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</li> <li id="toc-All-direct" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#All-direct"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.2</span> <span>All-direct</span> </div> </a> <ul id="toc-All-direct-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Implications" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Implications"> <div class="vector-toc-text"> <span class="vector-toc-numb">4</span> <span>Implications</span> </div> </a> <ul id="toc-Implications-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-References" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#References"> <div class="vector-toc-text"> <span class="vector-toc-numb">5</span> <span>References</span> </div> </a> <ul id="toc-References-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Further_reading" 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Available in 15 languages" > <label id="p-lang-btn-label" for="p-lang-btn-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--action-progressive mw-portlet-lang-heading-15" aria-hidden="true" ><span class="vector-icon mw-ui-icon-language-progressive mw-ui-icon-wikimedia-language-progressive"></span> <span class="vector-dropdown-label-text">15 languages</span> </label> <div class="vector-dropdown-content"> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li class="interlanguage-link interwiki-es mw-list-item"><a href="https://es.wikipedia.org/wiki/Perfil_lip%C3%ADdico" title="Perfil lipídico – Spanish" lang="es" hreflang="es" data-title="Perfil lipídico" data-language-autonym="Español" data-language-local-name="Spanish" class="interlanguage-link-target"><span>Español</span></a></li><li class="interlanguage-link interwiki-fr mw-list-item"><a href="https://fr.wikipedia.org/wiki/Exploration_d%27une_anomalie_lipidique" title="Exploration d'une anomalie lipidique – French" lang="fr" hreflang="fr" data-title="Exploration d'une anomalie lipidique" data-language-autonym="Français" data-language-local-name="French" class="interlanguage-link-target"><span>Français</span></a></li><li class="interlanguage-link interwiki-gl mw-list-item"><a href="https://gl.wikipedia.org/wiki/Perfil_lip%C3%ADdico" title="Perfil lipídico – Galician" lang="gl" hreflang="gl" data-title="Perfil lipídico" data-language-autonym="Galego" data-language-local-name="Galician" class="interlanguage-link-target"><span>Galego</span></a></li><li class="interlanguage-link interwiki-gu mw-list-item"><a href="https://gu.wikipedia.org/wiki/%E0%AA%B2%E0%AA%BF%E0%AA%AA%E0%AB%80%E0%AA%A1_%E0%AA%AA%E0%AB%8D%E0%AA%B0%E0%AB%8B%E0%AA%AB%E0%AA%BE%E0%AA%87%E0%AA%B2" title="લિપીડ પ્રોફાઇલ – Gujarati" lang="gu" hreflang="gu" data-title="લિપીડ પ્રોફાઇલ" data-language-autonym="ગુજરાતી" data-language-local-name="Gujarati" class="interlanguage-link-target"><span>ગુજરાતી</span></a></li><li class="interlanguage-link interwiki-hy mw-list-item"><a href="https://hy.wikipedia.org/wiki/%D4%BC%D5%AB%D5%BA%D5%AB%D5%A4%D5%A1%D5%B5%D5%AB%D5%B6_%D5%BA%D6%80%D5%B8%D6%86%D5%AB%D5%AC" title="Լիպիդային պրոֆիլ – Armenian" lang="hy" hreflang="hy" data-title="Լիպիդային պրոֆիլ" data-language-autonym="Հայերեն" data-language-local-name="Armenian" class="interlanguage-link-target"><span>Հայերեն</span></a></li><li class="interlanguage-link interwiki-hi mw-list-item"><a href="https://hi.wikipedia.org/wiki/%E0%A4%B2%E0%A4%BF%E0%A4%AA%E0%A4%BF%E0%A4%A1_%E0%A4%AA%E0%A5%8D%E0%A4%B0%E0%A5%8B%E0%A4%AB%E0%A4%BE%E0%A4%87%E0%A4%B2" title="लिपिड प्रोफाइल – Hindi" lang="hi" hreflang="hi" data-title="लिपिड प्रोफाइल" data-language-autonym="हिन्दी" data-language-local-name="Hindi" class="interlanguage-link-target"><span>हिन्दी</span></a></li><li class="interlanguage-link interwiki-he mw-list-item"><a href="https://he.wikipedia.org/wiki/%D7%A4%D7%A8%D7%95%D7%A4%D7%99%D7%9C_%D7%A9%D7%95%D7%9E%D7%A0%D7%99%D7%9D" title="פרופיל שומנים – Hebrew" lang="he" hreflang="he" data-title="פרופיל שומנים" data-language-autonym="עברית" data-language-local-name="Hebrew" class="interlanguage-link-target"><span>עברית</span></a></li><li class="interlanguage-link