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Lipid Panel

Test Codes

EPIC: LAB18, Beaker: LIPID, Antrim: 13480

Department

Chemistry

Instructions

It is recommended that the patient fast for 9-12 hours prior to blood draw.

Specimen Collection Criteria

Collect: One Gold-top SST tube. (Minimum Whole Blood: 4.0 mL)

Contact Laboratory for acceptability of other tube types.
See Minimum Pediatric Specimen Requirements for Microtainer^® collection.

Physician Office/Draw Specimen Preparation

Let SST specimens clot 30-60 minutes then immediately centrifuge to separate serum from cells. Refrigerate (2-8°C or 36-46°F) the centrifuged SST tube within two hours of collection. (Minimum: 0.5 mL)

Preparation for Courier Transport

Transport: Centrifuged SST tube refrigerated (2-8°C or 36-46°F). (Minimum: 0.5 mL)

Rejection Criteria

• Moderate to grossly hemolyzed specimens.
• Red-top tubes with serum not separated from cells within two hours of collection.

In-Lab Processing

Let SST specimens clot 30-60 minutes. Centrifuge SST tubes or Microtainers^® to separate serum from cells. Deliver immediately to the appropriate testing station.

Storage

Specimen Stability for Testing:

Centrifuged SST Tubes and Microtainers^® with Separator Gel
Room Temperature (20-26°C or 68-78.8°F): 2-4 hours
Refrigerated (2-8°C or 36-46°F): 7 days
Frozen (-20°C/-4°F or below): Unacceptable

Red-top Tubes and Microtainers^® without Separator Gel
Room Temperature (20-25°C or 68-77°F): 2-4 hours
Refrigerated (2-8°C or 36-46°F): Unacceptable
Frozen (-20°C/-4°F or below): Unacceptable

Serum Specimens (Pour-Overs)
Room Temperature (20-26°C or 68-78.8°F): 2-4 hours
Refrigerated (2-8°C or 36-46°F): 7 days
Frozen (-20°C/-4°F or below): 7 days

Specimen Storage in Department Prior to Disposal:

Refrigerated (2-8°C or 36-46°F): 7 days

Laboratory

Dearborn Chemistry Laboratory
Farmington Hills Chemistry Laboratory 
Grosse Pointe Chemistry Laboratory 
Royal Oak Automated Chemistry Laboratory 
Troy Chemistry Laboratory
Taylor Chemistry Laboratory

Performed

Sunday – Saturday, 24 hours a day.
Results available within 4 hours.

Reference Range

See specific analytes for reference range for: Cholesterol, HDL Cholesterol, and Triglyceride.

LDL Cholesterol, Calculated
Age 0-19: 50 - 109 mg/dL.
Age 20 or Older: 50 - 129 mg/dL.

LDL Cholesterol Reference Range
Less than 70 mg/dL:	Optimal for a very high-risk person.
Less than 100 mg/dL:	Optimal for a high-risk person.
100-129 mg/dL:	Near or above optimal.
130-159 mg/dL:	Borderline high.
160-190 mg/dL:	High.
Greater than 190 mg/dL:	Very high.

Formulas
LDL-C, calculated = TC/0.948 – HDL-C/0.971 – (TG/8.56 + [TG x NonHDL-C]/2140 – TG²/16100) – 9.44
Non-HDL Cholesterol, calculated = Total Cholesterol - HDL Cholesterol.

Total cholesterol: HDL cholesterol ratio-risk of coronary artery disease
Less than 5.0	Desirable
5.0 - 6.0	Borderline
Greater than 6.0	High

NOTE: The appropriate LDL cholesterol level for an individual depends on overall risk factors for cardiovascular disease. According to ATP III guidelines risk factors are ASCVD (coronary heart disease, symptomatic carotid artery disease, peripheral arterial disease, abdominal aortic aneurysm), diabetes mellitus, cigarette smoking, hypertension, low HDL cholesterol (less than 40 mg/dL), family history of premature CHD and age (males 45 years or older, females 55 years or older). An HDL cholesterol 60 mg/dL or greater is regarded as a negative risk factor.

Test Methodology

Enzymatic, Spectrophotometry, Detergent Solubilization/Enzymatic.

Interpretation

See specific analytes for interpretations.
This panel includes: Cholesterol, HDL Cholesterol, Triglyceride, and calculations for LDL Cholesterol, Non - HDL Cholesterol and Cholesterol / HDL ratio.

NOTE: LDL Cholesterol cannot be calculated when Triglycerides are greater than 400 mg/dL.

Formulas
LDL Cholesterol, Calculated = Total Cholesterol - [(HDL– Cholesterol) – (Triglycerides/5)].
Non-HDL Cholesterol, Calculated = Total Cholesterol – HDL Cholesterol.

Clinical Utility

This panel aids in the evaluation of hyperlipidemia as an index of coronary artery disease.

Several organizations have issued guidelines for management of dyslipidemias, all aiming to standardize and optimize patient care. The recent ACC/AHA guidelines aim to reduce/prevent heart disease, peripheral vascular disease and stroke by taking into account lifestyle and lipid levels (1). Based on this information an estimate of ASCVD risk can be calculated and a decision on whether or not to treat (e.g. with statins) and modify lifestyle can be made. The ACC/AHA guidelines do not recommend specific cholesterol set-points but aim for a particular percent decrease in LDL cholesterol. Our lab will continue to use the ATP guideline cut points in lipid reporting (2). The National Lipid Association also has recommendations that are similar to the ATP III guidelines (3).

Reference

1. Stone NJ, Robinson JG, Lichetenstein AH et al: ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2014 63:2889-2934.
2. Third report of the National Cholesterol Education Program (NCEP) Expert Panel on detection, evaluation and treatment of high blood cholesterol in adults (ATP III). Circulation 2002;106:3143-3421.
3. Jacobson TA, Ito MK, Maki KC et al. National Lipid Association recommendations for patient-centered management of dyslipidemia. Part 1 – executive summary. J Clin Lipidol 2014;8:473-488.

CPT Codes

80061

Contacts

Last Updated

11/4/2024