Measurement of blood lipids and lipoproteins
- Robert S Rosenson, MD
Robert S Rosenson, MD
- Section Editor — Lipids
- Professor of Medicine
- Mount Sinai School of Medicine
- Director, Cardiometabolic Disorders
- Mount Sinai Heart
- Section Editor
- Mason W Freeman, MD
Mason W Freeman, MD
- Section Editor — Lipids
- Professor of Medicine
- Harvard Medical School
- Deputy Editors
- Howard Libman, MD, FACP
Howard Libman, MD, FACP
- Deputy Editor — Primary Care (Adult)
- Professor of Medicine, Emeritus
- Harvard Medical School
- Gordon M Saperia, MD, FACC
Gordon M Saperia, MD, FACC
- Senior Deputy Editor — UpToDate
- Deputy Editor — Cardiovascular Medicine
- Assistant Professor of Medicine
- Tufts University School of Medicine
Lipids, such as cholesterol and triglyceride, are insoluble in plasma. They are made soluble by attachment to circulating lipoproteins that transport lipids to various tissues for energy utilization, lipid deposition, steroid hormone production, and bile acid formation. The lipoprotein consists of esterified and unesterified cholesterol, triglycerides, and phospholipids, and protein.
There are five major lipoproteins in blood: chylomicrons; very low-density lipoprotein (VLDL); intermediate-density lipoprotein (IDL); low-density lipoprotein (LDL); and high-density lipoprotein (HDL). Each of these classes of lipoproteins carries cholesterol and triglyceride to a varying degree, with LDL carrying the majority of cholesterol and VLDL carrying the majority of triglyceride.
In general, patient care issues related to screening, diagnosis, and treatment are based on the results of the measurement of serum lipids, which is generally accomplished by obtaining a lipid profile. On occasion, measurement of serum lipoproteins is necessary for one or more of these purposes. This topic will discuss the issues relevant to the measurement of serum lipids and lipoproteins. Other issues related to lipids and lipoproteins, such as their role in atherosclerosis, are discussed separately. (See "Lipoprotein classification, metabolism, and role in atherosclerosis".)
LIPID PROFILE AND COMPONENTS
A standard serum lipid profile measures the concentration of total and high-density lipoprotein (HDL) cholesterol as well as the triglycerides. With these values, the low-density lipoprotein (LDL) cholesterol concentration can be estimated. (See 'LDL cholesterol' below.)
Total and HDL cholesterol — Serum total and HDL-C are measured directly and can be obtained in fasting or nonfasting individuals; there are only small, clinically insignificant differences in these values between measurements in the fasting or non-fasting state . (See 'Fasting versus non-fasting tests' below.)To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
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- LIPID PROFILE AND COMPONENTS
- Total and HDL cholesterol
- Total cholesterol to HDL cholesterol ratio
- LDL cholesterol
- - Friedewald equation
- - Direct measurement
- - Other indirect methods
- LDL PARTICLE SIZE AND NUMBER
- NON-HDL CHOLESTEROL
- INDICATIONS FOR MEASUREMENT
- Lipid profile
- LDL cholesterol
- Other measurements of LDL
- FASTING VERSUS NON-FASTING TESTS
- CAUSES OF INACCURATE RESULTS
- SOCIETY GUIDELINE LINKS
- SUMMARY AND RECOMMENDATIONS