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Serum Lipid Profile; Normal Value, Causes, Treatment

Serum lipid profile or lipid panel is a panel of blood tests that serves as an initial broad medical screening tool for abnormalities in lipids, such as cholesterol and triglycerides. The results of this test can identify certain genetic diseases and can determine approximate risks for cardiovascular disease, certain forms of pancreatitis, and other diseases.

Cholesterol is carried through your blood, attached to proteins. This combination of proteins and cholesterol is called a lipoprotein. You may have heard of different types of cholesterol, based on what type of cholesterol the lipoprotein carries. They are-

Low-density lipoprotein (LDL)

LDL, or “bad,” cholesterol transports cholesterol particles throughout your body. LDL cholesterol builds up in the walls of your arteries, making them hard and narrow.

High-density lipoprotein (HDL)

HDL, or “good,” cholesterol picks up excess cholesterol and takes it back to your liver.

The lipid profile typically includes

Low-density lipoprotein (LDL)
High-density lipoprotein (HDL)
Triglycerides
Total cholesterol

Using these values, a laboratory may also calculate

Very low-density lipoprotein (VLDL)
Cholesterol:HDL ratio

The lipid profile tests are of 7 types

Total lipids
Serum total cholesterol
serum HDL cholesterol
Total cholesterol/HDL cholesterol ratio
Serum triglycerides
Serum Phospholipids
Electrophoretic fractionation to determination percentage of
- (a) Chylomicrons
- (b) LDL
- (c) VLDL
- (d) HDL

Normal Value

Cholesterol levels are measured in milligrams (mg) of cholesterol per deciliter (dL) of blood. Ideal results for most adults are:

LDL: 70 to 130 mg/dL (the lower the number, the better)
HDL: more than 40 to 60 mg/dL (the higher the number, the better)
total cholesterol: less than 200 mg/dL (the lower the number, the better)
triglycerides: 10 to 150 mg/dL (the lower the number, the better)

Levels and ranges

In adults, total cholesterol levels less than 200 milligrams per deciliter (mg/dL) are considered healthy.

A reading between 200 and 239 mg/dL is borderline high.
A reading of 240 mg/dL and above is considered high.

LDL cholesterol levels should be less than 100 mg/dL.

100–129 mg/dL is acceptable for people with no health problems but may be a concern for anyone with heart disease or heart disease risk factors.
130—159 mg/dL is borderline high.
160–189 mg/dL is high.
190 mg/dL or higher is considered very high.

HDL levels should be kept higher. The optimal reading for HDL levels is of 60 mg/dL or higher.

A reading of less than 40 mg/dL is considered a major risk factor for heart disease.
A reading from 41 mg/dL to 59 mg/dL is borderline low.

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Serum triglyceride levels and classifications are as followsLess than 100 mg/dL – Optimal

101-150 mg/dL – Normal
150-199 mg/dL – Borderline
200-499 mg/dL – High
500 mg/dL or higher – Very high

Canadian and European guidelines differ slightly from U.S. guidelines. These conversions are based on U.S. guidelines.

Total cholesterol (U.S. and some other countries)	Total cholesterol (Canada and most of Europe)
Below 200 mg/dL	Below 5.2 mmol/L	Desirable
200-239 mg/dL	5.2-6.2 mmol/L	Borderline high
240 mg/dL and above	Above 6.2 mmol/L	High

LDL cholesterol (U.S. and some other countries)	LDL cholesterol* (Canada and most of Europe)
Below 70 mg/dL	Below 1.8 mmol/L	Best for people who have heart disease or diabetes.
Below 100 mg/dL	Below 2.6 mmol/L	Optimal for people at risk of heart disease.
100-129 mg/dL	2.6-3.3 mmol/L	Near optimal if there is no heart disease. High if there is heart disease.
130-159 mg/dL	3.4-4.1 mmol/L	Borderline high if there is no heart disease. High if there is heart disease.
160-189 mg/dL	4.1-4.9 mmol/L	High if there is no heart disease. Very high if there is heart disease.
190 mg/dL and above	Above 4.9 mmol/L	Very high

HDL cholesterol (U.S. and some other countries)	HDL cholesterol* (Canada and most of Europe)
Below 40 mg/dL (men) Below 50 mg/dL (women)	Below 1 mmol/L (men) Below 1.3 mmol/L (women)	Poor
50-59 mg/dL	1.3-1.5 mmol/L	Better
60 mg/dL and above	Above 1.5 mmol/L	Best

Triglycerides (U.S. and some other countries)	Triglycerides (Canada and most of Europe)
Canadian and European guidelines differ slightly from U.S. guidelines. These conversions are based on U.S. guidelines.

