Lipid Panel with reflex to direct LDL

Also Known as: Non-fasting Lipid Panel

What is a Lipid Profile test?

The standard lipid panel measures the amount of specific fat molecules called lipids in the blood. It measures a variety of substances, including many types of cholesterol, as a panel test. The standard lipid panel is used to assess the risk of cardiovascular diseases such as heart disease, heart attack, and stroke in both children and adults. Lipids are fat molecules found in the blood. Cholesterol and triglycerides are two main types of lipids transported inside lipoprotein particles. The standard lipid panel examines your blood to detect various kinds of lipids, including:

Total Cholesterol: This determines your total cholesterol level in the blood. It is a necessary component of mammalian cell membranes since it ensures adequate permeability and fluidity.

LDL(Low-density lipoprotein) Cholesterol (Calculated): This type of cholesterol, referred to as "bad cholesterol," can build up in blood vessels and raise your risk of cardiovascular disease.

HDL (High-Density Lipoprotein) Cholesterol: This type of "good cholesterol" helps reduce LDL buildup. HDL is one of the five major types of lipoproteins (chylomicrons, VLDL, IDL, LDL, HDL) that enable lipids such as cholesterol and triglycerides to be transported through the water-based bloodstream. HDL carries roughly thirty percent of blood cholesterol in healthy people.

Triglycerides: This type of fat in excess is linked to cardiovascular disease and pancreatic inflammation. Triglyceride levels in the blood have been related to atherosclerosis and, as a result, the risk of heart disease and stroke. Triglyceride levels can be raised by eating a high-carbohydrate diet, with carbohydrates accounting for more than 60% of total energy intake.

Cholesterol/HDL ratio (Calculated) : Cholesterol.total/Cholesterol in HDL [Mass Ratio] in Serum or Plasma

Non-HDL Cholesterol (Calculated): Total cholesterol minus HDL cholesterol is non-HDL cholesterol. It's been hypothesized that non-HDL cholesterol is a better predictor of cardiovascular risk than LDL alone.

Total cholesterol, HDL cholesterol, triglyceride (TG), LDL cholesterol (calculated), cholesterol/HDL ratio (calculated), andHDL cholesterol non-(calculated) are all evaluated in the Lipid Panel with Reflex to Direct LDL. If the TG level is >400 mg/dL, direct LDL-C measurement will be performed at an additional cost.

What is the test used for?

The standard lipid profile helps evaluate cardiovascular health by measuring cholesterol in the blood. Too much cholesterol can clog the arteries and blood vessels, causing damage and increasing the risk of heart disease, stroke, and heart attack.

A standard lipid profile can be ordered for a variety of reasons, including:

Screening: This is routine testing that determines whether your cholesterol is normal, borderline, intermediate, or high-risk.

Monitoring: Lipid testing can monitor the cholesterol in your blood if you have abnormal findings from previous tests or other risk factors for heart disease.

Treatment response: A lipid profile can be used to evaluate your response to treatment if you've been told to make lifestyle modifications or take cholesterol medications.

Diagnosis: Lipid levels can be tested to diagnose various medical conditions, such as liver diseases.

Lipid panel with reflex to direct LDLD is effective for detecting, classifying, and monitoring hyperlipidemia, especially in people who are likely to have high triglyceride levels.

Why and when do you need this test?

A standard lipid profile test may be necessary for a range of situations. The test can be used for screening, diagnosis, or monitoring, depending on the medical condition.

Screening is the process of detecting a health problem before any apparent signs or symptoms arise. The lipid profile can evaluate patients at high risk of cardiovascular disease before they progress to conditions such as heart disease or a heart attack. Screening can help prevent problems by providing early warning, but it can also be costly, cause anxiety, and lead to possibly unnecessary treatments. Various specialists weigh in on the facts and reach different judgments about who should be examined and how frequently they should be screened.

