Lipid Panel with Reflex to Direct LDL

The Lipid Panel with Reflex to Direct LDL test contains 1 test with 6 biomarkers.

Description: A Lipid Panel is a blood test that measures your cholesterol levels to evaluate your risk of cardiovascular disease.

Also Known As: Lipid Profile Test, Lipid Test, Cholesterol Profile Test, Cholesterol Panel Test, Cholesterol Test, Coronary Risk Panel, Lipid Blood Test, Lipid Panel with Reflex Test, Direct LDL-C Test, Direct LDL Cholesterol Test, DLDL Test, LDL D Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: If a cholesterol or HDL cholesterol measurement is to be performed along with triglycerides, the patient should be fasting 9-12 hours prior to collection.

Important Reflex Information: If Triglyceride result is >400 mg/dL, then Direct LDL will be performed at an additional charge of $34

When is a Lipid Panel with Reflex to Direct LDL test ordered?

A fasting lipid profile should be done once every four to six years in healthy persons who have no additional risk factors for heart disease. A single total cholesterol test, rather than a complete lipid profile, may be used for initial screening. If the screening cholesterol test result is high, a lipid profile will almost certainly be performed.

More regular testing with a full lipid profile is indicated if other risk factors are present or if earlier testing revealed a high cholesterol level.

Other risk factors, in addition to high LDL cholesterol, include:

  • Smoking
  • Obesity or being overweight
  • Unhealthy eating habits
  • Not getting enough exercise and being physically inactive
  • Age is a factor
  • Hypertension is a condition in which the blood pressure is elevated.
  • Premature heart disease in the family
  • Having experienced a heart attack or having pre-existing heart disease

Diabetes or pre-diabetes is a condition in which a person has High HDL is a "negative risk factor," and its existence permits one risk factor to be removed from the total.

The American Academy of Pediatrics recommends routine lipid testing for children and young adults. Children and teenagers who are at a higher risk of developing heart disease as adults should be screened with a lipid profile earlier and more frequently. A family history of heart disease or health problems such as diabetes, high blood pressure, or being overweight are some of the risk factors, which are comparable to those in adults. According to the American Academy of Pediatrics, high-risk children should be examined with a fasting lipid profile between the ages of 2 and 8.

A lipid profile can also be done at regular intervals to assess the effectiveness of cholesterol-lowering lifestyle changes like diet and exercise, as well as pharmacological therapy like statins.

When calculating LDL cholesterol is impossible due to a considerable increase in triglycerides, a direct LDL-C test is ordered. A doctor may order it if previous tests have revealed elevated triglyceride levels. When triglyceride levels are too high to calculate LDL-C, certain laboratories will automatically do this direct LDL test. This saves the doctor time by avoiding the need to order another test, the patient time by avoiding the need for a second blood sample, and the time it takes to get the test results.

What does a Lipid Panel with Reflex to Direct LDL blood test check for?

Lipids are a class of fats and fat-like compounds that are essential components of cells and energy sources. The level of certain lipids in the blood is measured by a lipid profile.

Lipoprotein particles transport two key lipids, cholesterol and triglycerides, through the bloodstream. Protein, cholesterol, triglyceride, and phospholipid molecules are all present in each particle. High-density lipoproteins, low-density lipoproteins, and very low-density lipoproteins are the three types of particles assessed with a lipid profile.

It's critical to keep track of and maintain optimal levels of these lipids in order to stay healthy. While the body creates the cholesterol required for normal function, some cholesterol is obtained from the diet. A high amount of cholesterol in the blood can be caused by eating too many foods high in saturated fats and trans unsaturated fats or having a hereditary tendency. The excess cholesterol may form plaques on the inside walls of blood vessels. Plaques can constrict or block blood channel openings, causing artery hardening and raising the risk of a variety of health problems, including heart disease and stroke. Although the explanation for this is unknown, a high level of triglycerides in the blood is linked to an increased risk of developing cardiovascular disease.

