Lexicon
Lipid Panel
Also known as Lipid profile
Definition
Lipid testing is a key tool used to assess cardiovascular risk and guide clinical management decisions, and consensus guidance defines the composition of a standard lipid profile and of an enhanced profile that adds apolipoprotein B and lipoprotein(a). [1] Dyslipidemia, in particular elevation of LDL-cholesterol, is one of the major cardiovascular risk factors, with high prevalence and an independent unfavorable impact on cardiovascular prognosis. [2] A lipid panel is part of the standard laboratory evaluation of related conditions such as obesity, alongside tests like hemoglobin A1c, a comprehensive metabolic panel and thyroid-stimulating hormone. [3]
How it works
Apolipoprotein B represents the total concentration of atherogenic lipoprotein particles in the circulation and more accurately reflects the atherogenic burden of lipoproteins than LDL-cholesterol. [4] Elevated triglycerides raise cardiovascular disease risk through triglyceride-rich lipoprotein particles found as part of non-HDL cholesterol, and many elevations are secondary to other causes. [5] In statin trials, each 1.0 mmol/L reduction in LDL cholesterol produced about a 12% proportional reduction in all-cause mortality and roughly a one-fifth reduction in major vascular events, largely irrespective of the initial lipid profile. [6]
Connected concepts
How it's measured
Consensus guidance recommends the Sampson-NIH calculation for LDL-cholesterol estimation and the reporting of non-HDL cholesterol in all lipid profiles. [1] When there is discordance between LDL-C and apoB, or between LDL-C and non-HDL-C, atherosclerotic cardiovascular disease risk generally aligns better with apoB or non-HDL-C, so apoB can be used in tandem with standard lipid measurements. [4] Simple lipid profiles do not always provide adequate information, and additional assays such as apolipoprotein B100 and apolipoprotein E genotype may be useful when characterising primary hypertriglyceridaemia. [5]
What levels mean
Consensus LDL-cholesterol treatment targets are risk-based, with an LDL-C below 1.4 mmol/L for very high risk, below 1.8 mmol/L for high risk, below 2.6 mmol/L for moderate risk and below 3.0 mmol/L for low risk. [1] Guidance suggests flagging very low HDL-cholesterol levels below 0.5 mmol/L and very high levels above 2.5 mmol/L to alert clinicians to potential secondary causes.
Community knowledge
## Beyond LDL-C
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- 1.Kenkre JS, Mazaheri T, Neely RDG, Soran H, Datta D, Penson P, Downie P, Yates AM. Standardising lipid testing and reporting in the United Kingdom; a joint statement by HEART UK and The Association for Laboratory Medicine. Ann Clin Biochem · 2025
- 2.Figorilli F, Mannarino MR, Sahebkar A, Pirro M. Lipid profile screening and ASCVD prevention. Expert Rev Cardiovasc Ther · 2023
- 3.Fuller T, Newberry Z, Nasir M, Tondt J. Obesity. Prim Care · 2024
- 4.Soffer DE, Marston NA, Maki KC, Jacobson TA, Bittner VA, Peña JM, Thanassoulis G, Martin SS. Role of apolipoprotein B in the clinical management of cardiovascular risk in adults: An Expert Clinical Consensus from the National Lipid Association. J Clin Lipidol · 2024
- 5.Wierzbicki AS, Kim EJ, Esan O, Ramachandran R. Hypertriglyceridaemia: an update. J Clin Pathol · 2022
- 6.
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