interwiki-pt mw-list-item"><a href="https://pt.wikipedia.org/wiki/Perfil_lip%C3%ADdico" title="Perfil lipídico – Portuguese" lang="pt" hreflang="pt" data-title="Perfil lipídico" data-language-autonym="Português" data-language-local-name="Portuguese" class="interlanguage-link-target"><span>Português</span></a></li><li class="interlanguage-link interwiki-ckb mw-list-item"><a href="https://ckb.wikipedia.org/wiki/%D9%BE%DA%95%DB%86%D9%81%D8%A7%DB%8C%D9%84%DB%8C_%DA%86%DB%95%D9%88%D8%B1%DB%8C%DB%8C%DB%95%DA%A9%D8%A7%D9%86" title="پڕۆفایلی چەورییەکان – Central Kurdish" lang="ckb" hreflang="ckb" data-title="پڕۆفایلی چەورییەکان" data-language-autonym="کوردی" data-language-local-name="Central Kurdish" class="interlanguage-link-target"><span>کوردی</span></a></li><li class="interlanguage-link interwiki-sr mw-list-item"><a href="https://sr.wikipedia.org/wiki/%D0%9B%D0%B8%D0%BF%D0%B8%D0%B4%D0%BD%D0%B8_%D1%81%D1%82%D0%B0%D1%82%D1%83%D1%81" title="Липидни статус – Serbian" lang="sr" hreflang="sr" data-title="Липидни статус" data-language-autonym="Српски / srpski" data-language-local-name="Serbian" class="interlanguage-link-target"><span>Српски / srpski</span></a></li><li class="interlanguage-link interwiki-sv mw-list-item"><a href="https://sv.wikipedia.org/wiki/Lipidprofil" title="Lipidprofil – Swedish" lang="sv" hreflang="sv" data-title="Lipidprofil" data-language-autonym="Svenska" data-language-local-name="Swedish" class="interlanguage-link-target"><span>Svenska</span></a></li><li class="interlanguage-link interwiki-uk mw-list-item"><a href="https://uk.wikipedia.org/wiki/%D0%9B%D1%96%D0%BF%D1%96%D0%B4%D0%BD%D0%B8%D0%B9_%D0%BF%D1%80%D0%BE%D1%84%D1%96%D0%BB%D1%8C" title="Ліпідний профіль – Ukrainian" lang="uk" hreflang="uk" data-title="Ліпідний профіль" data-language-autonym="Українська" data-language-local-name="Ukrainian" class="interlanguage-link-target"><span>Українська</span></a></li><li class="interlanguage-link interwiki-vi mw-list-item"><a href="https://vi.wikipedia.org/wiki/Bilan_Lipid" title="Bilan Lipid – Vietnamese" lang="vi" hreflang="vi" data-title="Bilan Lipid" data-language-autonym="Tiếng Việt" data-language-local-name="Vietnamese" class="interlanguage-link-target"><span>Tiếng Việt</span></a></li><li class="interlanguage-link interwiki-zh-yue mw-list-item"><a href="https://zh-yue.wikipedia.org/wiki/%E9%A9%97%E8%A1%80%E8%84%82" title="驗血脂 – Cantonese" lang="yue" hreflang="yue" data-title="驗血脂" data-language-autonym="粵語" data-language-local-name="Cantonese" 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<div class="mw-indicators"> </div> <div id="siteSub" class="noprint">From Wikipedia, the free encyclopedia</div> </div> <div id="contentSub"><div id="mw-content-subtitle"></div></div> <div id="mw-content-text" class="mw-body-content"><div class="mw-content-ltr mw-parser-output" lang="en" dir="ltr"><div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Panel of blood tests</div> <p class="mw-empty-elt"> </p> <div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Medical diagnostic method </div> <style data-mw-deduplicate="TemplateStyles:r1257001546">.mw-parser-output .infobox-subbox{padding:0;border:none;margin:-3px;width:auto;min-width:100%;font-size:100%;clear:none;float:none;background-color:transparent}.mw-parser-output .infobox-3cols-child{margin:auto}.mw-parser-output .infobox .navbar{font-size:100%}@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-full-data:not(.notheme)>div:not(.notheme)[style]{background:#1f1f23!important;color:#f8f9fa}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-full-data:not(.notheme) div:not(.notheme){background:#1f1f23!important;color:#f8f9fa}}@media(min-width:640px){body.skin--responsive .mw-parser-output .infobox-table{display:table!important}body.skin--responsive .mw-parser-output .infobox-table>caption{display:table-caption!important}body.skin--responsive .mw-parser-output .infobox-table>tbody{display:table-row-group}body.skin--responsive .mw-parser-output .infobox-table tr{display:table-row!important}body.skin--responsive .mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}</style><table