Lipid Profile

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Also known as: Lipid Panel; Coronary Risk Panel
Formal name: Lipid Profile

At a Glance

Why Get Tested?

To assess your risk of developing cardiovascular disease (CVD); to monitor treatment

When to Get Tested?

Screening: for adults, every five years; for youths, once between the ages of 9 and 11 and again between ages 17 and 21
Monitoring: at regular intervals when risk factors are present, when prior results showed high risk levels, and/or to monitor effectiveness of treatment

Sample Required?

A blood sample is obtained by inserting a needle into a vein in your arm or from a fingerstick

Test Preparation Needed?

Typically, fasting for 9-12 hours before having your blood drawn is required; only water is permitted. Follow any instructions you are given.

The Test Sample

What is being tested?

Lipids are a group of fats and fat-like substances that are important constituents of cells and sources of energy. A lipid profile measures the level of specific lipids in the blood.

Two types of lipids, cholesterol and triglycerides, are transported in the blood by lipoprotein particles. Each particle contains a combination of protein, cholesterol, triglyceride, and phospholipid molecules. The particles measured with a lipid profile are classified by their density into high-density lipoproteins (HDL), low-density lipoproteins (LDL), and very low-density lipoproteins (VLDL).

Monitoring and maintaining healthy levels of these lipids is important in staying healthy. While the body produces the cholesterol needed to function properly, the source for some cholesterol is the diet. Eating too much of foods that are high in cholesterol, saturated fats, and trans unsaturated fats (trans fats) or having an inherited predisposition can result in a high level of cholesterol in the blood. The extra cholesterol may be deposited in plaques on the walls of blood vessels. Plaques can narrow or eventually block the opening of blood vessels, leading to hardening of the arteries (atherosclerosis) and increasing the risk of numerous health problems, including heart disease and stroke. A high level of triglycerides in the blood is also associated with an increased risk of developing cardiovascular disease (CVD), although the reason for this is not well understood.

A lipid profile typically includes:

  • Total cholesterol —this test measures all of the cholesterol in all the lipoprotein particles.
  • High-density lipoprotein cholesterol (HDL-C) — measures the cholesterol in HDL particles; often called "good cholesterol" because it removes excess cholesterol and carries it to the liver for removal.
  • Low-density lipoprotein cholesterol (LDL-C) — calculates the cholesterol in LDL particles; often called "bad cholesterol" because it deposits excess cholesterol in walls of blood vessels, which can contribute to atherosclerosis. Usually, the amount of LDL cholesterol (LDL-C) is calculated using the results of total cholesterol, HDL-C, and triglycerides.
  • Triglycerides — measures all the triglycerides in all the lipoprotein particles; most is in the very low-density lipoproteins (VLDL).

Some other information may be reported as part of the lipid profile. These parameters are calculated from the results of the tests identified above.

  • Very low-density lipoprotein cholesterol (VLDL-C) — calculated from triglycerides/5; this formula is based on the typical composition of VLDL particles.
  • Non-HDL-C — calculated from total cholesterol minus HDL-C.
  • Cholesterol/HDL ratio — calculated ratio of total cholesterol to HDL-C.

An extended profile (or advanced lipid testing) may also include low-density lipoprotein particle number/concentration (LDL-P). This test measures the number of LDL particles, rather than measuring the amount of LDL-cholesterol. It is thought that this value may more accurately reflect heart disease risk in certain people. For more, see Common Questions #5 or the article on Lipoprotein Subfraction Testing.

How is the sample collected for testing?

A blood sample is obtained by inserting a needle into a vein in the arm. Sometimes a drop of blood is collected by puncturing the skin on a fingertip. This fingerstick sample is typically used when a lipid profile is being measured on a portable testing device, for example, at a health fair.

NOTE: If undergoing medical tests makes you or someone you care for anxious, embarrassed, or even difficult to manage, you might consider reading one or more of the following articles: Coping with Test Pain, Discomfort, and Anxiety, Tips on Blood Testing, Tips to Help Children through Their Medical Tests, and Tips to Help the Elderly through Their Medical Tests.

Another article, Follow That Sample, provides a glimpse at the collection and processing of a blood sample and throat culture.

Is any test preparation needed to ensure the quality of the sample?

Typically, fasting for 9-12 hours before having the blood sample drawn is required; only water is permitted. Follow any instructions you are given.

The Test

Common Questions

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Article Sources

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NOTE: This article is based on research that utilizes the sources cited here as well as the collective experience of the Lab Tests Online Editorial Review Board. This article is periodically reviewed by the Editorial Board and may be updated as a result of the review. Any new sources cited will be added to the list and distinguished from the original sources used.

Sources Used in Current Review

Davidson M, et al. Clinical Utility of Inflammatory Markers and Advanced Lipid Testing: Advice from an Expert Panel of Lipid Specialists. Journal of Clinical Lipidology 2011 Sep; 5(5): 338-67.

Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Sep 2002. PDF available for download at http://www.nhlbi.nih.gov/guidelines/cholesterol/atp3full.pdf through http://www.nhlbi.nih.gov. Accessed October 2012.

