than water for up to 12 hours prior to the test.

Because of this requirement, most people choose to have their cholesterol test done in the morning.

During and after

A cholesterol test is a fairly simple procedure. It involves drawing blood from a vein and is performed in the same way as most other blood tests.

Prior to drawing blood, a technician will examine the arm to locate a good vein and clean the area with antiseptic. They will then wrap a band around the arm, near where the puncture site will be, to help the vein fill with blood.

The technician will then insert a needle into the vein and blood will collect in a vial. The band will be removed while the needle is still in place. After enough blood is collected, the technician will remove the needle and hold a cotton swab on the site to stop the bleeding. The area may be covered with a small bandage.

After the test, there are no special considerations. Most people are able to go about their normal day immediately following a cholesterol test and can drive themselves home. In very rare cases, the test site may become infected, but this is extremely unusual.

The results of the test determine whether the cholesterol levels in the person’s blood are healthy.

The results will be broken down into several categories by the type of fat. The results are measured in milligrams of cholesterol per deciliter of blood (mg/dL).

Total cholesterol levels

Having a result less than 200 mg/dL is considered good. Borderline high results range from 200-239 mg/dL. High cholesterol levels are considered to be any number over 240 mg/dL.

HDL cholesterol levels

With HDL, it is higher levels that are desirable. A result below 40 mg/dL is poor. A result between 40 and 59 mg/dL is better, while a reading of 60 mg/dL or higher is the best result.

LDL cholesterol levels

LDL cholesterol recommendations vary the health of an individual.

  • People with heart disease or diabetes should aim for LDL levels below 70 mg/dL.
  • Individuals with no heart disease but who are at higher risk for heart disease need to keep levels below 100 mg/dL.
  • For people with no increased risk of heart disease, LDL levels between 100 and 129 mg/dL are near perfect.
  • A reading from 130 to 159 mg/dL is considered borderline high for those with no heart disease and high for those where heart disease is present.
  • A reading from 160 to 189 mg/dL is considered high for those without heart disease and very high for those with heart disease.
  • A reading above 190 mg/dL is considered very high for all groups.

Triglyceride levels

Triglyceride levels are considered desirable when below 150 mg/dL. Between 150 and 199 mg/dL is borderline high. Levels between 200 and 499 mg/dL are considered high. Any level above the upper end of this range is considered very high.

Having high cholesterol doesn’t automatically mean a person will develop heart disease. There are many ways to manage cholesterol levels and lower the risk for developing heart disease.

A doctor can recommend lifestyle changes and medications that can help manage and lower high cholesterol.

Share on PinterestLifestyle changes such as following a healthful diet and losing weight are recommended for people with high cholesterol.

Lifestyle changes for high cholesterol include the following:

Sugars and carbohydrates increase triglyceride levels, so eating a healthful diet that is low in saturated fat and dietary cholesterol, low in sugar and carbohydrates and high in soluble fiber is recommended.

Doctors use medication to treat the cholesterol levels of the highest risk individuals. There are several types of drugs available that can help manage cholesterol levels. These drugs include statins, nicotinic acid, fibric acid, and cholesterol absorption inhibitors.

Those that need medication should still follow all lifestyle and dietary recommendations for lowering cholesterol. A combination of lifestyle changes and medication can normally lower cholesterol levels for most people.

Source: https://www.medicalnewstoday.com/articles/315910

Lipid Blood Tests: Test Details, Preparation & Results

What is a Lipid Panel? Normal Values & Results Interpretation

Directly linked to risk of heart and blood vessel disease.

Goal values:

  • 75-169 mg/dL for those age 20 and younger
  • 100-199 mg/dL for those over age 21

Preparation:

This test may be measured any time of the day without fasting. However, if the test is drawn as part of a total lipid profile, it requires a 12-hour fast (no food or drink, except water). For the most accurate results, wait at least two months after a heart attack, surgery, infection, injury or pregnancy to check cholesterol levels.

Cholesterol is a type of fat, found in your blood. It is produced by your body and also comes from the foods you eat (animal products).

Cholesterol is needed by your body to maintain the health of your cells. Too much cholesterol leads to coronary artery disease.