class="infobox"><tbody><tr><th colspan="2" class="infobox-above" style="background-color: lightblue">Lipid profile</th></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_Subject_Headings" title="Medical Subject Headings">MeSH</a></th><td class="infobox-data"><span class="reflink plainlinks nourlexpansion"><a rel="nofollow" class="external text" href="https://meshb.nlm.nih.gov/record/ui?ui=-">-</a></span></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/MedlinePlus" title="MedlinePlus">MedlinePlus</a></th><td class="infobox-data"><span class="reflink plainlinks nourlexpansion"><a rel="nofollow" class="external text" href="https://medlineplus.gov/ency/article/003491.htm">003491</a></span></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/EMedicine" title="EMedicine">eMedicine</a></th><td class="infobox-data"><span class="reflink plainlinks nourlexpansion"><a rel="nofollow" class="external text" href="http://emedicine.medscape.com/article/--overview">-</a></span></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/LOINC" title="LOINC">LOINC</a></th><td class="infobox-data"><a rel="nofollow" class="external text" href="https://s.details.loinc.org/LOINC/24331-1.html?sections=Comprehensive">24331-1</a>, <a rel="nofollow" class="external text" href="https://s.details.loinc.org/LOINC/57698-3.html?sections=Comprehensive">57698-3</a></td></tr></tbody></table> <p>A <b>lipid profile</b> or <b>lipid panel</b> is a <a href="/wiki/Test_panel" title="Test panel">panel</a> of <a href="/wiki/Blood_test" title="Blood test">blood tests</a> used to find abnormalities in <a href="/wiki/Blood_lipid" class="mw-redirect" title="Blood lipid">blood lipid</a> ( such as <a href="/wiki/Cholesterol" title="Cholesterol">cholesterol</a> and <a href="/wiki/Triglyceride" title="Triglyceride">triglycerides</a>) concentrations.<sup class="noprint Inline-Template" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources in the body of the article. (May 2020)">not verified in body</span></a></i>]</sup> The results of this test can identify certain <a href="/wiki/Inborn_error_of_lipid_metabolism" title="Inborn error of lipid metabolism">genetic diseases</a> and can determine approximate risks for <a href="/wiki/Cardiovascular_disease" title="Cardiovascular disease">cardiovascular disease</a>, certain forms of <a href="/wiki/Pancreatitis" title="Pancreatitis">pancreatitis</a>, and other diseases. </p><p>Lipid panels are usually ordered as part of a <a href="/wiki/Physical_exam" class="mw-redirect" title="Physical exam">physical exam</a>, along with other panels such as the <a href="/wiki/Complete_blood_count" title="Complete blood count">complete blood count</a> (CBC) and <a href="/wiki/Basic_metabolic_panel" title="Basic metabolic panel">basic metabolic panel</a> (BMP).<sup class="noprint Inline-Template" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources in the body of the article. (May 2020)">not verified in body</span></a></i>]</sup> </p> <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="Components">Components</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Lipid_profile&action=edit&section=1" title="Edit section: Components"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>A lipid profile report typically includes:<sup id="cite_ref-StatPearls_1-0" class="reference"><a href="#cite_note-StatPearls-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> </p> <ul><li><a href="/wiki/Low-density_lipoprotein" title="Low-density lipoprotein">Low-density lipoprotein</a> (LDL)</li> <li><a href="/wiki/High-density_lipoprotein" title="High-density lipoprotein">High-density lipoprotein</a> (HDL)</li> <li>Total <a href="/wiki/Triglyceride" title="Triglyceride">triglycerides</a></li> <li>Total <a href="/wiki/Cholesterol" title="Cholesterol">cholesterol</a></li></ul> <p>LDL is not usually actually measured, but calculated from the other three using the <i>Friedewald equation</i>.