Did you know that the standard lipid panel results that many people get from their doctor’s office might be slightly – or even completely – wrong? It’s a scary thought for anyone concerned about their heart health and yet many people get lipid lab assessments based on lab methodologies that are decades old. However, there is a better lab test for people who want to know their real data without breaking the bank. Interested? Read on.<\/p>\n
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For many years, the standard lipid panel test has been used (and is used today) to take a snapshot of specific types of fats in the blood. Inexpensive and easy to perform, the lipid panel is a helpful way to get a baseline screen in people who are getting started with measuring their blood markers or are generally healthy. The standard lipid panel test is fast, almost every\u00a0lab can perform it, and it is fairly easy to interpret. With all these benefits, the lipid panel has become a centerpiece of lab testing during most routine physical exams.<\/p>\n
To better understand why the lipid panel is useful and how it relates to our heart and vascular health, let’s take a look at our cardiovascular system and the concept of cardiovascular disease.<\/p>\n
Cardiovascular disease is medical lingo\u00a0that signifies\u00a0certain diseases related to the heart and blood vessels. \u00a0As background, the heart is the body’s pump and has the important function of pushing blood through the blood vessels – the pipes of the body – to deliver oxygen and nutrients to your organs and other tissues.\u00a0As the pump, the heart also helps bring back waste and toxins from the body to be removed\u00a0by organs\u00a0like the lungs. Amazingly, this cycle starts\u00a0the moment we are born and continues until the day we die.<\/p>\n
In that context, cardiovascular disease represents underlying problems that can eventually lead to problems like a\u00a0heart attack or a stroke. Special types of lab testing (see below) can identify our risk for cardiovascular disease and, if abnormal, motivate us to start making positive lifestyle changes to enjoy\u00a0a longer, healthier life.<\/p>\n
Improvements in medical technology and our understanding of how fats\u00a0function in the body have led to interesting developments since\u00a0the lipid panel test first came about. Over time, this improved\u00a0understanding of the interplay between\u00a0the levels of different types of molecules like fats and protein in our blood and our cardiovascular disease risk has led to advancements in lab tests and testing protocols. \u00a0To put these new understandings\u00a0into practice, lab testing companies have developed new types of lab tests (e.g. VAP, NMR LipoProfile) to measure markers so that people can get a more detailed\u00a0understanding of their cardiovascular risk.<\/p>\n
One advanced lipid test panel\u00a0that measures some of these new markers is the Cardio IQ Test Panel<\/a>. This lab test panel includes\u00a0many of the traditional markers of the standard lipid panel (e.g. total cholesterol, HDL and triglycerides) but also tests\u00a0some newer\u00a0blood markers that show promise in helping determine one’s cardiovascular risk. Specifically, the Cardio IQ test panel includes the LDL particle number test<\/strong>, the apolipoprotein B test<\/strong>, and the Lipoprotein (a) test<\/strong>.<\/p>\n Let’s take a closer look at these advanced lipid panel tests and why your standard lipid panel numbers might actually be incorrect.<\/p>\n The LDL particle number test, or LDL-P, is a blood test that reports the measured number of LDL particles found in your sample of blood. This LDL-P lab test does this using a lab technique called spectrophotometry. In spectrophotometry, the blood is analyzed by assessing variations in light and wavelength reflection. This sophisticated methodology is a place where advanced lipid testing may uncover major differences in your lipid profile when compared to standard lipid testing.<\/p>\n To understand why, it helps to understand what some of the numbers on the results of a standard lipid panel actually mean. Pull out a copy of your previous lipid panel results or, alternatively, open up the sample report on our lipid panel test<\/a> page. As you can see, this lipid panel test reports a number known as the LDL-Cholesterol (LDL-C) – a form of LDL or low-density lipoprotein. In this lipid panel test, LDL-Cholesterol is calculated using a special medical formula known as the Friedewald equation<\/a> using your measured cholesterol level. In other words, the LDL-Cholesterol on the standard lipid panel is calculated as opposed to being directly measured using the LDL particle number test.<\/p>\n You might be asking yourself why the LDL-C number was ever calculated (as opposed to being measure directly) in the first place. The main, underlying assumption driving the use of a calculated LDL-C number is that it was thought that the LDL molecule was primarily comprised of cholesterol in most people. With this assumption, estimating the LDL-C number would be accurate as long as the calculation of the total cholesterol number was accurate. And, using the Friedewald equation, calculating the LDL-C level was easy to do. Until more recently, the cost of directly calculating the LDL particle number was prohibitively expensive to use on a widespread screening basis.<\/p>\n With the progression of our understanding of LDL, its composition and how it functions in the body, we have learned that calculating the LDL-C level in this way is not always accurate. Later\u00a0studies suggested that the amount of cholesterol in the LDL molecule actually varies widely from person to person, poking holes in the assumptions underlying the LDL-C calculation.