LDL cholesterol
(Low-density lipoprotein cholesterol)
Material: | 1 ml serum, fasting (Stability in serum at 4 °C – 8 °C: 7 days) | Reference range | Target values depending on current risk profile (as per ESC guidelines, AHA/ACC guidelines or ASCVD/Framingham score) |
Indication | Suspicion of lipid metabolism disorder, evaluation of the cardiovascular risk. |
Please note | The 10 year risk can be calculated with the PROCAM algorithm or the ASCVD score. If triglyceride values are > 400 mg/dl, a valid determination of any cholesterol metabolic parameters is no longer possible. If desired, lipid electrophoresis can be carried out in these cases. Diagnostic approach: As was already shown in the Framingham study over 50 years ago, individual blood lipids only have a minor predictive forecast value for cardiovascular risk, with the exception of pronounced hypercholesterinemia (> 240 mg/dl) and LDL cholesterol of more than 190 mg/dl. The presence of multiple risk factors, which lead to some sort of multiplication effect, is what’s decisive. Apart from increased LDL cholesterol and low HDL cholesterol, the focus is on familial predisposition, arterial hypertension, nicotine abuse and diabetes mellitus as well as previous cardiovascular events, especially in young persons. In the assessment of the personal cardiovascular risk, individual risk factors should never be looked at in isolation. For screening purposes, total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides should be determined initially. On suspicion of secondary hyperlipoproteinemia, in a second step endocrine and metabolic kidney and liver diseases should be ruled out, and a potential influence of medication intake (oral contraceptives, beta-blockers, diuretics, glucocorticoids, and retinoids) should be clarified. The third step of a cardiovascular risk assessment covers additional new risk factors of recent years amongst tests of the lipid metabolism. Lipoprotein (see there), CRP ultrasensitive (see there) and, if required, homocysteine (see there) are paramount. A thrombophilia test is also recommended (see there). In most hereditary lipid metabolic disorders today, the genetic defect is known. In the clinical day-to-day life, a definite genetic evaluation is only required in individual cases, as therapeutic options are rather limited anyway. Thus, the therapeutic questions are generally reduced to whether or not LDL cholesterol, triglycerides or both as well as homocysteine, if applicable, should be decreased. Please also refer to: Lipid metabolism diagnostics |
Accredited | ja |
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