<sup id="cite_ref-StatPearls_1-1" class="reference"><a href="#cite_note-StatPearls-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> A laboratory can optionally calculate the two extra values from the report: </p> <ul><li><a href="/wiki/Very_low-density_lipoprotein" title="Very low-density lipoprotein">Very low-density lipoprotein</a> (VLDL)</li> <li>Cholesterol:HDL ratio</li></ul> <div class="mw-heading mw-heading2"><h2 id="Procedure_and_indication">Procedure and indication</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Lipid_profile&action=edit&section=2" title="Edit section: Procedure and indication"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Recommendations for cholesterol testing come from the Adult Treatment Panel (ATP) III guidelines, and are based on many large clinical studies, such as the <a href="/wiki/Framingham_Heart_Study" title="Framingham Heart Study">Framingham Heart Study</a>.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (April 2022)">citation needed</span></a></i>]</sup> </p><p>For healthy adults with no cardiovascular risk factors, the ATP III guidelines recommend screening once every five years.<sup id="cite_ref-2" class="reference"><a href="#cite_note-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> A lipid profile may also be ordered at regular intervals to evaluate the success of lipid-lowering drugs such as <a href="/wiki/Statin" title="Statin">statins</a>.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (April 2022)">citation needed</span></a></i>]</sup> </p><p>In the pediatric and adolescent population, lipid testing is not routinely performed. However, the <a href="/wiki/American_Academy_of_Pediatrics" title="American Academy of Pediatrics">American Academy of Pediatrics</a> and the <a href="/wiki/National_Heart,_Lung,_and_Blood_Institute" title="National Heart, Lung, and Blood Institute">National Heart, Lung, and Blood Institute</a> (NHLBI) recommend that children aged 9–11 be screened once for severe cholesterol abnormalities.<sup id="cite_ref-3" class="reference"><a href="#cite_note-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> This screening can be valuable to detect <a href="/wiki/Inborn_error_of_lipid_metabolism" title="Inborn error of lipid metabolism">genetic diseases</a> such as <a href="/wiki/Familial_hypercholesterolemia" title="Familial hypercholesterolemia">familial hypercholesterolemia</a> that can be lethal if not treated early.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (July 2020)">citation needed</span></a></i>]</sup> </p><p>Traditionally, most laboratories have required patients to fast for 9–12 hours before screening. However, studies have questioned the utility of <a href="/wiki/Fasting" title="Fasting">fasting</a> before lipid panels, and some diagnostic labs routinely accept non-fasting samples.<sup id="cite_ref-4" class="reference"><a href="#cite_note-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-5" class="reference"><a href="#cite_note-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-6" class="reference"><a href="#cite_note-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Fasting_lipid_test_7-0" class="reference"><a href="#cite_note-Fasting_lipid_test-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Methods">Methods</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Lipid_profile&action=edit&section=3" title="Edit section: Methods"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="mw-heading mw-heading3"><h3 id="Friedewald">Friedewald</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Lipid_profile&action=edit&section=4" title="Edit section: Friedewald"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Typically the laboratory measures only three quantities: total cholesterol; HDL; Triglycerides. A typical procedure used by <a href="/wiki/NHANES" class="mw-redirect" title="NHANES">NHANES</a> 2004 uses the following measurement methods:<sup id="cite_ref-h704_8-0" class="reference"><a href="#cite_note-h704-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> </p> <ul><li>Total cholesterol is measured using a mixture of enzymes. First an esterase converts cholesterol esters into cholesterol and free fatty acid. Then an oxidase oxidizes the cholesterol, producing a H<sub>2</sub>O<sub>2</sub> side-product that changes the color of a dye. The amount of oxidation can be precisely quantified by light absorbance at 500 nm.