Your blood cholesterol level is related to the foods you eat or to genetic conditions (passed down from other generations of family members).

High Density Lipoprotein (HDL) “Good cholesterol”

High levels linked to a reduced risk of heart and blood vessel disease. The higher your HDL level, the better.

Goal value:

Preparation:

This test may be measured any time of the day without fasting. However, if the test is drawn as part of a total lipid profile, it requires a 12-hour fast (no food or drink, except water). For the most accurate results, wait at least two months after a heart attack, surgery, infection, injury or pregnancy to check HDL levels.

HDL is a lipoprotein (a combination of fat and protein) found in the blood. It is called “good” cholesterol because it removes excess cholesterol from the blood and takes it to the liver. A high HDL level is related to lower risk of heart and blood vessel disease.

Low Density Lipoprotein (LDL) “Bad cholesterol”

High levels are linked to an increased risk of heart and blood vessel disease, including coronary artery disease, heart attack and death. Reducing LDL levels is a major treatment target for cholesterol-lowering medications.

Goal values:

  • Less than 70 mg/dL for those with heart or blood vessel disease and for other patients at very high risk of heart disease (those with metabolic syndrome)
  • Less than 100 mg/dL for high risk patients (e.g., some patients who have multiple heart disease risk factors)
  • Less than 130 mg/dL for individuals who are at low risk for coronary artery disease

Preparation:

Blood should be collected after a 12-hour fast (no food or drink, except water). For the most accurate results, wait at least two months after a heart attack, surgery, infection, injury or pregnancy to check LDL levels.

LDL is a lipoprotein (a combination of fat and protein) found in the blood. It is called “bad” cholesterol because it picks up cholesterol from the blood and takes it to the cells. A high LDL level is related to a higher risk of heart and blood vessel disease.

Triglycerides (TG)

Elevated in obese or diabetic patients. Level increases from eating simple sugars or drinking alcohol. Associated with heart and blood vessel disease.

Goal value:

Preparation:

Blood should be collected after a 12-hour fast (no food or drink, except water). For the most accurate results, wait at least two months after a heart attack, surgery, infection, injury or pregnancy to check triglyceride levels.

Triglycerides are a type of fat found in the blood. The blood level of this type of fat is most affected by the foods you eat (such as sugar, fat or alcohol) but can also be high due to being overweight, having thyroid or liver disease and genetic conditions. High levels of triglycerides are related to a higher risk of heart and blood vessel disease.

  • See also Blood Tests to Determine Risk of Coronary Artery Disease

This information is about testing and procedures and may include instructions specific to Cleveland Clinic. Please consult your physician for information pertaining to your testing.

Last reviewed by a Cleveland Clinic medical professional on 12/10/2018.

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Source: https://my.clevelandclinic.org/health/diagnostics/17176-lipid-blood-tests

Order Your Own Lipid Panel with My Lab ReQuest™

What is a Lipid Panel? Normal Values & Results Interpretation

With My Lab ReQuest, you no longer have to wait for a doctor’s order to request your own lipid panel. Insurance isn’t necessary to request your test, either. Place your order online in just four easy steps and choose from any of our 75+ Patient Service Centers across Arizona to complete your test. Take charge of your health with My Lab ReQuest!


Why Order Your Own Cardio Health Screen (Lipid Panel) with My Lab ReQuest?

  • 1) To take charge of your health and have the most accurate and up-to-date information to proactively manage your health and make educated decisions
  • 2) You prefer the convenience and the time savings of ordering directly
  • 3) Your insurance does not pay for laboratory testing

Since the passage of the law in 2015 that allows for consumers in Arizona to order their own lab tests, thousands of patients have used our My Lab ReQuest service to take charge of their health and make more informed healthcare decisions.

Our Cardio Health Screen (Lipid Panel) is just one of the heart health screenings we offer to help you assess your risk for heart disease.

Patients choose Sonora Quest Laboratories to meet their lab testing needs for a wide range of reasons, including:

Award-Winning Quality

As the nation's largest integrated laboratory system, Sonora Quest Laboratories delivers award-winning quality services every day to more than 23,000 patients across Arizona.

We are the #1 bioscience company in Arizona, according to Ranking Arizona, and we are also the only healthcare company to even win the Arizona Governor's Award for Quality.

