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Cleveland Clinic Laboratories Technical Brief Lipid Panel, Basic Background Information A lipid panel is a group of blood tests that are typically ordered together to determine the risk of developing coronary artery disease (CAD). The tests measure various lipids, including cholesterol, triglycerides, high-density lipoprotein (HDL) and low-density lipoprotein (LDL). Found in the blood and stored in the body’s tissues, lipids are an important part of cell structure and other biological functions. However, lipid disorders such as high cholesterol are risk factors for developing coronary artery disease, heart attack, stroke or other life-threatening illnesses. Reducing risk factors is key to the prevention of cardiovascular events, the No. 1 cause of death in the United States. These risk factors include age, smoking, hypertension, diabetes, elevated LDL and low HDL cholesterol. The National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP-III) classified lipid results (see chart, below) and established guidelines for lipid testing and patient management. Clinical Indications Healthy adults with no other heart disease risk factors are recommended to be tested with a fasting lipid profile once every five years, or as a part of a regular health examination. In some cases, lipid testing is ordered for children and adolescents if they are at an increased risk of developing heart disease. A lipid profile may be ordered at regular intervals to evaluate the success of lipid-lowering strategies, such as diet, exercise and drug therapy. Interpretation The National Cholesterol Education Program (NCEP) has set general and therapeutic goals, which may vary depending on a patient’s other risk factors. Thorough assessment of a patient’s results should be conducted by a patient’s physician. Together with other known risk factors of heart disease, the lipid profile is considered in developing a treatment plan. Treatment options may involve modifications to diet, exercise or use of lipid-lowering medications. Adult Values Desirable Borderline Higher Risk Cholesterol, total 199 mg/dL or less 200-239 mg/dL 240 mg/dL or greater Triglycerides 149 mg/dL or less 150-199 mg/dL 200-499 mg/dL HDL Cholesterol 60 mg/dL or greater 39 mg/dL or less 130-159 mg/dL 160 mg/dL or greater LDL Cholesterol (calculated) 129 mg/dL or less (99 mg/dL or less for highest risk patients) Appearance Clear VLDL Cholesterol (calculated) 30 mg/dL or less 06.02.11 Cleveland Clinic Laboratories 9500 Euclid Avenue, L15, Cleveland, Ohio 44195 800.628.6816 | www.clevelandcliniclabs.com References 1. American Heart Association. Guide to primary prevention of cardiovascular diseases: Risk intervention, Blood Lipid Management. Available online at http:www.nhlbi.nih.gov/ guidelines/cholesterol/atp3full.pdf through http://www. americanheart.org. 2. 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. 3. Medline Plus Medical Encyclopedia. Coronary Risk Profile. (May 12, 2008). Available online at http://www. nim.nih.gov/medlineplus/ency/article/003491.htm. 4. 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. Test Overview Test Name Lipid Panel, Basic Methodology Enzymatic Specimen Requirements Volume/Size: 1 mL; Type: Plasma; Tube/Container: Lithium heparin (Green); Transport Temperature: Refrigerated. Minimum Specimen Requirements Volume/Size: 0.5 mL Alternate Specimen Requirements Volume/Size: 1 mL; Type: Serum; Tube/Container: SST (Gold) Clinical Information Evaluation of hyper- or hypolipidemia and risk for cardiovascular disease. Measures triglycerides; total cholesterol; HDL cholesterol; calculated VLDL cholesterol; calculated LDL cholesterol; calculated total cholesterol to HDL ratio; calculated LDL to HDL ratio; calculated non HDL cholesterol. Special Information Patient should be fasting for a minimum of 12 hours and on a stable diet 3 weeks prior to collection. If triglycerides are greater than 400mg/dL, LDL cholesterol will be measured (direct) and billed. Indicate the number of hours of fasting and age of patient on requisition. Billing Code 80058 CPT Code 80061 Technical Information Contact: Scientific Information Contact: Anne Bordner Blank, MBA, MT(ASCP) 216.444.2173 [email protected] Edmunds Z. Reineks, MD, PhD 216.444.9143 [email protected]. 201106.036