It is helpful for you to become familiar with the information provided in this report so that, with the help of your healthcare team, you can:
What are lipids?
“Lipids” refers to “fats” normally found in the blood.
While a normal amount of blood fat helps your body function properly and promotes health and well-being, high levels can cause health problems, particularly as we age.
What is a Lipid Panel?
A “lipid panel” is a measure of the fat in your blood.
You may be surprised to learn that your blood normally contains more than one type of fat. The typical lipid panel measures two main types of blood fat, cholesterol and triglycerides. Their functions and the effect of high levels on your health can be quite different. While both contribute to premature cardiovascular disease, high levels of triglycerides have also been found to increase your chance of having a heart attack or stroke even when the LDL-Cholesterol is not elevated (see below). Triglycerides can also cause an acute medical condition called “pancreatitis” when triglycerides are extremely high.
How often should i have a lipid Panel?
Adults over the age of 20 years old should measure their lipids at least once every five years.
Children should be screened between 9 and 11 years old and again between 17 and 20 years old. Your healthcare team may recommend more frequent tests if you or your child are at increased risk for heart disease, stroke, or other complications.
Here is a brief overview of the two main types of blood fat, cholesterol and triglycerides.
Cholesterol is a type of fat normally found in the bloodstream. It plays an important role in helping the body make cells, hormones, vitamins, and promote normal growth and development. However, when the level of bad cholesterol in the bloodstream gets too high, it can cause health problems by damaging the blood vessels and organs.
What are the different types of cholesterol in the blood?
Triglycerides are a type of fat found in the blood that provide fuel to help with daily activities, just as a car needs gasoline to function properly. Much of the triglycerides in our bloodstream come from what we eat, although the body also makes triglycerides, especially when we are asleep. When we eat, our body takes the triglycerides it doesn’t immediately need and stores them in fat cells to be used later as fuel. While triglycerides are important for your body’s normal function, high levels of triglycerides can cause health problems.
What will my Lipid Panel measure?
This is the sum of cholesterol contained in HDL + LDL. A high total cholesterol level can increase your risk of cardiovascular disease. Decisions about when to treat high cholesterol are usually based upon the level of the LDL-C or non-HDL-C rather than the total cholesterol level. The cholesterol level can be measured any time of day, as it is not necessary to avoid eating before your blood test.
Total Cholesterol/HDL-C Ratio
This value is found by dividing your Total Cholesterol by your HDL-C. Although this ratio is shown on many lipid panels, its usefulness is uncertain. Use of the Total Cholesterol/HDL-C ratio in evaluating health risks is not recommended and it should not influence your healthcare decisions.
This is a type of fat found in the blood that provides fuel to help with daily activities. Much of the triglycerides in our bloodstream come from what we eat, although the body also makes triglycerides, especially when we are asleep. When we eat, our body takes the triglycerides it doesn’t immediately need and stores them in fat cells to be used later as fuel. While triglycerides are important for your body’s normal function, high levels of triglycerides can cause health problems. Triglyceride levels of 150 mg/dL or higher are considered “high” and are also associated with an increased risk of heart disease. Because your triglyceride level can be affected by eating, it is best measured after fasting for at least 9 hours. Individuals with high triglyceride levels may benefit from treatment with medication. Diets high in saturated fats and carbohydrates, especially refined carbohydrates (like white bread), added sugars and total fat (including saturated fat) as well as alcohol and some medications can increase triglyceride levels. Being overweight also increases triglyceride levels. Very high levels of triglycerides (≥ 500 mg/dL) can irritate the pancreas (causing pancreatitis) and lead to other health problems.
High-Density Lipoprotein Cholesterol (HDL-C)
HDL-C helps the body get rid of excess cholesterol that may otherwise collect in blood vessels. High levels of HDL-C are usually associated with a lower risk of cardiovascular heart disease. Normal or high levels of HLD-C, however, may be less effective in lowering risk if the LDL-C or non-HDL-C are elevated, especially in those who are “high-risk or very high-risk”. Your HDL-C level will be lower if you smoke, have an extremely low-fat diet, or have high level of triglycerides.
Low-Density Lipoprotein Cholesterol (LDL-C)
High levels can build up in your blood vessels, leading to blockage of blood flow to organs such as the heart and brain. Your healthcare team will look at your risk factors for heart attack and stroke, such as previous stroke or heart attack, diabetes, smoking, age, blood pressure, and family history to decide whether you would benefit from medication to lower your LDL-C level.
This is determined by subtracting the HDL-C from the Total Cholesterol. When you subtract the HDL-C, everything else is “bad”.
Interactive Lipid Panel
Hover over anything bordered or highlighted in red to view more information.
To better determine your risk of heart attack or stroke, your healthcare team may also measure your:
Often referred to as “Lp(a)” or Lp “little a”. A high Lp(a) level (≥ 100 nmol/L or 50 mg/dL) is a potential independent predictor of having a heart attack and stroke. Measurements of Lp(a) can be useful to your healthcare team in deciding the intensity of treatment needed and the best LDL-C level for you to stay healthy.
Hemoglobin A1c (A1c)
This test is used to determine if you are “pre-diabetic” or have diabetes. It is an estimate of your average blood glucose (or “blood sugar”) level over the past 3 months. A level between 5.7 and 6.4% may indicate that you have pre-diabetes. People with diabetes generally have levels of 6.5% or more.
ApoB is the protein found in the LDL particle. Since there is one ApoB in each LDL particle, measuring ApoB tells us how many LDL particles, which are associated with cardiovascular disease, there are. Measuring ApoB can be especially helpful if the triglycerides are elevated.
Other laboratory tests*
LDL particle number
LDL particle number (LDL-P) measures the actual number of LDL cholesterol particles in your blood. Some studies suggest that individuals with a higher number of LDL particles have a greater risk of heart disease.
Your triglyceride count may affect the LDL-P. In most cases, the higher your triglycerides, the greater the number of LDL particles. Patients who are overweight, have elevated triglycerides, and have elevated blood sugar are likely to have increased particle numbers.
The LDL-C reflects the concentration of cholesterol within all the LDL particles rather than the number of particles. Some patients with relatively low LDL-C levels, but who have increased particle numbers, may be at greater risk for heart disease. The usefulness of this test is uncertain and debated in the medical community.
Reference Range for LDL-P
LDL-P is measured by a nuclear magnetic resonance (NMR) lipid profile test. A value of less than 1,000 is considered ideal. Above 2,000 is considered very high. LDL-P is measured in nmol/L.
How you can lower your LDL-P
Statin drugs lower LDL-P substantially, as do most medications that lower LDL-C because they work by helping your body clear LDL particles from the circulation. Reducing your intake of fats and starches as well as getting plenty of exercise leading to weight loss will also help lower LDL-P.
As mentioned, people with high levels of triglycerides and low HDL-C are likely to have high LDL-P despite normal or low LDL-C. These individuals will benefit most from low-carbohydrate diets, exercise, and weight loss to reduce LDL-P.
*The Foundation of the NLA does not make a recommendation for using the test(s) covered in this section. However, your healthcare team may choose to order them for additional information.