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Test ID LMPP Lipoprotein Metabolism Profile

Reporting Name

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

Specimen Type

Serum


Necessary Information


Patient's age and sex are required.



Specimen Required


Patient Preparation:

1. Fasting-overnight (12-14 hours)

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

Collection Container/Tube:

Preferred: Red top

Acceptable: Serum gel

Submission Container/Tube: Plastic vial

Specimen Volume: 5 mL


Specimen Minimum Volume

2 mL

Specimen Stability Information

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

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

Day(s) and Time(s) Performed

Monday through Saturday; 4 p.m.

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

LOINC Code Information

Test ID Test Order Name Order LOINC Value
LMPP Lipoprotein Metabolism Profile In Process

 

Result ID Test Result Name Result LOINC Value
TCS Cholesterol, Total, CDC, S 2093-3
HDLS HDL Cholesterol, CDC, S 2085-9
TRIGC Triglycerides, CDC, S 2571-8
APLBS Apolipoprotein B, S 1884-6
2839 LDL Cholesterol 2089-1
2840 LDL Triglycerides 3046-0
2844 VLDL cholesterol 2091-7
2847 VLDL triglycerides 3047-8
2842 Beta VLDL Cholesterol 2091-7
2843 Beta VLDL triglycerides 3045-2
2855 Chylomicron cholesterol 34467-1
2856 Chylomicron triglycerides 35363-1
2849 Lp(a) Cholesterol 10835-7
23924 LpX 42178-4
23937 Interpretation 59462-2

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)

Interpretation

For discussion of primary disorders associated with dyslipidemias see Lipids and Lipoproteins in Blood Plasma (Serum) in Special Instructions.

 

For discussion of Lp(a), see LPAWS / Lipoprotein (a) Cholesterol, Serum.

Clinical Reference

1. Schriver CR, Beaudet AL, Sly WS, Valle D: Lipoprotein and lipid disorders. In The Metabolic Basis of Inherited Disease. Sixth edition. Edited by JB Stanbury, JB Wyngaarden, DS Frederickson. New York, McGraw-Hill Book Company, 1989, pp 1129-1302

2. Grinstead GF, Ellefson RD: Heterogeneity of lipoprotein Lp(a) and apolipoprotein(a). Clin Chem 1988;34:1036-1040

3. Jacobson TA, Ito MK, Maki KC, et al: National Lipid Association recommendations for patient-centered management of dyslipidemia: Part 1-executive summary. J Clin Lipidol 2014 Sep-Oct;8(5):473-488

4. Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents: summary report. Pediatrics 2011 Dec;128 Suppl 5:S213-S256

5. Contois JH, McConnell JP, Sethi AA, et al: Apolipoprotein B and Cardiovascular Disease Risk: Position Statement from the AACC Lipoproteins and Vascular Diseases Division Working Group on Best Practices. Clinical Chemistry 2009:55:3:407-419

Analytic Time

3 days

Method Name

Ultracentrifugation/Electrophoresis/Automated Enzymatic/Colorimetric Analysis

Forms

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