<sup id="cite_ref-h704_8-1" class="reference"><a href="#cite_note-h704-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup></li> <li>Triglyceride concentration is also measured using an enzyme mixture. A lipase releases <a href="/wiki/Glycerol" title="Glycerol">glycerol</a> from the molecules, which gets oxidized by another enzyme while producing H<sub>2</sub>O<sub>2</sub>. The same color-change follows.<sup id="cite_ref-h704_8-2" class="reference"><a href="#cite_note-h704-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup></li> <li>HDL is measured in two steps. First a special reagent is added to the serum that binds apoB-containing lipoprotein particles, shielding them from the enzymes in the next step. Then a mixture of <a href="/wiki/PEGylation" title="PEGylation">PEGylated</a> enzymes is added with dye. The chemical reaction is the same as the total cholesterol measurement, except that the enzymes are blocked from acting on non-HDL lipoproteins by the reagent and their own PEG tails.<sup id="cite_ref-h704_8-3" class="reference"><a href="#cite_note-h704-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup></li></ul> <p>From these three data LDL may be calculated. According to Friedewald's equation:<sup id="cite_ref-Friedewald-Levy-Fredrickson-1972_9-0" class="reference"><a href="#cite_note-Friedewald-Levy-Fredrickson-1972-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> </p> <ul><li>[LDL] <span class="texhtml"> = </span> [Total cholesterol] − [HDL] − <style data-mw-deduplicate="TemplateStyles:r1214402035">.mw-parser-output .sfrac{white-space:nowrap}.mw-parser-output .sfrac.tion,.mw-parser-output .sfrac .tion{display:inline-block;vertical-align:-0.5em;font-size:85%;text-align:center}.mw-parser-output .sfrac .num{display:block;line-height:1em;margin:0.0em 0.1em;border-bottom:1px solid}.mw-parser-output .sfrac .den{display:block;line-height:1em;margin:0.1em 0.1em}.mw-parser-output .sr-only{border:0;clip:rect(0,0,0,0);clip-path:polygon(0px 0px,0px 0px,0px 0px);height:1px;margin:-1px;overflow:hidden;padding:0;position:absolute;width:1px}</style><span class="sfrac">⁠<span class="tion"><span class="num"> [Triglycerides] </span><span class="sr-only">/</span><span class="den">5</span></span>⁠</span></li></ul> <p>Other calculations of LDL from those same three data have been proposed which yield some significantly different results.<sup id="cite_ref-10" class="reference"><a href="#cite_note-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> </p><p>VLDL can be defined as the total cholesterol that is neither HDL nor LDL. With that definition, Friedewald's equation<sup id="cite_ref-Friedewald-Levy-Fredrickson-1972_9-1" class="reference"><a href="#cite_note-Friedewald-Levy-Fredrickson-1972-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> yields: </p> <ul><li>[VLDL] <span class="texhtml"> = </span> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1214402035"><span class="sfrac">⁠<span class="tion"><span class="num"> [Triglycerides] </span><span class="sr-only">/</span><span class="den">5</span></span>⁠</span></li></ul> <p>The alternative calculations mentioned above may yield significantly different values for VLDL. </p><p>The Friedewald method is reasonably reliable for the majority of patients, but is notably inaccurate in patients with <a href="/wiki/Hypertriglyceridemia" title="Hypertriglyceridemia">hypertriglyceridemia</a> (> 400 mg/dL or 4.5 mmol/L). It also underestimates LDL-C in patients with low LDL-C (< 25 mg/dL or 0.6 mmol/L). It does not take into account <a href="/wiki/Intermediate-density_lipoprotein" title="Intermediate-density lipoprotein">intermediate-density lipoprotein</a>.<sup id="cite_ref-StatPearls_1-2" class="reference"><a href="#cite_note-StatPearls-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> </p><p>A "Martin/Hopkins" variation that takes into how triglycerides-to-VLDL ratio tends to vary with other parameters appears more reliable and accurate.