Ulta Lab Tests

Advanced TRL Phenotyping & Therapy Readiness Panel

The Advanced TRL Phenotyping & Therapy Readiness Panel provides a detailed evaluation of triglyceride-rich lipoproteins, atherogenic particle burden, inflammation, and metabolic readiness. By combining advanced lipid, NMR particle analysis, ApoB, ApoC-III, insulin, liver function, and OmegaCheck testing, this blood panel delivers deep insight into remnant-driven cardiovascular risk beyond standard cholesterol testing.

Serum, Blood
Phlebotomist

Severe Hypertriglyceridemia Precision Panel

The following is a list of what is included in the item above. Click the test(s) below to view what biomarkers are measured along with an explanation of what the biomarker is measuring.

Apolipoprotein B

Also known as: Cholesterol, LDL, LDL, LDL Cholesterol, Direct, Low Density Lipoprotein

Direct LDL

The test for low-density lipoprotein cholesterol (LDL-C) is used as part of a lipid profile to predict an individual's risk of developing heart disease. The LDL cholesterol is considered the most important form in determining risk of heart disease. LDL values amy be used to monitor levels after the start of diet or exercise programs or to determine whether or not prescribing one of the lipid-lowering drugs, such as statins, would be useful.

Also known as: A1c, Glycated Hemoglobin, Glycohemoglobin, Glycosylated Hemoglobin, HA1c, HbA1c, Hemoglobin A1c, Hemoglobin A1c HgbA1C, Hgb A1c

HEMOGLOBIN A1C

The A1c test evaluates the average amount of glucose in the blood over the last 2 to 3 months. It does this by measuring the concentration of glycated (also often called glycosylated) hemoglobin A1c. Hemoglobin is an oxygen-transporting protein found inside red blood cells (RBCs). There are several types of normal hemoglobin, but the predominant form – about 95-98% – is hemoglobin A. As glucose circulates in the blood, some of it spontaneously binds to hemoglobin A. The hemoglobin molecules with attached glucose are called glycated hemoglobin. The higher the concentration of glucose in the blood, the more glycated hemoglobin is formed. Once the glucose binds to the hemoglobin, it remains there for the life of the red blood cell – normally about 120 days. The predominant form of glycated hemoglobin is referred to as HbA1c or A1c. A1c is produced on a daily basis and slowly cleared from the blood as older RBCs die and younger RBCs (with non-glycated hemoglobin) take their place. This test is used to monitor treatment in someone who has been diagnosed with diabetes. It helps to evaluate how well their glucose levels have been controlled by treatment over time. This test may be used to screen for and diagnose diabetes or risk of developing diabetes. In 2010, clinical practice guidelines from the American Diabetes Association (ADA) stated that A1c may be added to fasting plasma glucose (FPG) and oral glucose tolerance test (OGTT) as an option for diabetes screening and diagnosis. For monitoring purposes, an A1c of less than 7% indicates good glucose control and a lower risk of diabetic complications for the majority of diabetics. However, in 2012, the ADA and the European Association for the Study of Diabetes (EASD) issued a position statement recommending that the management of glucose control in type 2 diabetes be more "patient-centered." Data from recent studies have shown that low blood sugar (hypoglycemia) can cause complications and that people with risk of severe hypoglycemia, underlying health conditions, complications, and a limited life expectancy do not necessarily benefit from having a stringent goal of less than 7% for their A1c. The statement recommends that people work closely with their doctor to select a goal that reflects each person's individual health status and that balances risks and benefits.

Also known as: LFTs, Liver Function Tests, Liver Panel

Albumin

Albumin is a protein made by the liver. A serum albumin test measures the amount of this protein in the clear liquid portion of the blood.

Albumin/Globulin Ratio

The ratio of albumin to globulin (A/G ratio) is calculated from measured albumin and calculated globulin (total protein - albumin). Normally, there is a little more albumin than globulins, giving a normal A/G ratio of slightly over 1. Because disease states affect the relative amounts of albumin and globulin, the A/G ratio may provide a clue as to the cause of the change in protein levels. A low A/G ratio may reflect overproduction of globulins, such as seen in multiple myeloma or autoimmune diseases, or underproduction of albumin, such as may occur with cirrhosis, or selective loss of albumin from the circulation, as may occur with kidney disease (nephrotic syndrome). A high A/G ratio suggests underproduction of immunoglobulins as may be seen in some genetic deficiencies and in some leukemias. More specific tests, such as liver enzyme tests and serum protein electrophoresis, must be performed to make an accurate diagnosis. With a low total protein that is due to plasma expansion (dilution of the blood), the A/G ratio will typically be normal because both albumin and globulin will be diluted to the same extent.

Alkaline Phosphatase

Alkaline phosphatase (ALP) is a protein found in all body tissues. Tissues with higher amounts of ALP include the liver, bile ducts, and bone.

