The importance of routinely reporting non-HDL cholesterol by the clinical laboratory
Journal
EPMA Journal
Date Issued
2017
Author(s)
Kostovska, Irena
DOI
10.1007/s13167-017-0108-4
Abstract
Background. It is well known that a standard lipid profile measures total
cholesterol, triglycerides, and HDL cholesterol (HDL-c), while LDL cholesterol is estimated. Subtracting HDL-c from total cholesterol, we can measure the amount of cholesterol carried by all lipoproteins except HDL. This simple math will give the amount of non-HDL cholesterol
(non-HDL-c) within all atherogenic lipoproteins. However, although it is so easy, biochemical laboratories rarely report the value of non-HDL-c.
Aim of the study. The aim of our study is to highlight the results of several
studies that clearly establish the clinical use of non–HDL cholesterol as a
common predictor of blood lipid patterns associated with increased risk of
heart disease.
Material. Recent literary evidence and clinical studies.
Results. The most important document regarding non-HDL-c was delivered by the National Cholesterol Education Program Adult Treatment Panel III, where non–HDL-c was highlighted as a key secondary goal of therapy in lipid treatment and lipoprotein management. Other studies suggest that non-HDL-c shows a better correlation with small dense LDL particles than do other lipid parameters, including LDL-c. The treatment goal for non-HDL-c is usually 30 mg/dL above the LDL-c treatment target.
Conclusion. Knowing that non–HDL-c is superior to LDL-c for the prediction of cardiovascular events, it is very important for each clinical chemistry laboratory to report non–HDL-c as a part of routine lipid status, with no added expense. Doctors could use it for optimal prevention of
atherosclerosis and cardiovascular disease.
cholesterol, triglycerides, and HDL cholesterol (HDL-c), while LDL cholesterol is estimated. Subtracting HDL-c from total cholesterol, we can measure the amount of cholesterol carried by all lipoproteins except HDL. This simple math will give the amount of non-HDL cholesterol
(non-HDL-c) within all atherogenic lipoproteins. However, although it is so easy, biochemical laboratories rarely report the value of non-HDL-c.
Aim of the study. The aim of our study is to highlight the results of several
studies that clearly establish the clinical use of non–HDL cholesterol as a
common predictor of blood lipid patterns associated with increased risk of
heart disease.
Material. Recent literary evidence and clinical studies.
Results. The most important document regarding non-HDL-c was delivered by the National Cholesterol Education Program Adult Treatment Panel III, where non–HDL-c was highlighted as a key secondary goal of therapy in lipid treatment and lipoprotein management. Other studies suggest that non-HDL-c shows a better correlation with small dense LDL particles than do other lipid parameters, including LDL-c. The treatment goal for non-HDL-c is usually 30 mg/dL above the LDL-c treatment target.
Conclusion. Knowing that non–HDL-c is superior to LDL-c for the prediction of cardiovascular events, it is very important for each clinical chemistry laboratory to report non–HDL-c as a part of routine lipid status, with no added expense. Doctors could use it for optimal prevention of
atherosclerosis and cardiovascular disease.
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