<sup id="cite_ref-11" class="reference"><a href="#cite_note-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-12" class="reference"><a href="#cite_note-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-pmid34709388_13-0" class="reference"><a href="#cite_note-pmid34709388-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="All-direct">All-direct</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Lipid_profile&action=edit&section=5" title="Edit section: All-direct"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Every part of the lipid panel can be measured directly using ultracentrifugation, which is the <a href="/wiki/Gold_standard" title="Gold standard">gold standard</a>.<sup id="cite_ref-StatPearls_1-3" class="reference"><a href="#cite_note-StatPearls-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> This type of measurement involves no errors from estimation and can also measure <a href="/wiki/Intermediate-density_lipoprotein" title="Intermediate-density lipoprotein">IDL</a>-C and <a href="/wiki/Lp(a)" class="mw-redirect" title="Lp(a)">Lp(a)</a>-C levels. Fully direct measurement is more costly, however.<sup id="cite_ref-pmid24240933_14-0" class="reference"><a href="#cite_note-pmid24240933-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup> </p><p>Laboratories may also use proprietrary tests for "direct chemical LDL-C" which require no prior separation by centrifugation. These tests are not yet standardized in US and Europe and lack validation.<sup id="cite_ref-pmid34709388_13-1" class="reference"><a href="#cite_note-pmid34709388-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup> A specific version of the test seems popular in Japan, however.<sup id="cite_ref-15" class="reference"><a href="#cite_note-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> A number of other LDL-C determination methods have been used in the past or have been proposed for future use.<sup id="cite_ref-16" class="reference"><a href="#cite_note-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Implications">Implications</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Lipid_profile&action=edit&section=6" title="Edit section: Implications"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1251242444">.mw-parser-output .ambox{border:1px solid #a2a9b1;border-left:10px solid #36c;background-color:#fbfbfb;box-sizing:border-box}.mw-parser-output .ambox+link+.ambox,.mw-parser-output .ambox+link+style+.ambox,.mw-parser-output .ambox+link+link+.ambox,.mw-parser-output .ambox+.mw-empty-elt+link+.ambox,.mw-parser-output .ambox+.mw-empty-elt+link+style+.ambox,.mw-parser-output .ambox+.mw-empty-elt+link+link+.ambox{margin-top:-1px}html body.mediawiki .mw-parser-output .ambox.mbox-small-left{margin:4px 1em 4px 0;overflow:hidden;width:238px;border-collapse:collapse;font-size:88%;line-height:1.25em}.mw-parser-output .ambox-speedy{border-left:10px solid #b32424;background-color:#fee7e6}.mw-parser-output .ambox-delete{border-left:10px solid #b32424}.mw-parser-output .ambox-content{border-left:10px solid #f28500}.mw-parser-output .ambox-style{border-left:10px solid #fc3}.mw-parser-output .ambox-move{border-left:10px solid #9932cc}.mw-parser-output .ambox-protection{border-left:10px solid #a2a9b1}.mw-parser-output .ambox .mbox-text{border:none;padding:0.25em 0.5em;width:100%}.mw-parser-output .ambox .mbox-image{border:none;padding:2px 0 2px 0.5em;text-align:center}.mw-parser-output .ambox .mbox-imageright{border:none;padding:2px 0.5em 2px 0;text-align:center}.mw-parser-output .ambox .mbox-empty-cell{border:none;padding:0;width:1px}.mw-parser-output .ambox .mbox-image-div{width:52px}@media(min-width:720px){.mw-parser-output .ambox{margin:0 10%}}@media print{body.ns-0 .mw-parser-output .ambox{display:none!important}}</style><table class="box-Unreferenced_section plainlinks metadata ambox ambox-content ambox-Unreferenced" role="presentation"><tbody><tr><td class="mbox-image"><div class="mbox-image-div"><span typeof="mw:File"><a href="/wiki/File:Question_book-new.svg" class="mw-file-description"><img alt="" src="//upload.wikimedia.org/wikipedia/en/thumb/9/99/Question_book-new.svg/50px-Question_book-new.svg.png" decoding="async" width="50" height="39" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/9/99/Question_book-new.svg/75px-Question_book-new.