Lipid Panel with Reflex to Direct LDL
Quest Diagnostics
Sample type: Serum
Requires fasting: No
Phlebotomy required
Details
The Lipid Panel with Reflex to Direct LDL panel includes evaluation of total cholesterol, HDL-cholesterol, triglyceride (TG), LDL-cholesterol (calculated), cholesterol/HDL ratio (calculated), and non-HDL cholesterol; direct LDL-C measurement will be performed at additional cost if the TG level is >400 mg/dL. This panel is useful in the detection, classification, and monitoring of hyperlipidemia, especially those expected to have highly elevated TG levels.
Reflex testing uses predefined clinical logic to automatically order one or more follow-up tests based on the initial test results. Reflex tests are performed automatically without the intervention of the ordering practitioner. They are conducted using the same sample your Patient already provided. If reflex tests are required, there will be additional charges.
Initial test
- Triglycerides
- Total Cholesterol
- HDL Cholesterol
- Non-HDL Cholesterol
- Total Cholesterol / HDL Ratio
- LDL Cholesterol (by calculation)
Possible reflex biomarkers
- Direct LDL
Estimated days for results: Results should be available in 2 - 5 business days after the sample is collected
The Lipid Panel with Reflex to Direct LDL panel includes evaluation of total cholesterol, HDL-cholesterol, triglyceride (TG), LDL-cholesterol (calculated), cholesterol/HDL ratio (calculated), and non-HDL cholesterol; direct LDL-C measurement will be performed at additional cost if the TG level is >400 mg/dL. This panel is useful in the detection, classification, and monitoring of hyperlipidemia, especially those expected to have highly elevated TG levels.
LDL-C is widely accepted as a key factor for assessing the risk of coronary artery disease (CAD) [1]. The American Heart Association recommends lipid testing for adults over the age of 20 every 4 to 6 years [2]. Direct LDL-C measurement is more accurate than calculated LDL-C for patients with TG levels >400 mg/dL, and patients with hyperlipoproteinemia type III (dysbetalipoproteinemia). Thus, as indicated above, this panel is especially useful for individuals likely to have highly elevated TG and provides a basis for more realistic assessment of CAD risk in this group. It may also help track treatment progress by allowing healthcare practitioners to evaluate overall lipid levels, as well as direct LDL-C [3].
In addition to genetic causes that lead to highly elevated TG levels, certain medical conditions can also increase TG, including diabetes, thyroid disease, liver and kidney diseases, and obesity [4].
Calculated LDL values have a variance of 11% to 26%, whereas direct LDL-C values have a variance of less than 4% [5].
In rare cases, gammopathy, especially monoclonal IgM (Waldenstrom’s macroglobulinemia), may cause unreliable results.
References
1. Grundy SM, et al. Circulation. 2019;139:e1082-e1143.
2. Stone NJ, et al. Circulation. 2014;129 (suppl 2):S1-S45.
3. Armbruster DA, Lambert PA. Lab Med. 1996;9:613-617.
4. NHLBI. High blood triglycerides.
https://www.nhlbi.nih.gov/health-topics/high-blood-triglycerides.
5. Schectman G, et al. Clin Chem. 1994;39:1495-1503.
2–5 business days
Total Cholesterol
<20 Years <170 <170
≥20 Years <200 <200
HDL Cholesterol
<20 Years >45 >45
≥20 Years ≥40 ≥50
Triglycerides
≤9 Years <75 <75
10–19 Years <90 <90
≥20 Years <150 <150
LDL-Cholesterol (Calc)
<20 Years <110 <110
≥20 Years <100 <100
Cholesterol/HDL Ratio (Calc)
<5.0 <5.0
Non-HDL Cholesterol
<20 Years <120 <120
≥20 Years <130 <130
Blood Draw Options with Fullscript
Fullscript offers several convenient phlebotomy options to complete your lab testing:
Quest Diagnostics Patient Service Centers (PSC)
- Location: Visit a nearby Quest Diagnostics Patient Service Center.
- Cost: $10 sample collection fee (paid during lab order checkout).
- Scheduling: Schedule your appointment here. Appointments are recommended to reduce wait times. Walk-ins are accepted, but may experience delays. Aim to arrive 10 minutes before your appointment.
- Collection Instructions:
- Bring a valid ID.
- Bring your digital or printed requisition form, available in the Labs tab of your Fullscript account.
- Check-in: Scan the QR code from your confirmation email or follow kiosk instructions.
- More Info: Quest Diagnostics blood draw guide
Getlabs Mobile Phlebotomy
- Location: Sample collection at your home or office.
- Cost: $85 sample collection fee (paid during lab order checkout).
- Availability: Available in most locations – enter your ZIP code during checkout to confirm.
- Scheduling: Schedule your appointment here through your Fullscript account.
- Collection Instructions:
- Have your digital or printed requisition form and valid ID ready.
- Your phlebotomist will contact you by phone to coordinate arrival.
- More Info: Getlabs blood draw guide
- Preferred Specimen(s): 2 mL serum
- Alternative: NA
- Minimum Volume: NA
- Collection Instructions: NA
- Transport Container: Serum separator tube (SST)
- Transport Temperature: Room Temperature
- Specimen Stability:
- Room temperature: 48 hours
- Refrigerated: 7 days
- Frozen: 28 days
- Reject Criteria:
- Gross hemolysis • Moderate to gross icterus • Anticoagulants other than heparin
State restrictions:
Patient can't order this test if they are located in Hawaii, Puerto Rico, New Jersey, New York, or Rhode Island
