Davis's Lab & Diagnostic Tests
Cholesterol, Total and Fractions
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Synonym/Acronym:
α1-Lipoprotein cholesterol, high-density lipoprotein cholesterol (HDLC); and β-lipoprotein cholesterol, low-density lipoprotein cholesterol (LDLC), very-low-density lipoprotein (VLDL); lipid fractionation; lipoprotein phenotyping.
Rationale
To assess and monitor risk for coronary artery disease (CAD); to assist in categorizing lipoprotein as an indicator of cardiac health.
Patient Preparation
There are no medication restrictions unless by medical direction. Instruct the patient to fast 6 to 12 hr before specimen collection if lipoprotein fractionation or triglyceride measurements are ordered and recommend fasting if cholesterol levels alone are measured for screening. Instruct the patient to avoid excessive exercise for at least 12 hr before lipoprotein fractionation testing and to refrain from alcohol consumption for 24 hr before lipoprotein fractionation testing. Protocols may vary among facilities.
Normal Findings
Method: Spectrophotometry for total cholesterol, HDLC and LDLC. Lipoprotein fractionation: Electrophoresis and 4°C test for specimen appearance. There is no quantitative interpretation of this test. The specimen appearance and electrophoretic pattern are visually interpreted.
| Total Cholesterol | ||
|---|---|---|
| Risk | Conventional Units | SI Units (Conventional Units × 0.0259) |
| Children and adolescents (less than 20 yr) | ||
| Desirable | Less than 170 mg/dL | Less than 4.4 mmol/L |
| Borderline | 170–199 mg/dL | 4.4–5.2 mmol/L |
| High | Greater than 200 mg/dL | Greater than 5.2 mmol/L |
| Adults and older adults | ||
| Desirable | Less than 200 mg/dL | Less than 5.2 mmol/L |
| Borderline | 200–239 mg/dL | 5.2–6.2 mmol/L |
| High | Greater than 240 mg/dL | Greater than 6.2 mmol/L |
| HDLC | Conventional Units | SI Units (Conventional Units × 0.0259) |
|---|---|---|
| Birth | 6–56 mg/dL | 0.16–1.45 mmol/L |
| Children, adults, and older adults | ||
| Desirable | Greater than 60 mg/dL | Greater than 1.55 mmol/L |
| Acceptable | 40–60 mg/dL | 1–1.55 mmol/L |
| Low | Less than 40 mg/dL | Less than 1 mmol/L |
| LDLC | Conventional Units | SI Units (Conventional Units × 0.0259) |
|---|---|---|
| Optimal | Less than 100 mg/dL | Less than 2.59 mmol/L |
| Near optimal | 100–129 mg/dL | 2.59–3.34 mmol/L |
| Borderline high | 130–159 mg/dL | 3.37–4.11 mmol/L |
| High | 160–189 mg/dL | 4.14–4.9 mmol/L |
| Very high | Greater than 190 mg/dL | Greater than 4.92 mmol/L |
| Hyperlipoproteinemia: Fredrickson Type | Specimen Appearance | Electrophoretic Pattern |
|---|---|---|
| Type I | Clear with creamy top layer | Heavy chylomicron band |
| Type IIa | Clear | Heavy β band |
| Type IIb | Clear or faintly turbid | Heavy β and pre-β bands |
| Type III | Slightly to moderately turbid | Heavy β band |
| Type IV | Slightly to moderately turbid | Heavy pre-β band |
| Type V | Slightly to moderately turbid with creamy top layer | Intense chylomicron band and heavy β and pre-β bands |
Critical Findings and Potential Interventions
N/A
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Synonym/Acronym:
α1-Lipoprotein cholesterol, high-density lipoprotein cholesterol (HDLC); and β-lipoprotein cholesterol, low-density lipoprotein cholesterol (LDLC), very-low-density lipoprotein (VLDL); lipid fractionation; lipoprotein phenotyping.
Rationale
To assess and monitor risk for coronary artery disease (CAD); to assist in categorizing lipoprotein as an indicator of cardiac health.
Patient Preparation
There are no medication restrictions unless by medical direction. Instruct the patient to fast 6 to 12 hr before specimen collection if lipoprotein fractionation or triglyceride measurements are ordered and recommend fasting if cholesterol levels alone are measured for screening. Instruct the patient to avoid excessive exercise for at least 12 hr before lipoprotein fractionation testing and to refrain from alcohol consumption for 24 hr before lipoprotein fractionation testing. Protocols may vary among facilities.
Normal Findings
Method: Spectrophotometry for total cholesterol, HDLC and LDLC. Lipoprotein fractionation: Electrophoresis and 4°C test for specimen appearance. There is no quantitative interpretation of this test. The specimen appearance and electrophoretic pattern are visually interpreted.
| Total Cholesterol | ||
|---|---|---|
| Risk | Conventional Units | SI Units (Conventional Units × 0.0259) |
| Children and adolescents (less than 20 yr) | ||
| Desirable | Less than 170 mg/dL | Less than 4.4 mmol/L |
| Borderline | 170–199 mg/dL | 4.4–5.2 mmol/L |
| High | Greater than 200 mg/dL | Greater than 5.2 mmol/L |
| Adults and older adults | ||
| Desirable | Less than 200 mg/dL | Less than 5.2 mmol/L |
| Borderline | 200–239 mg/dL | 5.2–6.2 mmol/L |
| High | Greater than 240 mg/dL | Greater than 6.2 mmol/L |
| HDLC | Conventional Units | SI Units (Conventional Units × 0.0259) |
|---|---|---|
| Birth | 6–56 mg/dL | 0.16–1.45 mmol/L |
| Children, adults, and older adults | ||
| Desirable | Greater than 60 mg/dL | Greater than 1.55 mmol/L |
| Acceptable | 40–60 mg/dL | 1–1.55 mmol/L |
| Low | Less than 40 mg/dL | Less than 1 mmol/L |
| LDLC | Conventional Units | SI Units (Conventional Units × 0.0259) |
|---|---|---|
| Optimal | Less than 100 mg/dL | Less than 2.59 mmol/L |
| Near optimal | 100–129 mg/dL | 2.59–3.34 mmol/L |
| Borderline high | 130–159 mg/dL | 3.37–4.11 mmol/L |
| High | 160–189 mg/dL | 4.14–4.9 mmol/L |
| Very high | Greater than 190 mg/dL | Greater than 4.92 mmol/L |
| Hyperlipoproteinemia: Fredrickson Type | Specimen Appearance | Electrophoretic Pattern |
|---|---|---|
| Type I | Clear with creamy top layer | Heavy chylomicron band |
| Type IIa | Clear | Heavy β band |
| Type IIb | Clear or faintly turbid | Heavy β and pre-β bands |
| Type III | Slightly to moderately turbid | Heavy β band |
| Type IV | Slightly to moderately turbid | Heavy pre-β band |
| Type V | Slightly to moderately turbid with creamy top layer | Intense chylomicron band and heavy β and pre-β bands |
Critical Findings and Potential Interventions
N/A
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