Alt

Alanine transaminase (ALT) is an enzyme found in the highest amounts in the liver. Injury to the liver results in release of the substance into the blood.

AST

AST (aspartate aminotransferase) is an enzyme found in high amounts in liver, heart, and muscle cells. It is also found in lesser amounts in other tissues.

Bilirubin, Direct

Bilirubin is a yellowish pigment found in bile, a fluid made by the liver. A small amount of older red blood cells are replaced by new blood cells every day. Bilirubin is left after these older blood cells are removed. The liver helps break down bilirubin so that it can be removed from the body in the stool.

Bilirubin, Indirect

Bilirubin is a yellowish pigment found in bile, a fluid made by the liver. A small amount of older red blood cells are replaced by new blood cells every day. Bilirubin is left after these older blood cells are removed. The liver helps break down bilirubin so that it can be removed from the body in the stool.

Bilirubin, Total

Bilirubin is a yellowish pigment found in bile, a fluid made by the liver. A small amount of older red blood cells are replaced by new blood cells every day. Bilirubin is left after these older blood cells are removed. The liver helps break down bilirubin so that it can be removed from the body in the stool.

Globulin

Globulins is the collective term for most blood proteins other than albumin. Identifying the types of globulins can help diagnose certain disorders. Globulins are roughly divided into three groups: alpha, beta, and gamma globulins. Gamma globulines include various types of antibodies such as immunoglobulins (Ig) M, G, and A.

Protein, Total

The total protein is the total amount of two classes of proteins, albumin and globulin that are found in the fluid portion of your blood. Proteins are important parts of all cells and tissues. Your albumin helps prevent fluid from leaking out of blood vessels and your globulins are an important part of your immune system.

Also known as: C-Reactive Protein, Cardio CRP, Cardio hs-CRP, CRP, High Sensitivity CRP, High-sensitivity C-reactive Protein, High-sensitivity CRP, Highly Sensitive CRP, hsCRP, Ultra-sensitive CRP

Hs Crp

A high-sensitivity CRP (hs-CRP) test may be used by itself, in combination with other cardiac risk markers, or in combination with a lipoprotein-associated phospholipase A2 (Lp-PLA2) test that evaluates vascular inflammation. The hs-CRP test accurately detects low concentrations of C-reactive protein to help predict a healthy person's risk of cardiovascular disease (CVD). High-sensitivity CRP is promoted by some as a test for determining a person's risk level for CVD, heart attacks, and strokes. The current thinking is that hs-CRP can play a role in the evaluation process before a person develops one of these health problems.

Also known as: Insulin (fasting)

Insulin

Insulin is a hormone that is produced and stored in the beta cells of the pancreas. It is vital for the transportation and storage of glucose at the cellular level, helps regulate blood glucose levels, and has a role in lipid metabolism. When blood glucose levels rise after a meal, insulin is released to allow glucose to move into tissue cells, especially muscle and adipose (fat) cells, where is it is used for energy production. Insulin then prompts the liver to either store the remaining excess blood glucose as glycogen for short-term energy storage and/or to use it to produce fatty acids. The fatty acids are eventually used by adipose tissue to synthesize triglycerides to form the basis of a longer term, more concentrated form of energy storage. Without insulin, glucose cannot reach most of the body's cells. Without glucose, the cells starve and blood glucose levels rise to unhealthy levels. This can cause disturbances in normal metabolic processes that result in various disorders, including kidney disease, cardiovascular disease, and vision and neurological problems. Thus, diabetes, a disorder associated with decreased insulin effects, is eventually a life-threatening condition.

Also known as: Cholesterol, HDL,Fasting Lipids,Cholesterol, LDL, Fasting Lipids, Lipid Panel (fasting), Lipid Profile (fasting), Lipids

Chol/HDLC Ratio

Cholesterol, Total

Cholesterol is a waxy, fat-like substance that occurs naturally in all parts of the body. Your body needs some cholesterol to work properly. But if you have too much in your blood, it can combine with other substances in the blood and stick to the walls of your arteries. This is called plaque. Plaque can narrow your arteries or even block them. High levels of cholesterol in the blood can increase your risk of heart disease. Your cholesterol levels tend to rise as you get older. There are usually no signs or symptoms that you have high blood cholesterol, but it can be detected with a blood test. You are likely to have high cholesterol if members of your family have it, if you are overweight or if you eat a lot of fatty foods. You can lower your cholesterol by exercising more and eating more fruits and vegetables. You also may need to take medicine to lower your cholesterol.

