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that are much smaller than the primary VLDL particles; evaluation of the cholesterol:triglyceride ratio in
the isolated total VLDL fraction is a necessary step in diagnosis. A high level of HDL may or may not
reflect a healthy status. In a person free of liver disease or intoxication of any form, a high level of HDL is
an indication of a healthy metabolic system and probably indicates a relatively low risk for atherosclerotic
disease. Otherwise, a high level of HDL may reflect the existence of an early stage of primary biliary
cirrhosis, chronic hepatitis, alcoholism, or some other form of chronic intoxication. This interpretational
problem is readily resolvable through simple quantitative testing involving ultracentrifugation, selective
precipitation, or a combination of these methods. Classifying the hyperlipoproteinemias into phenotypes
has limited value for the evaluation of genetic traits, but does place disorders that affect plasma lipid and
lipoprotein concentrations into convenient groups for evaluation and treatment. A clear distinction must
be made between primary (inherited) and secondary (liver disease, alcoholism, metabolic diseases) causes
of dyslipoproteinemia.
Useful For: Determining the existence and type of dyslipoproteinemia Quantitation of cholesterol and
triglycerides in VLDL, LDL, HDL, Lp(a), and any other significant lipoprotein fractions. Classifying
hyperlipoproteinemias (lipoprotein phenotyping) Evaluating patients with abnormal lipid values
(cholesterol, triglyceride, HDL, LDL) Quantifying Lp(a) cholesterol
Interpretation: For discussion of various lipoprotein fractions, see Clinical Information. For a
discussion of Lp(a), see #89005 Lipoprotein (a) Cholesterol, Serum For treatment recommendations, see
Lipids and Lipoproteins in Blood Plasma (Serum), National Cholesterol Education Program Guidelines,
in Special Instructions.
Reference Values:
The National Cholesterol Education Program (NCEP) has set the following guidelines for lipids (total
cholesterol, triglycerides, HDL, and LDL cholesterol) in adults ages 18 and up:
TOTAL CHOLESTEROL
Optimal: or =240 mg/dL
TRIGLYCERIDES
Normal: or =500 mg/dL
HDL CHOLESTEROL
Low: or =60 mg/dL
LDL CHOLESTEROL
Optimal: or =190 mg/dL
The National Cholesterol Education Program (NCEP) and National Health and Nutrition Examination
Survey (NHANES) have set the following guidelines for lipids (total cholesterol, triglycerides, HDL, and
LDL cholesterol) in children ages 2-17:
TOTAL CHOLESTEROL
Desirable: or =200 mg/dL
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