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/9/99/Question_book-new.svg/100px-Question_book-new.svg.png 2x" data-file-width="512" data-file-height="399" /></a></span></div></td><td class="mbox-text"><div class="mbox-text-span">This section <b>does not <a href="/wiki/Wikipedia:Citing_sources" title="Wikipedia:Citing sources">cite</a> any <a href="/wiki/Wikipedia:Verifiability" title="Wikipedia:Verifiability">sources</a></b>.<span class="hide-when-compact"> Please help <a href="/wiki/Special:EditPage/Lipid_profile" title="Special:EditPage/Lipid profile">improve this section</a> by <a href="/wiki/Help:Referencing_for_beginners" title="Help:Referencing for beginners">adding citations to reliable sources</a>. Unsourced material may be challenged and <a href="/wiki/Wikipedia:Verifiability#Burden_of_evidence" title="Wikipedia:Verifiability">removed</a>.</span> <span class="date-container"><i>(<span class="date">May 2020</span>)</i></span><span class="hide-when-compact"><i> (<small><a href="/wiki/Help:Maintenance_template_removal" title="Help:Maintenance template removal">Learn how and when to remove this message</a></small>)</i></span></div></td></tr></tbody></table> <style data-mw-deduplicate="TemplateStyles:r1236090951">.mw-parser-output .hatnote{font-style:italic}.mw-parser-output div.hatnote{padding-left:1.6em;margin-bottom:0.5em}.mw-parser-output .hatnote i{font-style:normal}.mw-parser-output .hatnote+link+.hatnote{margin-top:-0.5em}@media print{body.ns-0 .mw-parser-output .hatnote{display:none!important}}</style><div role="note" class="hatnote navigation-not-searchable">See also: <a href="/wiki/Low-density_lipoprotein" title="Low-density lipoprotein">LDL</a> and <a href="/wiki/High-density_lipoprotein" title="High-density lipoprotein">HDL</a></div> <p>This test is used to identify <a href="/wiki/Hyperlipidemia" title="Hyperlipidemia">dyslipidemia</a> (various disturbances of cholesterol and triglyceride levels), many forms of which are recognized risk factors for <a href="/wiki/Cardiovascular_disease" title="Cardiovascular disease">cardiovascular disease</a> and rarely <a href="/wiki/Pancreatitis" title="Pancreatitis">pancreatitis</a>. </p><p>A total cholesterol reading can be used to assess an individual's risk for heart disease; however, it should not be relied upon as the only indicator. The individual components that make up total cholesterol reading—<a href="/wiki/Low-density_lipoprotein" title="Low-density lipoprotein">LDL</a>, <a href="/wiki/High-density_lipoprotein" title="High-density lipoprotein">HDL</a>, and <a href="/wiki/Very_low-density_lipoprotein" title="Very low-density lipoprotein">VLDL</a>—are also important in measuring risk.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (July 2011)">citation needed</span></a></i>]</sup> </p><p>For instance, someone's total cholesterol may be high, but this may be due to very high HDL ("good cholesterol") cholesterol levels,—which can help prevent heart disease (the test is mainly concerned with high LDL, or "bad cholesterol" levels). So, while a high total cholesterol level may help give an indication that there is a problem with cholesterol levels, the components that make up total cholesterol should also be measured.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (July 2011)">citation needed</span></a></i>]</sup> </p> <div class="mw-heading mw-heading2"><h2 id="References">References</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Lipid_profile&action=edit&section=7" title="Edit section: References"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist reflist-columns references-column-width" style="column-width: 25em;"> <ol class="references"> <li id="cite_note-StatPearls-1"><span class="mw-cite-backlink">^ <a href="#cite_ref-StatPearls_1-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-StatPearls_1-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-StatPearls_1-2"><sup><i><b>c</b></i></sup></a> <a href="#cite_ref-StatPearls_1-3"><sup><i><b>d</b></i></sup></a></span> <span class="reference-text"><style data-mw-deduplicate="TemplateStyles:r1238218222">.