Most importantly, we are accredited by the College of American Pathologists (CAP), the organization whose accreditation ensures the highest standard of care for laboratory patients.

Convenient Locations

Schedule an appointment or walk in to any of our 75+ Patient Service Centers located across Arizona! We have over 45 locations in Metro Phoenix, 14 locations in Tucson and Southern Arizona, and various other locations across Northern and Western Arizona. Moreover, several of our locations are conveniently located inside of Safeway markets so that you can plan your screening around your trip to your neighborhood grocery store.

Lipids are fats and fat- substances that are found in your bloodstream. Lipids are important in supporting bodily functions, but high levels of lipids can put a person at risk for cardiovascular disease.

With a Cardio Health Screen, cholesterol, high-density lipoproteins (HDL), low-density lipoproteins, very low-density lipoproteins (VLDL), and triglycerides are measured to assess your risk for heart disease.

Why test your cholesterol levels?

Cholesterol can be an important indicator of your health. High levels of LDL cholesterol or low levels of HDL cholesterol can put you at risk for heart disease and stroke. Currently, the CDC estimates that over 95 million adults age 20 or over have high cholesterol.

As a result, it’s important that individuals schedule cholesterol screenings to check their cholesterol levels, especially since most people with high cholesterol levels will not present any symptoms.

Furthermore, if you have risk factors for high cholesterol, you may face additional risk for heart disease and stroke.

How often should you get tested?

The American Heart Association recommends a lipid panel every four to six years for adults over the age of 20. If you have cardiovascular disease, or are at high risk for cardiovascular disease, your doctor may recommend a lipid panel screening more frequently.

Interpreting your test results

According to the CDC, desirable cholesterol levels for adults are as follows:

Desirable Cholesterol Levels Milligrams per deciliter (mg/dL)
Total CholesterolLess than 200 mg/dL
HDL Cholesterol40 mg/dL or higher
LDL CholesterolLess than 100 mg/dL

Although cholesterol levels are an important measure of your health, it’s important that these numbers be evaluated alongside other risk factors. Talk to your doctor about your cholesterol levels and other risk factors such as family history that help to provide a more comprehensive view of your risk for heart disease.

What are the risk factors for high cholesterol?

While anyone can have high cholesterol, certain risk factors may increase your risk for heart disease. According to the CDC, some common risk factors for high cholesterol are:

  • A family history of heart disease and/or high blood cholesterol
  • Diabetes
  • Older age
  • Being male
  • Being overweight or obese
  • Previously having had high cholesterol

According to the CDC, some of the risk factors for undesirable levels of HDL, LDL, and triglycerides are as follows:

HDL

  • Genetic factors
  • Type 2 diabetes
  • Smoking
  • Being overweight
  • Sedentary lifestyle

LDL

  • Diet high in saturated and trans fat

Triglycerides

  • Being overweight or obesity
  • Sedentary lifestyle
  • Smoking
  • Excess alcohol consumption
  • Diet high in carbohydrates
  • Underlying diseases or genetic disorders

If you have any of these risk factors, it’s important to discuss with your doctor if you should have your cholesterol screened more regularly.

Managing your cholesterol

Once you have been diagnosed with high cholesterol, there are many steps you can take to lower your cholesterol and improve your health. The American Heart Association recommends the following lifestyle changes to lower your cholesterol levels:

  • Eating a healthy diet
  • Becoming more physically active
  • Quitting smoking
  • Losing weight

In addition to lifestyle changes, medication may also be recommended to help with the management of your cholesterol. For the best results and for more information on what steps to take to manage your cholesterol, contact your medical provider.

Resources

Visit our patient resources section for more information on cardiovascular disease and steps that you can take to improve your heart health. For additional information and resources in support of your heart health, please visit the American Heart Association website.

Other heart health tests

Additional heart health screenings are also available as part of our My Lab ReQuest menu. A Cholesterol, Total screening, which does not include HDL, LDL, VLDL and triglycerides levels, can be ordered for just $11.

An hsCRP (High Sensitivity C-Reactive Protein for Cardio) screening, while not used in the diagnosis of a specific disease, can serve as a general marker for inflammation or infection and can help to identify potential heart problems when combined with other heart health screenings.

