INVESTIGATIONS OF SERUM LIPIDS

&
THEIR INTERPRETATIONS

B.SC. NURSING 2ND YEAR,

S.L.M. GLOBAL NURSING COLLEGE

A Lecture By Amaresh Kumar Nayak

Investigations of Serum Lipids(Lipid
Profile / Lipid Panel) :
 Measuring blood fats is an important tool in determining your risk of cardiovascular disease. A Lipid profile
or lipid panel is a series of tests used to determine the amount of fat in your blood.

 Components or Parameters of Lipid Profile Tests :

A lipid profile typically includes:
 Total cholesterol —this test measures all of the cholesterol in all the lipoprotein particles.
 High-density lipoprotein cholesterol (HDL-C) — measures the cholesterol in HDL particles; often called
"good cholesterol" because it removes excess cholesterol and carries it to the liver for removal.
 Low-density lipoprotein cholesterol (LDL-C) — calculates the cholesterol in LDL particles; often called "bad
cholesterol" because it deposits excess cholesterol in walls of blood vessels, which can contribute to
atherosclerosis. Usually, the amount of LDL cholesterol (LDL-C) is calculated using the results of total
cholesterol, HDL-C, and triglycerides.
 Triglycerides — measures all the triglycerides in all the lipoprotein particles; most is in the very low-density
lipoproteins (VLDL).
Some other information may be reported as part of the lipid profile. These parameters are calculated from the
results of the tests identified above.
 Very low-density lipoprotein cholesterol (VLDL-C) — calculated from triglycerides/5; this formula is based
on the typical composition of VLDL particles.
 Non-HDL-C — calculated from total cholesterol minus HDL-C.
Conditions for carrying out Lipid Profile Test :

 A patient undergoing Lipid Profile Test must be in a 9 – 12 hours fasting state before his blood sample
is drawn.
 During this time the patient should not consume any kind of food or drink (including any form of coffee
or tea). However, he/she can consume plain water.
 On the day of testing the patient should avoid smoking & carrying out rigorous exercise as these can
again affect the result of the test.

 Benefits Of Lipid Profile Tests :

 The lipid profile tests have been shown to be good indicators of whether someone is likely to
have a heart attack or stroke caused by blockage of blood vessels.
 The results of lipid profile tests is used to guide clinicians to decide how a person at risk should be
treated.
 The results of the lipid profile are considered along with other known risk factors of heart disease, such
as high blood pressure or diabetes to develop a plan of treatment and follow-up.
Normal Values of Lipid Profile Test Parameters :

The normal values for serum lipids depend on the patient's age, sex, and race.
Lipid Profile Test Normal Reference Ranges (in mg/dl)
Parameters In case of males In case of females
Total Cholesterol Upto 200 Upto 200

Triglyceride Upto 150 Upto 150

HDL Cholesterol 30 - 60 40 – 60

LDL Cholesterol Upto 130 Upto 130

VLDL Cholesterol Upto 30 Upto 30

Chol / HDL Ratio 3.55 – 5.85 3.25 – 5.00

LDL / HDL Ratio 2.5 – 3.8 2.5 – 3.8

Interpretation of Lipid Profile Test Results :
Total Cholesterol levels :
According to the guidelines of National Cholesterol Education Program (NCEP), following
interpretations can be made :
Desirable : Less than 200 mg/dL (5.18 mmol/L)
Borderline high : 200-239 mg/dL (5.18 to 6.18 mmol/L)
High : 240 mg/dL (6.22 mmol/L) or higher.
This may put you at an increased risk for heart disease.

 Fasting Triglyceride Levels :

 Elevated levels of triglycerides are also a risk factor for heart disease. According to the
National Heart, Lung, and Blood Institute (NHLBI) :
Desirable : Less than 150 mg/dL (1.70 mmol/L)
Borderline high : 150-199 mg/dL (1.7-2.2 mmol/L)
High : 200-499 mg/dL (2.3-5.6 mmol/L)
Very high : Greater than 500 mg/dL (5.6 mmol/L)
Interpretation of Lipid Profile Test Results :
 High Density Lipoprotein Cholesterol (HDL-C) Level :
 High density lipoproteins, or HDL, are considered to be the “Good Cholesterol", because
HDL’s role in the body is to take cholesterol to the liver for degradation or processing, as
a result cholesterol level decreases in the blood.

 According to the National Cholesterol Education Program (NCEP) :

 An acceptable HDL range is between 40- 60 mg/dL (1.04–1.56 mmol/L).
 Any HDL level above more than 60 mg/dL (1.56 mmol/L) is considered high. A high HDL
level is considered very healthy, since it has a protective role in guarding against heart
disease.
 An undesirable level of HDL is any level below 40 mg/dL (1.04 mmol/L). In this case, low
HDL levels may help to contribute to heart disease.
Interpretation of Lipid Profile Test Results :
 Low Density Lipoproteins Level : (Normal upto 130 mg/dl)
 Low density lipoproteins, also known as LDLs, are considered to be the "bad cholesterol". This
type of lipoprotein circulates from the liver to other organs and tissues in the body, carrying
cholesterol where it is needed.
 This type of cholesterol tends to linger and has been connected with various types of heart
disease, including atherosclerosis, heart attack, stroke, and coronary heart disease. The current
guidelines for LDL levels are :

 LDL levels less than 100 mg/dL ( 2.6 mmol/L) are considered optimal.

 LDL levels between 100 – 129 mg/dL (2.6–3.34 mmol/L) are considered near or above
optimal.

 LDL levels between 130 – 159 mg/dL (3.36–4.13 mmol/L) are considered borderline high.

 LDL levels between 160 – 189 mg/dL (4.14 - 4.90 mmol/L) are considered high.

 LDL levels at or above 190 mg/dL (4.91 mmol/L) is considered very high.