HDL Cholesterol

LDL-Cholesterol

Non HDL Cholesterol

Triglycerides

Triglycerides are a form of fat and a major source of energy for the body. This test measures the amount of triglycerides in the blood. Most triglycerides are found in fat (adipose) tissue, but some triglycerides circulate in the blood to provide fuel for muscles to work. After a person eats, an increased level of triglycerides is found in the blood as the body converts the energy not needed right away into fat. Triglycerides move via the blood from the gut to adipose tissue for storage. In between meals, triglycerides are released from fat tissue to be used as an energy source for the body. Most triglycerides are carried in the blood by lipoproteins called very low density lipoproteins (VLDL). High levels of triglycerides in the blood are associated with an increased risk of developing cardiovascular disease (CVD), although the reason for this is not well understood. Certain factors can contribute to high triglyceride levels and to risk of CVD, including lack of exercise, being overweight, smoking cigarettes, consuming excess alcohol, and medical conditions such as diabetes and kidney disease.

Also known as: Lipoprotein A, Lp (a), Lp(a)

Lipoprotein (A)

Lipoprotein-a, or Lp(a) are molecules made of proteins and fat. They carry cholesterol and similar substances through the blood. A high level of Lp(a) is considered a risk factor for heart disease. High levels of lipoproteins can increase the risk of heart disease. The test is done to check your risk of atherosclerosis, stroke, and heart attack.

HDL P

HDL SIZE

LARGE HDL P

LARGE VLDL P

LDL P

LDL SIZE

SMALL LDL P

VLDL SIZE

ARACHIDONIC ACID

ARACHIDONIC ACID/EPA

DHA

DPA

EPA

EPA+DPA+DHA

LINOLEIC ACID

OMEGA-3 TOTAL

OMEGA-6 TOTAL

OMEGA-6/OMEGA-3 RATIO

Also known as: Very Low-Density Lipoprotein Cholesterol, VLDL, VLDL-C

Cholesterol, Very Low

Triglycerides

Triglycerides are a form of fat and a major source of energy for the body. This test measures the amount of triglycerides in the blood. Most triglycerides are found in fat (adipose) tissue, but some triglycerides circulate in the blood to provide fuel for muscles to work. After a person eats, an increased level of triglycerides is found in the blood as the body converts the energy not needed right away into fat. Triglycerides move via the blood from the gut to adipose tissue for storage. In between meals, triglycerides are released from fat tissue to be used as an energy source for the body. Most triglycerides are carried in the blood by lipoproteins called very low density lipoproteins (VLDL). High levels of triglycerides in the blood are associated with an increased risk of developing cardiovascular disease (CVD), although the reason for this is not well understood. Certain factors can contribute to high triglyceride levels and to risk of CVD, including lack of exercise, being overweight, smoking cigarettes, consuming excess alcohol, and medical conditions such as diabetes and kidney disease.
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The Advanced TRL Phenotyping & Therapy Readiness Panel panel contains 12 tests with 42 biomarkers .

The Advanced TRL Phenotyping & Therapy Readiness Panel is an in-depth cardiometabolic and lipid metabolism assessment designed to characterize triglyceride-rich lipoproteins (TRLs), quantify atherogenic particle burden, and evaluate metabolic and inflammatory readiness for advanced lipid-focused interventions. This panel goes well beyond traditional cholesterol testing by integrating particle-level lipoprotein analysis, regulatory apolipoproteins, inflammatory markers, insulin and glucose control, liver function, and fatty acid balance into a single, cohesive evaluation.

TRLs—including very-low-density lipoproteins (VLDL) and their remnants—are increasingly recognized as central drivers of atherosclerotic cardiovascular disease, insulin resistance–associated dyslipidemia, and residual cardiovascular risk. Standard lipid panels can identify elevated triglycerides, but they cannot explain why triglycerides are elevated, how many atherogenic particles are circulating, or whether metabolic and inflammatory conditions are amplifying risk. This panel addresses those gaps by combining quantitative lipid measurements with functional and phenotypic markers.

Key components include apolipoprotein C-III (ApoC-III), a critical regulator of TRL clearance; apolipoprotein B (ApoB), which reflects total atherogenic particle number; NMR lipoprotein fractionation to define particle size and concentration; VLDL measurement to directly assess TRL burden; and hs-CRP to capture vascular inflammation. Insulin and hemoglobin A1c provide metabolic context, while the Liver Function Panel helps assess hepatic involvement in lipid production and clearance. OmegaCheck adds a nutritional and inflammatory dimension by evaluating omega-3 and omega-6 fatty acid balance.

The Advanced TRL Phenotyping & Therapy Readiness Panel is designed for individuals and clinicians seeking a biologically precise understanding of lipid metabolism and cardiometabolic risk. It supports advanced phenotyping, risk stratification, and readiness assessment for personalized lipid and metabolic health strategies.

When and Why Someone Would Order This Panel

Persistent Hypertriglyceridemia or Remnant-Driven Risk

This panel is commonly ordered when triglycerides remain elevated or fluctuate despite lifestyle changes or standard lipid management. TRL accumulation may be driven by impaired clearance, overproduction, insulin resistance, or inflammatory signaling. Measuring ApoC-III, VLDL, and NMR particle profiles helps clarify the dominant driver behind triglyceride elevation.