(©2012) American Heart Association. Cholesterol Levels. Available online at http://www.heart.org/HEARTORG/Conditions/Cholesterol/Cholesterol_UCM_001089_SubHomePage.jsp through http://www.heart.org. Accessed October 2012.

(November 2012) American Association of Family Physicians. High Cholesterol. Available online at http://familydoctor.org/familydoctor/en/diseases-conditions/high-cholesterol.html through http://familydoctor.org. Accessed October 2012.

Kavey R-EW, et al. Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents: Summary report. Pediatrics 2011; 128: DOI:10.1542/peds.2009-2107C. PDF available for download at http://pediatrics.aappublications.org/site/misc/2009-2107.pdf through http://pediatrics.aappublications.org. Accessed October 2012.

KidsHealth.org. Cholesterol and Your Child. Available online at http://kidshealth.org/parent/medical/heart/cholesterol.html# through http://kidshealth.org. Accessed October 2012.

CDC. FASTSTATS – Leading Causes of Death (2009 data). Available online at http://www.cdc.gov/nchs/fastats/lcod.htm through http://www.cdc.gov. Accessed October 2012.

KidsHealth.org. Cholesterol and Your Child. Available online at http://kidshealth.org/parent/medical/heart/cholesterol.html# through http://kidshealth.org. Accessed October 2012.

(2006) Sekar K. Increased Small Low-Density Lipoprotein Particle Number, A Prominent Feature of the Metabolic Syndrome in the Framingham Heart Study. Circulation. Available online at http://circ.ahajournals.org/content/113/1/20.full through http://circ.ahajournals.org. Accessed October 2012.

(September 23, 2002) Blake G, et al. Low-Density Lipoprotein Particle Concentration and Size as Determined by Nuclear Magnetic Resonance Spectroscopy as Predictors of Cardiovascular Disease in Women. Circulation, Available online at http://circ.ahajournals.org/content/106/15/1930.full throughhttp://circ.ahajournals.org. Accessed October 2012.

Blakenstein R, et al. Predictors of Coronary Heart Disease Events Among Asymptomatic Persons With Low Low-Density Lipoprotein Cholesterol. Journal of the American College of Cardiology Volume 58, Issue 4, 19 July 2011, Pp 364–374.

Krauss R. Lipoprotein subfractions and cardiovascular disease risk. Curr Opin Lipidol 2010 Aug;21(4):305-11. Abstract available online at http://www.ncbi.nlm.nih.gov/pubmed/20531184 through http://www.ncbi.nlm.nih.gov. Accessed October 2012. 

Prado K, et al. Low-density lipoprotein particle number predicts coronary artery calcification in asymptomatic adults at intermediate risk of cardiovascular disease. J Clin Lipidol 2011 Sep-Oct;5(5):408-13. Abstract available online at http://www.ncbi.nlm.nih.gov/pubmed/21981843 through http://www.ncbi.nlm.nih.gov. Accessed October 2012.

(May 2012) Lavie C, et.al. To B or Not to B: Is Non–High-Density Lipoprotein Cholesterol an Adequate Surrogate for Apolipoprotein B? Mayo Clin Proc. 2010 May; 85(5): 446–450. Available online at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2861974/ through http://www.ncbi.nlm.nih.gov. Accessed October 2012.

Sources Used in Previous Reviews

Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA (2001) 285: 2486-2497.

(September 2002) National Heart, Lung, Blood Institute. National Cholesterol Education Program Guidelines, Cholesterol, ATP III. II.3-b, II.9-c. PDF available for download at http://www.nhlbi.nih.gov/guidelines/cholesterol/atp3full.pdf through http://www.nhlbi.nih.gov . Accessed June 2009.

American Heart Association. Guide to primary prevention of cardiovascular diseases: Risk intervention, Blood Lipid Management. Available online at http://www.americanheart.org/presenter.jhtml?identifier=4704 through http://www.americanheart.org. Accessed June 2009.

(Updated December 19, 2008) American Heart Association. What your Cholesterol Levels Mean. Available online at http://www.americanheart.org/presenter.jhtml?identifier=183#HDL through http://www.americanheart.org. Accessed May 2009.

American Academy of Family Physicians. Cholesterol: What Your Level Means. (Updated October 2007). Available online at http://familydoctor.org/online/famdocen/home/common/heartdisease/risk/029.html through http://familydoctor.org. Accessed September 2008.

(May 12, 2008) Medline Plus Medical Encyclopedia. Coronary Risk Profile. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/003491.htm. Accessed October 2008.

ARUP Consult. Physicians Guide. Lipid Panel, Extended. Available online at http://www.aruplab.com/guides/ug/tests/0020468.jsp through http://www.aruplab.com. Accessed October 2008.

Clarke, W. and Dufour, D. R., Editors (2006). Contemporary Practice in Clinical Chemistry. AACC Press. Washington, DC. Pp 251-253.

Pagana K, Pagana T. Mosby's Manual of Diagnostic and Laboratory Tests. 3rd Edition, St. Louis: Mosby Elsevier; 2006. Pp 351-356.