The importance of routinely reporting non-HDL cholesterol by the clinical laboratory

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.