Residual Cardiovascular Risk Despite Acceptable LDL Cholesterol

Many individuals show ongoing cardiovascular risk even when LDL cholesterol appears controlled. This panel is useful when there is concern that remnant particles, elevated ApoB, Lipoprotein (a), or inflammation may be contributing to hidden atherogenic burden not captured by routine testing.

Advanced Cardiometabolic Risk Assessment

Healthcare providers may order this panel when evaluating metabolic syndrome features, insulin resistance, mixed dyslipidemia, or cardiometabolic dysfunction. The inclusion of insulin, hemoglobin A1c, and TRL-specific markers allows for a unified assessment of lipid and glucose regulation.

Family History of Premature Cardiovascular Disease

Inherited lipid abnormalities and genetically influenced particle patterns may warrant advanced phenotyping. Lipoprotein (a), ApoB, and NMR fractionation help identify inherited contributors to early cardiovascular risk.

Therapy Readiness and Longitudinal Monitoring

This panel may be used to assess readiness for advanced lipid or metabolic strategies by evaluating baseline particle burden, inflammatory state, hepatic function, and fatty acid balance. It is also well suited for longitudinal tracking to observe shifts in TRL behavior and metabolic health over time.

What Does the Panel Measure

Lipid Panel and Direct LDL

The Lipid Panel includes triglycerides, HDL cholesterol, LDL cholesterol, non-HDL cholesterol, and the cholesterol-to-HDL ratio, establishing baseline lipid concentrations. Direct LDL provides an accurate LDL measurement when triglycerides or metabolic factors may interfere with calculated values.

Apolipoprotein C-III (ApoC-III)

ApoC-III is a key regulator of TRL metabolism. Elevated levels inhibit triglyceride breakdown and slow hepatic clearance of remnant particles, contributing to prolonged circulation of atherogenic lipoproteins.

Apolipoprotein B (ApoB)

ApoB represents the total number of atherogenic lipoprotein particles, including LDL, VLDL remnants, and Lipoprotein (a). It provides a direct measure of particle burden independent of cholesterol content.

Lipoprotein Fractionation by NMR and VLDL

NMR lipoprotein fractionation characterizes particle size and concentration, offering detailed insight into TRL and LDL phenotypes. VLDL measurement directly reflects triglyceride-rich lipoprotein burden.

Lipoprotein (a) and hs-CRP

Lipoprotein (a) identifies inherited cardiovascular risk related to thrombosis and atherosclerosis. hs-CRP measures low-grade systemic and vascular inflammation that can accelerate plaque development.

Insulin, Hemoglobin A1c, Liver Function Panel, and OmegaCheck

Insulin and hemoglobin A1c assess glucose regulation and insulin resistance. The Liver Function Panel evaluates hepatic health, central to lipid production and clearance. OmegaCheck measures omega-3 and omega-6 fatty acid balance, providing insight into inflammatory and cardiovascular nutritional status.

How Patients and Healthcare Providers Use the Results

TRL Phenotyping and Risk Stratification

Results allow clinicians to determine whether cardiovascular risk is driven by particle number, remnant accumulation, insulin resistance, inflammation, or inherited factors. ApoB, ApoC-III, VLDL, and NMR data together clarify TRL phenotype and atherogenic burden.

Identifying Contributing Conditions

This panel may support evaluation of hypertriglyceridemia, metabolic syndrome, insulin resistance, type 2 diabetes–associated dyslipidemia, inherited lipid disorders, chronic inflammation, and elevated cardiovascular risk.

Therapy Readiness and Monitoring

By evaluating liver function, inflammation, metabolic control, and fatty acid balance alongside lipid particles, the panel supports informed decision-making around readiness for advanced lipid or metabolic health strategies and provides a robust baseline for monitoring change.

Longitudinal Insight

Repeat testing can help track improvements or persistence of TRL dysregulation, inflammatory activity, and metabolic stress, offering a dynamic view of cardiometabolic health over time.

The Advanced TRL Phenotyping & Therapy Readiness Panel delivers a comprehensive, mechanism-driven view of triglyceride-rich lipoprotein metabolism and cardiometabolic risk. By integrating particle-level lipid analysis, regulatory apolipoproteins, inflammation, glucose control, liver health, and fatty acid balance, this panel moves beyond traditional cholesterol testing to reveal the biological drivers of atherogenic burden.

Used as part of a broader clinical evaluation, this panel supports deeper understanding, refined risk stratification, and informed longitudinal assessment. Its value lies in illuminating how TRLs behave within the body and how metabolic and inflammatory factors shape cardiovascular risk, empowering more precise and personalized health conversations.

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