<\/span>1<\/sup><\/a><\/span>\n With that understanding and ongoing improvements in lab testing technologies and methodologies, it has become easier to directly analyze the LDL particles themselves as opposed to calculating their numbers. In doing so, variations have been found between LDL-C and LDL-P numbers, leading to a greater appreciation of the LDL-P test. Some recent studies have supported the accuracy of LDL-P testing as it turns out that\u00a0the LDL particle number is probably\u00a0a more accurate predictor of cardiovascular risk that\u00a0the LDL-C level.<\/span>2<\/sup><\/a><\/span>\n Additionally, the spectrophotometry\u00a0technique used in LDL-P testing can also help determine other attributes of the LDL molecules that can help assess cardiovascular risk. Specifically, the LDL particle size<\/strong> breakdown, peak size<\/strong> and pattern type<\/strong> attributes are often measured at the same time as the LDL-P number itself. These attributes shed additional light on the relative risk of any particular individual’s cardiovascular risk as it relates to LDL.<\/p>\n When reported, LDL particle sizes are described as\u00a0small, medium and large.\u00a0Smaller LDL particles contain less cholesterol and more triglycerides and seem to be the particle type more\u00a0likely to lead to cardiovascular disease. In contrast, larger LDL particles seem less dangerous and may have a\u00a0protective role in preventing cardiovascular disease.<\/p>\n For some people, all of this data might be overwhelming to digest. For people not necessarily interested in the subtleties of their LDL particles, the LDL pattern type is something of a shortcut to understanding one’s LDL composition. As a snapshot of one’s LDL composition, the LDL pattern type is reported as either pattern type A or\u00a0pattern type B. On average, pattern type A signifies larger molecules (better) while pattern type B means smaller LDL molecules (worse). The LDL particle number, breakdown and pattern type are all reported as part of the Cardio IQ Test Panel.<\/p>\n Apolipoproteins are molecules that transport fats in the blood. Cholesterol and other fats\u00a0cannot move through the blood by themselves so they hook up and bind with apolipoproteins to get to where they need to go.<\/p>\n Apolipoprotein B, or ApoB, is a specific (and nasty) type of lipoprotein. ApoB likes to help bad stuff\u00a0accumulate in our blood vessel walls, forming little buildups\u00a0called plaques. Over time, a plaque can get big enough or break open to cause a blood vessel blockage, leading to a bad event like a heart attack or stroke. Because of their tendency to help<\/a> plaques form, elevated apolipoprotein B test<\/a> levels are also correlated with an increased risk of cardiovascular disease.<\/p>\n ApoB levels can also be elevated even when the standard LDL-C levels are normal which makes advanced lipid testing more important for anyone who is concerned and has a normal lipid panel. In conjunction with the LDL particle number, the ApoB test provides more information into one’s\u00a0current cardiovascular health.<\/p>\n The Lipoprotein (a) test, also known as an Lp(a) test<\/a>, measures the level of Lp(a)\u00a0in the blood. Lp(a) is a lipoprotein and\u00a0is a risk<\/a> factor for cardiovascular disease and a condition called aortic stenosis (narrowing of a major vessel known as the aorta).\u00a0Lp(a) levels are thought to be determined by one’s genes and levels remain fairly stable over one’s lifetime. Lp(a) levels above 125 nmol\/L (some labs use 75 nmol \/ L) are considered high. Although the Lp(a) test is not frequently performed as part of standard lab tests, up to 20% of people may have an abnormal Lp(a) test level.<\/p>\n Unfortunately, high Lp(a) levels cannot\u00a0be\u00a0effectively managed by changing one’s lifestyle. If one has an elevated Lp(a) level, one should consider specific types of supplements and other interventions in conjunction with a qualified\u00a0medical provider. Also, if someone has a high Lp(a) test level, it is likely that other family members\u00a0do as well and they should also consider getting an Lp(a) test.<\/p>\n Most people with abnormal advanced lipid test markers should get\u00a0help from a qualified medical provider. \u00a0Some medical providers have developed specialized expertise in managing problems related to abnormal results. In many cases, medical providers who specialize in functional medicine or integrative medicine will have incorporated\u00a0specific treatment protocols into their practices for managing these types of findings.<\/p>\n We hope that his overview of some of the newer advanced lipid tests will help you or someone you care about stay healthier in honor of the day of the heart. If you found this article helpful, please consider\u00a0sharing it. Good luck with keeping your heart healthy!<\/p>\n 1. Am J Cardiol. 2002 Oct 17;90(8A):22i-29i. Did you know that the standard lipid panel results that many people get from their doctor’s office might be slightly – or even completely – wrong? It’s a scary thought for anyone concerned about their heart health and yet many people get lipid lab assessments based on lab methodologies that are decades old. However, there […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_genesis_hide_title":false,"_genesis_hide_breadcrumbs":false,"_genesis_hide_singular_image":false,"_genesis_hide_footer_widgets":false,"_genesis_custom_body_class":"","_genesis_custom_post_class":"","_genesis_layout":""},"categories":[17,16,15,18],"tags":[],"yoast_head":"\nLDL Particle Number Test<\/h2>\n
Apolipoprotein B Test<\/h2>\n
Lipoprotein (a) Test<\/h2>\n
Managing Abnormal Lipid\u00a0Tests<\/h2>\n
Advanced Lipid Testing – Final Thoughts<\/h2>\n
Advanced Lipid Testing – Additional References<\/h2>\n
\n2. J Clin Lipidol. 2007 Dec 1; 1(6): 583\u2013592.<\/p>\n","protected":false},"excerpt":{"rendered":"