Lipid Panel: Beyond Total Cholesterol—Non-HDL, ApoB, Lp(a), and Secondary Causes
Lipid Panel: Beyond Total Cholesterol—Non-HDL, ApoB, Lp(a), and Secondary Causes LDL-C is calculated, not measured. Non-HDL may be better. And nobody's checking Lp(a) yet even though they should be. The lipid panel is ordered on nearly every adult in primary care, yet most providers look at the LDL-C, compare it to a target, and stop. The panel actually contains much more information—and the advanced markers that are increasingly recommended (non-HDL, apoB, Lp(a)) are the ones that predict cardiovascular events better than LDL alone. The Standard Panel Total cholesterol : LDL + HDL + VLDL. Largely supplanted by its components for clinical decisions. LDL-C : Usually calculated by the Friedewald equation (TC − HDL − TG/5). Inaccurate when triglycerides >400 (equation breaks down) or when LDL is very low. Direct LDL measurement is available but not standard. HDL-C : Higher is generally protective. Very low HDL (<40 men, <50 women) increases cardiovascular risk. Pharmac...