Hyperlipoproteinemia laboratory findings
Lipoprotein Disorders Microchapters |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hardik Patel, M.D., Aditya Govindavarjhulla, M.B.B.S. [2]
Overview
Laboratory Findings
Complete Lipid Profile
The US National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) suggests screening asymptomatic individuals with a complete fasting lipid profile every 5 years, with a shorter interval for those with high-normal lipid levels and longer interval for low-risk individuals with low or normal lipid levels. Obtain complete lipid profile after 9 to 12-hour fast. The reference values according to ATP III classification for making the diagnosis and risk stratification are depicted below:
Levels of total cholesterol (mg/dl) | |
< 200 | Desirable |
200 - 239 | Borderline high |
≥ 240 | High |
Levels of LDL cholesterol (mg/dl) | |
< 100 | Optimal |
100 - 129 | Near optimal |
130 - 159 | Borderline high |
160 - 189 | High |
≥ 190 | Very high |
Levels of HDL Cholesterol (mg/dl) | |
< 40 | Low |
≥ 60 | High |
Levels of serum triglycerides (mg/dl) | |
< 150 | Normal |
150 - 199 | Borderline high |
200 - 499 | High |
≥ 500 | Very high |
Other Laboratory Tests
For careful medical evaluation, must take into consideration all medications (both prescription and over-the-counter medications) and perform following tests to rule out secondary hyperlipidemias:
- Random blood sugar
- HbA1c
- Serum thyroid-stimulating hormone
- Liver function tests
- Renal function tests
- Urinalysis
Other tests that may be done include: Studies of cells called fibroblasts to see how the body absorbs LDL cholesterol Gene or receptor analysis for the defect associated with this condition.
Approach
Shown below is an diagnostic algorithm to diagnose hyperlipidemia.[1]
Hyperlipidemia | |||||||||||||||||||||||||||||||||||||||||
Triglycerides > 75th Percentile | NO | Type IIa | |||||||||||||||||||||||||||||||||||||||
YES | |||||||||||||||||||||||||||||||||||||||||
Types I, IIb, IV, V | |||||||||||||||||||||||||||||||||||||||||
Total Cholesterol/Apo B ratio ≥ 6.2 | NO | Types IIb, IV | |||||||||||||||||||||||||||||||||||||||
YES | |||||||||||||||||||||||||||||||||||||||||
Types I, III, V | |||||||||||||||||||||||||||||||||||||||||
Triglycerides/Apo B ratio < 10.0 | NO | Types I, V | |||||||||||||||||||||||||||||||||||||||
YES | |||||||||||||||||||||||||||||||||||||||||
Type III | |||||||||||||||||||||||||||||||||||||||||
References
- ↑ Sniderman A, Tremblay A, Bergeron J, Gagné C, Couture P (2007). "Diagnosis of type III hyperlipoproteinemia from plasma total cholesterol, triglyceride, and apolipoprotein B". Journal of Clinical Lipidology. 1 (4): 256–63. doi:10.1016/j.jacl.2007.07.006. PMID 21291689. Retrieved 2012-10-24. Unknown parameter
|month=
ignored (help)