*It is solely your responsibility to promptly discuss all laboratory test results with a physician. Neither Sonora Quest Laboratories nor its Medical Director will provide interpretation, counseling, consulting, or care recommendations on the basis of any laboratory results provided to you.

Source: https://www.sonoraquest.com/my-lab-request/heart-health-screenings/cardio-health-screen-lipid-panel/

Lipid Profile (Triglycerides): Reference Range, Interpretation, Collection and Panels

What is a Lipid Panel? Normal Values & Results Interpretation

Triglycerides are lipid compounds composed of a glycerol esterified to 3 fatty acid chains of varying length and composition. These fatty acid chains can be saturated or unsaturated, and the chemical composition of each chain is different.

Each chain consists of carbon and hydrogen atoms with varying single or double-bonded chains, depending on the degree of saturation or unsaturation.

Triglycerides are formed of mixed chains, and the structural comparison between the chains is heterogenous in nature.

Triglyceride is the most abundant dietary lipid compound found throughout the diet and is the method with which energy is stored in the body.

Initial digestion of dietary triglycerides takes place with pancreatic lipase, which hydrolyzes one fatty acid chain at a time to form 2 free fatty acid (FFA) chains and one 2-monoglyceride (2MG) compound per each triglyceride.

Bile salts are released in the duodenum in response to cholecystokinin release occurring in the presence of lipid compounds within the ingesta. Bile salts aid in forming lipid micelles, which create a hydrophilic surface with a hydrophobic core of lipid molecules, including FFA.

Absorption of lipid compounds into the enterocyte for biochemical usage occurs through diffusion across the cellular membrane and also through lipid transporters that are located on the luminal side of the enterocyte.

Once in the enterocyte, FFA chains and 2MG compounds are transported to the endoplasmic reticulum, where they are reformed into triglycerides and packaged into chylomicrons in the golgi apparatus to receive chylomicron specific apolipoproteins, namely apo B48, which is a marker for TG chylomicron.

These newly formed chylomicrons are then released from the enterocyte and transported to circulation by the lymphatic system. [10]

Once in the circulation, the triglyceride-rich chylomicrons pass through the vasculature, where they undergo a complex process of protein exchange mediated by HDL and, based upon this protein exchange process, are either received in the liver for further metabolism and packaging or undergo delipidation at the vascular endothelial surface by lipoprotein lipase (LPL). [10] The largest proportion of chylomicrons containing dietary triglycerides undergo hepatic uptake, where triglycerides are packaged into very-low dense lipoprotein (VLDL) for transport to peripheral tissues.

VLDL is the major carrier of triglycerides and FFA in serum and is synthesized within the hepatocyte, while a smaller percentage of FFA travels in a unesterified form, which is complexed to albumin for transport.

[11] Once the VLDL is release into serum, it travels to peripheral tissues where it undergoes a delipidation cascade, and triglyceride is removed by LPL at multiple LPL receptor sites along the endothelium.

[10] Following delipidation, a VLDL remnant (IDL) is formed, which has released the bulk of triglyceride originally packaged and is cleared by the liver or transformed to LDL by serum protein exchange process.

Triglyceride is the major high-energy compound for energy storage supplying 9 Kcal/g of FFA.

Those lipids that are intended for storage are recognized by and are removed from VLDL by LPL as well as storage specific transmembrane proteins that aid in a process of lipid droplet formation within adipocytes and muscle tissue for use later as an energy source.

[10, 12] Liberation of triglycerides from lipid stores begins under metabolic stressors when circulating systemic nutrient supply is not sufficient to meet metabolic energy demand.

Regulation of enzymes needed for lipolysis occur through cyclic adenosine monophosphate (cAMP)–mediated and cAMP-independent pathways that activate adipose triglyceride lipase, hormone-sensitive lipase, and monoacylglycerol lipase, which hydrolyzes the ester bonds of stored triglyceride producing glycerol and FFA chains. [13] Glycerol undergoes cellular removal through transcellular aquaporins, and FFAs are either moved to serum, esterified or metabolized into signaling molecules. [13]

Once FFA has been liberated from adipocytes for use in energy production they are transported and received by cells for metabolism and mobilized to intracellular mitochondria and peroxisomes for use. These lipid compounds undergo fatty acid oxidation, providing acetyl-CoA for hepatic ketogenesis and substrates for energy production through oxidative phosphorylation. [11]

Triglycerides and FFA have been implicated in playing a role in atherosclerotic disease formation. High triglyceride is a marker for elevated levels of atherogenic lipoproteins that contain triglyceride and FFA. [14] As mentioned previously, elevation of triglycerides can indicate insulin resistance in the setting of low levels of HDL and elevated LDL.

