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Test ID LMPP Lipoprotein Metabolism Profile

Useful For

Diagnosing dyslipoproteinemia

 

Quantitation of cholesterol and triglycerides in very-low-density lipoprotein (VLDL), LDL, HDL, and chylomicrons

 

Identification of LpX

 

Classifying hyperlipoproteinemias (lipoprotein phenotyping)

 

Evaluating patients with abnormal lipid values (cholesterol, triglyceride, HDL, LDL)

 

Quantifying lipoprotein a (Lp[a]) cholesterol

Profile Information

Test ID Reporting Name Available Separately Always Performed
TCS Cholesterol, Total, CDC, S No Yes
TRIGC Triglycerides, CDC, S No Yes
APLBS Apolipoprotein B, S No Yes
HDLS HDL Cholesterol, CDC, S No Yes
LMPP1 Lipoprotein Metabolism Profile 1 No Yes

Method Name

Ultracentrifugation/Electrophoresis/Automated Enzymatic/Colorimetric Analysis

Reporting Name

Lipoprotein Metabolism Profile

Specimen Type

Serum

Collection Container/Tube:

Preferred: Red top

Acceptable: Serum gel

Submission Container/Tube: Plastic vial

Specimen Volume: 5 mL

Collection Instructions:

1. Fasting-overnight (12-14 hours)

2. Patient must not consume any alcohol for 24 hours before the specimen is drawn.

Additional Information: Patient's age and sex are required.

Forms: If not ordering electronically, complete, print, and send a Cardiovascular Test Request Form (T724) with the specimen (http://www.mayomedicallaboratories.com/media/customer-service/forms/cardiovascular-request-form.pdf).

Specimen Minimum Volume

2 mL

Specimen Stability Information

Specimen Type Temperature Time
Serum Refrigerated (preferred) 7 days
  Frozen  60 days

Clinical Information

Lipoprotein metabolism profile analysis adds practical information about the etiology of cholesterol and/or triglyceride elevation. In some patients, increased serum lipids reflects elevated levels of intermediate-density lipoprotein (IDL), very-low-density lipoprotein (VLDL), lipoprotein a (Lp[a]), or even the abnormal lipoprotein complex-LpX. These elevations can be indicative of a genetic deficiency in lipid metabolism or transport, nephrotic syndrome, endocrine dysfunction or even cholestasis. Identification of the lipoprotein associated with lipid elevation is achieved using the gold-standard methods, which include ultracentrifugation, selective precipitation, electrophoresis, and direct measurement of cholesterol and triglycerides in isolated lipoprotein fractions. Proper characterization of a patient’s dyslipidemic phenotype aids clinical decisions and guides appropriate therapy.

 

Classifying the hyperlipoproteinemias into phenotypes places disorders that affect plasma lipid and lipoprotein concentrations into convenient groups for evaluation and treatment. A clear distinction must be made between primary (inherited) and secondary (liver disease, alcoholism, metabolic diseases) causes of dyslipoproteinemia. Lipoprotein profiling will identify the presence of Lp(a) and LpX and distinguish between the following dyslipidemias:

-Exogenous hyperlipemia (Type I)

-Familial Hypercholesterolemia (Type IIa)

-Familial Combined Hyperlipidemia (Type IIb)

-Familial dysbetalipoproteinemia (Type III)

-Endogenous hyperlipemia (Type IV)

-Mixed hyperlipemia (Type V)

Reference Values

Age

2-9 years

10-17 years

>18 years

Total Cholesterol (mg/dL)

**

Acceptable: <170

Borderline high: 170-199

High: ≥200

*

Desirable: < 200

Borderline high: 200 - 239

High: ≥ 240

Triglycerides (mg/dL)

**

Acceptable: <75 

Borderline high: 75-99

High: ≥100

**

Acceptable: <90 

Borderline high: 90-129

High: ≥130

*

Normal: <150

Borderline high: 150-199

High: 200-499

Very high: ≥500

LDL Cholesterol (mg/dL)

**

Acceptable: <110

Borderline high: 110-129

High: ≥130

***

Desirable: <100

Above Desirable: 100-129

Borderline high: 130-159

High: 160-189

Very high: ≥190

LDL Triglycerides (mg/dL)

≤ 50

≤ 50

Apolipoprotein B (mg/dL)

**

Acceptable: <90

Borderline high: 90-109

High: ≥110

Desirable: <90

Above Desirable: 90-99

Borderline high: 100-119

High: 120-139

Very high: ≥140

HDL Cholesterol (mg/dL)

**

Low: <40

Borderline low: 40-45

Acceptable: > 45

***

Males: ≥40

Females: ≥50

 

VLDL Cholesterol (mg/dL)

<30

<30

VLDLTriglycerides (mg/dL)

<90

<120

Beta VLDL Cholesterol (mg/dL)

<15

<15

Beta VLDL

Triglycerides (mg/dL)

<15

<15

Chylomicron Cholesterol

Undetectable

Undetectable

Chylomicron Triglycerides

Undetectable

Undetectable

Lp(a) cholesterol

<3

<3

LpX

Undetectable

Undetectable

 

Reference values have not been established for patients that are <2 years of age.

*National Cholesterol Education Program (NCEP)

**Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents

***National Lipid Association

Cautions

Reference values are based on fasting collections; it is essential that the patient fasts 12 to 14 hours before the test.

 

Result can be falsely decreased in patients with elevated levels of N-acetyl-p-benzoquinone imine (NAPQI)-a metabolite of acetaminophen), N-acetylcysteine (NAC), and metamizole.

Day(s) Performed

Monday through Saturday; 4 p.m.

Report Available

3 days

Performing Laboratory

Mayo Medical Laboratories in Rochester

CPT Code Information

80061-Lipid panel (includes: HDL [CPT Code 83718], total cholesterol [CPT Code 82465], and triglycerides [CPT Code 84478])

82172-Apolipoprotein B

83700-Lp(a) cholesterol electrophoresis

NY State Approved

Yes