Causes of Increasing Lipid in Blood

Reasons you may not be able to have the test or why the results may not be helpful include:

Diabetes
Kidney disease
Polycystic ovary syndrome (PCOS)
Cushing’s syndrome
Metabolic syndrome
Hypothyroidism
Lack of exercise – Not getting enough exercise can increase your LDL levels. Not only that, exercise has been shown to boost your healthy HDL levels.
Smoking – Smoking can also increase your bad cholesterol, causing plaque to build up in your arteries.
Genetics – If high cholesterol runs in your family, you’re at increased risk of having high cholesterol yourself.
Medicines, such as diuretics, corticosteroids, male sex hormones (androgens), tranquilizers, estrogen, birth control pills, antibiotics, and niacin (vitamin B3).
Physical stress, such as infection, heart attack, surgery.
Eating 9 to 12 hours before the test.
Other conditions, such as hypothyroidism, diabetes, or kidney or liver disease.
Alcohol or drug abuse or withdrawal.
Liver disease (such as cirrhosis or hepatitis), malnutrition, or hyperthyroidism.
Pregnancy.
Values are the highest during the third trimester and usually return to the prepregnancy levels after delivery of the baby.

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Treatment of Serum Lipid Profile

A report from Harvard Health has identified “11 cholesterol lowering foods” that actively decrease cholesterol levels:

oats
barley and whole grains
beans
eggplant and okra
nuts
vegetable oil (canola, sunflower)
fruits (mainly apples, grapes, strawberries, and citrus)
soy and soy-based foods
fatty fish (particularly salmon, tuna, and sardines)
foods rich in fiber

Adding these to a balanced diet can help keep cholesterol in check. The same report also lists foods that are bad for cholesterol levels, including:

red meat
full-fat dairy
margarine
hydrogenated oils
baked goods

Lipid-lowering therapy

Drug treatment for an individual with hypercholesterolemia will depend on their cholesterol level and other risk factors. Diet and exercise are the first approaches used to reduce cholesterol levels. Statin treatment is normally prescribed for people with a higher risk of heart attack.

Statins are the leading group of cholesterol-lowering drugs; others include selective cholesterol absorption inhibitors, resins, fibrates, and niacin. The statins available on prescription in the United States include:

Side effects can include

statin-induced myopathy (a muscle tissue disease)
fatigue
a slightly greater risk of diabetes and diabetes complications, though this is hotly debated

Statins – Statins block a substance your liver needs to make cholesterol. This causes your liver to remove cholesterol from your blood. Statins may also help your body reabsorb cholesterol from built-up deposits on your artery walls, potentially reversing coronary artery disease. Choices include atorvastatin , fluvastatin , lovastatin (Altoprev), pitavastatin , pravastatin , rosuvastatin and simvastatin .

Bile-acid-binding resins – Your liver uses cholesterol to make bile acids, a substance needed for digestion. The medications cholestyramine (Prevalite), colesevelam (Welchol) and colestipol (Colestid) lower cholesterol indirectly by binding to bile acids. This prompts your liver to use excess cholesterol to make more bile acids, which reduces the level of cholesterol in your blood.

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Cholesterol absorption inhibitors – Your small intestine absorbs the cholesterol from your diet and releases it into your bloodstream. The drug ezetimibe (Zetia) helps reduce blood cholesterol by limiting the absorption of dietary cholesterol. Ezetimibe can be used in combination with a statin drug.

Injectable medications – A new class of drugs can help the liver absorb more LDL cholesterol — which lowers the amount of cholesterol circulating in your blood. Alirocumab (Praluent) and evolocumab (Repatha) may be used for people who have a genetic condition that causes very high levels of LDL or in people with a history of coronary disease who have intolerance to statins or other cholesterol medications.

Medications for High Triglycerides

If you also have high triglycerides, your doctor may prescribe

Fibrates

The medications fenofibrate (TriCor, Fenoglide, others) and gemfibrozil (Lopid) decrease triglycerides by reducing your liver’s production of very-low-density lipoprotein (VLDL) cholesterol and by speeding up the removal of triglycerides from your blood. VLDL cholesterol contains mostly triglycerides.

Niacin

Niacin decreases triglycerides by limiting your liver’s ability to produce LDL and VLDL cholesterol. But niacin doesn’t provide any additional benefit than using statins alone. Niacin has also been linked to liver damage and stroke, so most doctors now recommend it only for people who can’t take statins.

Omega-3 fatty acid supplements

Omega-3 fatty acid supplements can help lower your triglycerides. They are available by prescription or over-the-counter. If you choose to take over-the-counter supplements, get your doctor’s OK first. Omega-3 fatty acid supplements could affect other medications you’re taking.