Lipid profile
Also known as: cholesterol test, lipid panel
Measures the fats carried in blood: total cholesterol, LDL ('bad', deposited in artery walls), HDL ('good', carried away for disposal) and triglycerides. Used mainly to estimate and manage the risk of heart attack and stroke.
- Kind
- Test panel
- Categories
- Lipid & cardiometabolic
- Specimen
- Serum
- Method
- Chemistry analyser, Calculation from other results
- Terminology
- LOINC 24331-1
- Type
- Blood test
- Sample
- Blood from a vein, fasting usually not needed
- Used for
- Cardiovascular risk assessment, familial hypercholesterolaemia, statin monitoring
- Measures
- Total, LDL, HDL and non-HDL cholesterol and triglycerides
- Result
- A panel of numeric values used in risk calculators and against treatment targets
Why is it used?
- Cardiovascular risk assessment from age 40, earlier with family history
- Known heart disease, stroke or peripheral artery disease
- Diabetes, kidney disease, high blood pressure
- Monitoring statin treatment
- Xanthomas or very early heart disease in a family (familial hypercholesterolaemia)
What does it measure?
| Component | What it measures | A higher value may be seen in | A lower value may be seen in |
|---|---|---|---|
| Total cholesterol TC | All cholesterol carried in blood | Diet, inherited disorders, hypothyroidism, kidney and liver disease | Hyperthyroidism, malnutrition, acute illness |
| LDL cholesterol LDL-C | Cholesterol in low-density lipoprotein (usually calculated) | Familial hypercholesterolaemia, diet, hypothyroidism, nephrotic syndrome | Lipid-lowering treatment, illness |
| HDL cholesterol HDL-C | Cholesterol in high-density lipoprotein | Exercise, moderate alcohol, oestrogen | Obesity, inactivity, smoking, diabetes, high triglycerides |
| Non-HDL cholesterol non-HDL | Total minus HDL: all the atherogenic particles | As for LDL; the value UK guidance uses for targets | Treatment |
| Triglycerides TG | Blood fat carried in chylomicrons and VLDL | Recent meal, alcohol, obesity, diabetes, some medicines, inherited disorders | Malnutrition, hyperthyroidism, fibrates |
A high or low value can be associated with several different situations; the result is interpreted with other results, symptoms, history and clinical findings.
How is it performed?
Venous blood, fasting no longer required for most purposes.
Specimen. Venous blood (serum); fasting rarely required
Do I need to prepare?
Usually none; a fasting sample if triglycerides are very high.
What do the results generally mean?
| Finding | What it may indicate |
|---|---|
| High LDL and non-HDL | Raised risk; combined with age, blood pressure and smoking into a 10-year risk score to decide on statins |
| Total cholesterol above 7.5 with family history | Possible familial hypercholesterolaemia; genetic testing and family screening |
| Very high triglycerides | Risk of pancreatitis; look for alcohol, diabetes, drugs |
Guideline thresholds
| Threshold | Value | Unit | Applies to | Country · source |
|---|---|---|---|---|
| Statin treatment goal (secondary prevention) | LDL cholesterol 2.0 or below, or non-HDL cholesterol 2.6 or below | mmol/L | People with established cardiovascular disease on statin treatment; escalate treatment if not achieved | UK UK |
| Statin treatment goal (primary prevention) | more than 40% reduction in non-HDL cholesterol | % from baseline | People started on a statin for primary prevention, measured at 3 months | UK UK |
| Consider familial hypercholesterolaemia | total cholesterol above 7.5 (adults) with a family history of premature heart disease | mmol/L | Adults; prompts formal assessment with Simon Broome or Dutch Lipid Clinic criteria and possible genetic testing | UK UK |
| Pancreatitis risk | triglycerides above 10 | mmol/L | Severe hypertriglyceridaemia; urgent specialist referral in UK guidance | UK UK |
Clinical decision thresholds come from the named guideline and country; they are not laboratory reference intervals, and they change when guidance changes.
What can affect the result?
- A recent meal and alcohol raise triglycerides; fasting is only needed when triglycerides are very high
- Acute illness, surgery and heart attack lower cholesterol for weeks
- Weight change, pregnancy and the menstrual cycle
- Untreated hypothyroidism raises LDL; check thyroid function before treating an unexpectedly high result
Medicines. Statins, ezetimibe, fibrates and PCSK9 inhibitors lower values; corticosteroids, some antiretrovirals, isotretinoin, thiazides and beta blockers can raise cholesterol or triglycerides.
What can the test not tell you?
- A person's overall cardiovascular risk on its own (age, blood pressure, smoking, diabetes and family history are combined with it)
- Whether arteries already contain plaque (that needs imaging)
- Which lipid-lowering treatment is appropriate
Cholesterol is one risk factor among several; the numbers matter less than the overall risk. Acute illness lowers cholesterol for weeks.
Other tests commonly used with it
Medicines monitored with this test
Each medicine page cites the official document that names this test in its monitoring plan.