Lipid profile

 

Alternative names, keywords

Total cholesterol, HDL cholesterol, HDL-C, high-density lipoprotein cholesterol, LDL cholesterol, LDL-C, low-density lipoprotein cholesterol, non-HDL cholesterol, triglyceride

Samples required

Clotted blood (gold cap, 5 mL tube). Smaller tubes are available for paediatric samples.

NICE CG181 recommends that patients no longer have to fast for routine lipid profile assessment.

Test indications

 

Test information

 

Non-fasting lipid profile:     

Fasting lipid profile (12 - 14h water only):

cholesterol
HDL cholesterol
triglyceride
TC/HDL ratio
non-HDL cholesterol

cholesterol
HDL cholesterol
triglyceride
TC/HDL ratio
non-HDL cholesterol
calculated LDL

 

Factors affecting test performance/ results

Cholesterol

N‑Acetylcysteine at the therapeutic concentration when used as a paracetamol antidote, and the paracetamol metabolite N‑acetyl‑p‑benzoquinone imine (NAPQI) independently may cause falsely low results.

Venepuncture immediately after or during the administration of metamizole may lead to falsely low results.

In very rare cases, gammopathy, in particular type IgM (Waldenström’s macroglobulinemia), may cause unreliable results.

HDL cholesterol

Elevated concentrations of free fatty acids and denatured proteins may cause falsely elevated HDL‑cholesterol results.

In rare cases, elevated immunoglobulin concentrations can lead to artificially increased HDL‑cholesterol results.

Abnormal liver function affects lipid metabolism; consequently, HDL and LDL results are of limited diagnostic value.

N‑Acetylcysteine at the therapeutic concentration when used as a paracetamol antidote, and the paracetamol metabolite N‑acetyl‑p‑benzoquinone imine (NAPQI), independently may cause falsely low results.

Venepuncture immediately after or during the administration of metamizole may lead to falsely low results.

In very rare cases, gammopathy, in particular type IgM (Waldenström’s macroglobulinemia), may cause unreliable results.

Triglyceride

Endogenous unesterified glycerol in the sample will falsely elevate serum triglycerides.

Dicynone (Etamsylate) at therapeutic concentrations may lead to false‑low results.

Ascorbic acid and calcium dobesilate cause artificially low triglyceride results.

Intralipid is directly measured as analyte in this assay and leads to high triglyceride results.

Paracetamol intoxications are frequently treated with N‑Acetylcysteine. N‑Acetylcysteine at a plasma concentration above 166 mg/L, and the paracetamol metabolite N‑acetyl‑p‑benzoquinone imine (NAPQI) independently may cause falsely low results.

Venepuncture immediately after or during the administration of metamizole may lead to falsely low results. A significant interference may occur at plasma metamizole concentrations above 0.05 mg/mL.

In very rare cases, gammopathy, in particular type IgM (Waldenström’s macroglobulinemia), may cause unreliable results.

 

Results should always be assessed in conjunction with the patient’s medical history, clinical examination and other findings.

Reference range

Cholesterol (total)

Adult < 5.0 mmol/L *

Risks increase with total cholesterol above 4.0 mmol/L and/or LDL cholesterol above 2 mmol/L

HDL cholesterol

> 1.0 mmol/L *

Non-HDL cholesterol

< 3.9 mmol/L *

LDL cholesterol

Calculation:
LDL = total - HDL - (trigs/2.19), only valid if TG is less than 3. If TG>3 a direct LDL assay is performed.

For calculation to be valid, patient should be fasting (i.e. 12 - 14h water only)

< 3.0 mmol/L *

Risks increase with total cholesterol above 4.0 mmol/L and/or LDL cholesterol above 2 mmol/L.
 

Total:HDL cholesterol ratio

< 4

Please see guidance in rear section of British National Formulary.

Triglycerides (triacylglycerol)

< 2.0 mmol/L *

Note new reference range introduced 22.8.16

A fasting repeat is recommended if the non-fasting triglyceride is > 5 mmol/L

* Source: Fasting is not routinely required for determination of a lipid profile... - a joint consensus statement from the European Atherosclerosis Society and European Federation of Clinical Chemistry and Laboratory Medicine.
Nordestgaard BG et al. European Heart Journal (2016) 37 , 1944–1958. doi:10.1093/eurheartj/ehw1520

Turnaround time

Same day

Enquiries

Biochemistry (Automation)