Adults without risk factors for cardiovascular disease should get their screening done every five years. Depending on a person's medical situation, a doctor may recommend a first lipid test in their 20s, 30s, or 40s. People with one or more risk factors are more likely to be screened frequently and to have their first test at a younger age. The following are some examples of risk factors:

Age ( over 45 for men, and 50-55 for women)
A prior result demonstrated high cholesterol.
History of cardiovascular disease
Smoking
Obesity or being overweight.
Unhealthy diet consumption
Lack of physical activity
Blood pressure that is too high (hypertension).
Having a first-degree relative diagnosed with heart disease at an early age (Men under 55, women under 65).
Diabetes or is at risk of developing diabetes.

You may need a lipid test every year or every few years if you have one or more risk factors. The results of previous tests may determine the testing frequency.

Some experts recommend annual lipid testing for adults over the age of 65. If a patient's levels appear stable, other doctors may reduce or stop regular screening.

LDL-C is commonly considered as a key determinant of accessing the risk of coronary artery disease (CAD). According to the American Heart Association, adults over the age of 20 should have their lipid levels checked every 4 to 6 years. For patients with TG values >400 mg/dL and individuals with hyperlipoproteinemia type III, direct LDL-C assessment is more accurate than calculated LDL-C. (dysbetalipoproteinemia). Since previously stated, this panel is particularly valuable for persons with high TG levels, as it provides a foundation for a more realistic assessment of CAD risk in this population. It may also help healthcare providers follow treatment progress by allowing them to assess total lipid levels as well as direct LDL-C.

What kind of sample is required for the test?

A healthcare provider will use a small needle to obtain a blood sample from a vein in your arm. A small amount of blood will be collected into a test tube or vial once the needle is inserted. When the needle goes in or out, it may sting a little. It usually takes less than five minutes to complete this process.

Do you need to prepare for the test?

Lipid testing without fasting may be advised, but you should check with your doctor's office ahead of time to see if you need to fast and always follow any pre-test instructions given to you.

Are there any risks to this test?

Having a blood test carries relatively little risk. You or your child may experience minor pain or bruising where the needle was inserted, but most symptoms disappear quickly.

What do the test results mean?

Your lipid profile's results are reported for each type of cholesterol and triglyceride. Milligrams per deciliter of blood (mg/dL) are the units of measurement.
The optimal or reference level is indicated below:

Reference Ranges	Male (mg/dL)	Female (mg/dL)
Total Cholesterol
<20 Years	<170	<170
≥20 Years	<200	<200
HDL Cholesterol
<20 Years	>45	>45
≥20 Years	≥40	≥50
Triglycerides
≤9 Years	<75	<75
10-19 Years	<90	<90

≥20 Years	<150	<150
LDL-Cholesterol (Calc)
<20 Years	<110	<110
≥20 Years	<100	<100
Cholesterol/HDL Ratio (Calc)	<5.0	<5.0
Non-HDL Cholesterol
<20 Years	<120	<120
≥20 Years	<130	<130

In addition to genetic causes that lead to highly elevated TG levels, certain medical conditions can also increase TG, including diabetes, thyroid disease, liver and kidney diseases, and obesity. Calculated LDL values have a variance of 11% to 26%, whereas direct LDL-C values have a variance of less than 4%. In rare cases, gammopathy, especially monoclonal IgM (Waldenstrom’s macroglobulinemia), may cause unreliable results.

Borderline, intermediate, and high-risk values are those that do not meet these targets. Higher-than-target total cholesterol, LDL, and triglyceride levels, as well as lower-than-target HDL levels, can all increase the risk of cardiovascular disease.

The results of your tests will be interpreted in light of your overall health and other risk factors. Many doctors utilize special risk calculators to decide the appropriate next steps based on your test results, age, and other factors. Continued cholesterol monitoring, lifestyle modifications, and drugs may be recommended to lower cholesterol and reduce cardiovascular risk.

Related tests: Lipid Panel test, Total cholesterol test, Direct LDL cholesterol, HDL cholesterol test, Triglycerides test, VLDL cholesterol test

Our clinical experts continually monitor the health and medical content posted on CURA4U, and we update our blogs and articles when new information becomes available. Last reviewed by Dr.Saad Zia on June 04, 2023.