23145 NMR LipoProfile Test - LDL, HDL-C and Triglycerides by NMR (123562)

​If EDTA plasma is submitted, the EDTA whole blood must be spun and plasma removed and aliquotted within 4 hrs of draw.

 
Overnight fasting specimen preferred. Specify fasting status. Specimens should be shipped within 48 hours of collection.  Avoid Friday, weekend and holiday collections as specimens MUST be shipped to LabCorp within 4 days of collection.

Economics and reimbursement. Medicare will pay for NMR lipid profiles but not all private insurers will reimburse for this panel. Please verify insurance coverage.

​Test measures LDL and HDL particle size and number of LDL particles. A lipid profile is also included based on NMR-derived lipid values. Medicare coverage is provided; contact private insurance carriers for coverage.
LDL particle number and size are similar for fasting and non-fasting specimens; however, triglycerides and VLDL results will be significantly higher with non-fasting samples.

Guidelines for Usage of NMR Lipid Profiles:
1. A standard lipid profile should always be ordered on new patients.
2. If LDL-Chol exceeds 160 mg/dL or 10-year risk based on LDL-C is >20%, an NMR Lipid Profile is superfluous. The problem is clearly LDL-C and this disorder should be treated.
3. If Triglycerides are <150 mg/dL and HDL-C is >=50 mg/dL, the presence of excess small dense LDL particles is unlikely and an NRM Lipid Profile is not indicated.
4. If Triglycerides are <150 mg/dL and HDL-C is <50 mg/dL, an NMR lipid profile may be useful if there is a strong family history of CHD or clinical characteristics of metabolic syndrome.
5. Based on our experience, measurement of Apolipoprotein B at the Marshfield campus is an acceptable alternative as an in-house test for assessing high LDL particle number states. Since one Apo B exists for every LDL particle, an increased Apo B will directly reflect atherogenic LDL particles (and also VLDL particles). In studies comparing Apo B with some 140-plus NMR lipid profiles at Marshfield Labs, Apo B detected increased LDL particles in 3/4 of patients with elevated LDL particles by NMR.
6. Non-HDL Cholesterol (Total C minus HDL-C) may frequently be a useful metric. Values above 130 mg/dL in patients with optimal LDL-C indicate high levels of VLDL-C, commonly seen in metabolic syndrome.
7. Serial NMR profiles are rarely if ever indicated.
8. Economics and reimbursement. Medicare will pay for NMR lipid profiles but not all private insurers will reimburse for this panel. Please verify insurance coverage.