[4, 14] Patients with this lipid profile typically have elevated VLDLs, small LDL and HDL particles, and have elevated levels of circulating chylomicrons and places patients at risk for coronary heart disease.

[14] Hypertriglyceridemia is a clinical risk factor for coronary artery disease (CAD), especially when low HDL is present, and should be considered a continued risk factor despite adequate control of LDL cholesterol. [4, 5, 14]

The USPSTF recommends lipid screening in both men and women who are at increased risk for coronary heart disease, men aged 35 years and older, or women aged 45 years and older.

[15] AHRQ has similar recommendations to start routine screening at age 35 years or in those patients who have heart disease risk factors and aged 20-35 years.

[16] Currently, no guidelines support routine screening of lipids in young adults aged 20-35 years without risks of coronary heart disease. wise, supporting evidence of routine lipid screening in children is lacking, and, therefore, no recommendation exists.

The NCEP Report of the Expert Panel on Blood Cholesterol levels in Children and Adolescents recommends screening lipid panels as routine health care in children of families in which premature heart disease is evident or familial dyslipidemias are established. [17]

Secondary causes for hypertriglyceridemia can be a source for abnormal triglyceride on screening lipid panel, and clinical investigation should aim at discovering suspected secondary causes and treating appropriately. Possible etiologies of secondary hypertriglyceridemia include disease states such as uncontrolled diabetes, nephrotic syndrome, end-stage renal disease, hypothyroidism, and HIV. [18]

Common substances and medications that may be responsible for elevation of triglycerides include but are not limited to ethanol, corticosteroids, noncardioselective beta-blockers, thiazide diuretics, bile-binding resins, oral estrogens, progestins, and tamoxifen, as well as antiretroviral therapy. [18, 19] Patients on medications or ingesting substances known to raise triglycerides who are at risk for developing secondary hypertriglyceridemia in the setting of CAD, diabetes, disease states secondarily elevating triglycerides, or other coronary artery disease–equivalent states should receive routine screening. Additionally, surveillance lipid profiles should be considered at appropriate intervals with attention to removal of secondary causes of hypertriglyceridemia or institution of triglyceride-lowering therapy as needed.

Very-high levels of triglyceride can place patients at risk for the development of pancreatitis and work-up of a new diagnosis of pancreatitis should include a baseline lipid panel to investigate triglyceride levels.

[8] Patients who present with extraordinarily high lipids levels or patients that have pancreatitis due to hypertriglyceridemia should have institution of triglyceride-lowering therapy, investigation of factors causing secondary hypertiglyceridemia, and consideration of concomitant familial dyslipidemia. [6, 9]

ACC/AHA cholesterol guidelines have not provided guideline specifics pertaining to triglycerides, but a 2011 scientific statement describes the screening processes of special populations [8, 20] beyond the scope of this article.

The clinical applicability of the lipid panel for analyzing triglyceride levels rests on the clinician's understanding of patient risk factors and use of those risk factors as guides to screening patients for hypertriglyceridemia and other dyslipidemias.

Once lipid-lowering therapy has been initiated, surveillance of lipid levels should continue until lipid levels are at recommended goal levels based upon the patient’s risk factor profile, with yearly checks thereafter.

Continued surveillance of lipid panels should persist if any adjustments in therapy occur or if poor compliance to therapy is suspected. Screening lipid panel can show falsely positive high-triglyceride levels and occurs in patients who have consumed a meal high in lipidcompounds and have not fasted for 8 hours prior to venipuncture.

Also, patients who have recently consumed ethanol can have elevation of triglycerides that may not necessarily be indicative of baseline levels.

Source: https://emedicine.medscape.com/article/2074115-overview

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