Non-HDL Cholesterol in Your Blood Test

When you have your lipid panel done, typically there are four numbers we see -total cholesterol, triglycerides, HDL cholesterol, and LDL cholesterol. Recently non-HDL cholesterol has been added. Non- HDL CHOLESTEROL is your total cholesterol minus your HDL cholesterol. This non-HDL is important for two reasons. #1. You don’t need to fast to check your non-HDL cholesterol.2.

For many people, it may be as good as or even more reliable than LDL cholesterol for assessing heart disease risk.

Traditionally, doctors have focused, mainly on LDL cholesterol, mostly because large studies have shown that statins and other drugs that lower LDL cholesterol levels also decrease the risk of heart attack, stroke, and other cardiovascular problems. Most labs don’t directly measure the LDL in your blood sample.

Instead they use a formula to calculate your LDL, based on your triglycerides, total cholesterol, and HDL cholesterol. Your total cholesterol is not affected by food. However, your Triglycerides are affected by food intake. It goes up after eating. What and when you eat affect your triglyceride levels, so ideally, you should fast before the blood test which help to standardize the results.

It is only the triglyceride levels which is affected by food. Since non-HDL cholesterol calculation is not based on triglyceride value, you may not required to fast before the test. The results are similar, whether you fast or not.

Non-HDL cholesterol value includes all the atherogenic ( Artery clogging ) Lipo protein particles-not just LDL, but also very low density Lipoprotein otherwise called VLDL and intermediate density Lipoprotein otherwise called IDL. These particles which transport triglycerides to tissues are eventually transformed into LDL.

Many lipid specialist think that the non-HDL cholesterol values may be superior to LDL cholesterol value for predicting heart disease risk. Most of us eat every few hours during the day, which means we spend better part of our waking hours in a “FED” state rather than the “FASTING STATE”. so results from non-fasting blood test better reflects our typical physiology.

And also the widely used online heart risk calculator use non-HDL cholesterol number.

The target for non-HDL cholesterol is no greater than 30 mg/dL above your recommended LDL level. For example, if your LDL goal is under 100 mg/dL, your non-HDL cholesterol level should be 130 or less. If your non-HDL cholesterol level is elevated, your doctor might further intensify your LDL lowering drug therapy or focus on lowering your elevated triglycerides.

Please note that I am not advocating having the lipid panel done non-fasting. I’m only telling that non-HDL cholesterol doesn’t need to be a fasting blood specimen. it is only the triglyceride which need to be fasting blood test. Since, triglycerides are part of the lipid panel. We all ask for fasting blood test for lipid panel.

Dr Keshava Aithal ಅಂಕ 8 Double 0