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/a/aa/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .cs1-ws-icon a{background:url("//upload.wikimedia.org/wikipedia/commons/4/4c/Wikisource-logo.svg")right 0.1em center/12px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-free a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-subscription a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .cs1-ws-icon a{background-size:contain;padding:0 1em 0 0}.mw-parser-output .cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;color:var(--color-error,#d33)}.mw-parser-output .cs1-visible-error{color:var(--color-error,#d33)}.mw-parser-output .cs1-maint{display:none;color:#085;margin-left:0.3em}.mw-parser-output .cs1-kern-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right{padding-right:0.2em}.mw-parser-output .citation .mw-selflink{font-weight:inherit}@media screen{.mw-parser-output .cs1-format{font-size:95%}html.skin-theme-clientpref-night .mw-parser-output .cs1-maint{color:#18911f}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .cs1-maint{color:#18911f}}</style><cite id="CITEREFLeeSiddiqui2023" class="citation journal cs1">Lee Y, Siddiqui WJ (2023). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/books/NBK542294/">"Cholesterol Levels"</a>. <i>StatPearls</i>. 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title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=EJIFCC&rft.atitle=Methods+of+Low-Density+Lipoprotein-Cholesterol+Measurement%3A+Analytical+and+Clinical+Applications.&rft.volume=33&rft.issue=4&rft.pages=282-294&rft.date=2022-12&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC9768618%23id-name%3DPMC&rft_id=info%3Apmid%2F36605300&rft.aulast=Islam&rft.aufirst=SMT&rft.au=Osa-Andrews%2C+B&rft.au=Jones%2C+PM&rft.au=Muthukumar%2C+AR&rft.au=Hashim%2C+I&rft.au=Cao%2C+J&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC9768618&rfr_id=info%3Asid%2Fen.wikipedia.org%3ALipid+profile" class="Z3988"></span></span> </li> </ol></div> <div class="mw-heading mw-heading2"><h2 id="Further_reading">Further reading</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Lipid_profile&action=edit&section=8" title="Edit section: Further reading"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFTalwalkarSreenivasGulatiBaxi2013" class="citation journal cs1">Talwalkar PG, Sreenivas CG, Gulati A, Baxi H (July 2013). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3743362">"Journey in guidelines for lipid management: From adult treatment panel (ATP)-I to ATP-III and what to expect in ATP-IV"</a>. <i>Indian J Endocrinol Metab</i>. <b>17</b> (4): 628–635. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.4103%2F2230-8210.113753">10.4103/2230-8210.113753</a></span>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3743362">3743362</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/23961478">23961478</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Indian+J+Endocrinol+Metab&rft.atitle=Journey+in+guidelines+for+lipid+management%3A+From+adult+treatment+panel+%28ATP%29-I+to+ATP-III+and+what+to+expect+in+ATP-IV&rft.volume=17&rft.issue=4&rft.pages=628-635&rft.date=2013-07&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC3743362%23id-name%3DPMC&rft_id=info%3Apmid%2F23961478&rft_id=info%3Adoi%2F10.4103%2F2230-8210.113753&rft.aulast=Talwalkar&rft.aufirst=PG&rft.au=Sreenivas%2C+CG&rft.au=Gulati%2C+A&rft.au=Baxi%2C+H&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC3743362&rfr_id=info%3Asid%2Fen.wikipedia.org%3ALipid+profile" class="Z3988"></span></li></ul>    </div><noscript><img src="https://login.wikimedia.org/wiki/Special:CentralAutoLogin/start?type=1x1&useformat=desktop" alt="" width="1" height="1" style="border: none; position: absolute;"></noscript> <div class="printfooter" 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