A lipid profile consists of the following elements:

  • Cholesterol total
  • HDL-C - commonly referred to as "good cholesterol" since it eliminates excess cholesterol from the body and transports it to the liver for elimination.
  • LDL-C - commonly referred to as "bad cholesterol" because it deposits excess cholesterol in the walls of blood arteries, contributing to atherosclerosis.
  • Triglycerides

The direct low-density lipoprotein cholesterol test determines the amount of LDL cholesterol in the blood, also known as "bad" cholesterol. LDL-C levels beyond a certain threshold are linked to an increased risk of artery hardening and heart disease. The amount of LDL-C is usually determined using readings from a typical lipid profile. This is a good estimate of LDL-C in most circumstances, although it becomes less accurate as triglyceride levels rise. When triglycerides are high, direct measurement of LDL-C is less impacted by them and can be employed.

Lab tests often ordered with a Lipid Panel with Reflex to Direct LDL test:

  • CBC with Smear Review
  • Comprehensive Metabolic Panel
  • VLDL
  • Lp-PLA2
  • Apolipoprotein A1
  • Apolipoprotein B
  • Lipoprotein (a)
  • Lipoprotein Fractionation Ion Mobility

Conditions where a Lipid Panel with Reflex to Direct LDL test is recommended:

  • Hypertension
  • Cardiovascular Disease
  • Heart Disease
  • Stroke

Commonly Asked Questions:

How does my health care provider use a Lipid Panel with Reflex to Direct LDL test?

The lipid profile is used as part of a cardiac risk assessment to help determine an individual's risk of heart disease and, if there is a borderline or high risk, to help make treatment options.

Lipids are a class of fats and fat-like compounds that are essential components of cells and energy sources. It's critical to keep track of and maintain optimal levels of these lipids in order to stay healthy.

To design a therapy and follow-up strategy, the results of the lipid profile are combined with other recognized risk factors for heart disease. Treatment options may include lifestyle changes such as diet and exercise, as well as lipid-lowering drugs such as statins, depending on the results and other risk factors.

A normal lipid profile test measures the following elements:

  • Total cholesterol is a test that determines how much cholesterol is present in all lipoprotein particles.
  • HDL-C — measures hdl cholesterol in particles, sometimes referred to as "good cholesterol" since it eliminates excess cholesterol and transports it to the liver for elimination.
  • LDL-C – estimates the cholesterol in LDL particles; sometimes known as "bad cholesterol" since it deposits excess cholesterol in blood vessel walls, contributing to atherosclerosis. The amount of LDL-C is usually estimated using the total cholesterol, HDL-C, and triglycerides readings.
  • Triglycerides – triglycerides are measured in all lipoprotein particles, with the highest concentration in very-low-density lipoproteins.
  • As part of the lipid profile, several extra information may be presented. The results of the above-mentioned tests are used to determine these parameters.
  • VLDL-C — derived using triglycerides/5; this calculation is based on the typical VLDL particle composition.
  • Non-HDL-C is the result of subtracting total cholesterol from HDL-C.
  • Cholesterol/HDL ratio — total cholesterol to HDL-C ratio computed.

An expanded profile may include include the amount and concentration of low-density lipoprotein particles. Rather than assessing the amount of LDL cholesterol, this test counts the number of LDL particles. This figure is thought to more accurately reflect the risk of heart disease in some persons.

Low density lipoprotein cholesterol levels are commonly used to determine a person's risk of heart disease or to monitor their response to cholesterol-lowering medication. Total cholesterol, high-density lipoprotein cholesterol, and triglycerides are all assessed in a conventional lipid profile. The amount of cholesterol present in low-density lipoprotein can be calculated using a mathematical calculation based on the three observed values. The calculated LDL-C value is often included in the lipid profile. The calculation is no longer applicable when triglycerides are high. The only way to precisely determine LDL-C in this case is to measure it directly.

A metabolic disease affecting lipids could cause high triglycerides. After eating, though, anyone can have high triglycerides. The direct LDL-C test can identify the amount of LDL in a person's blood in either condition.

What do my Lipid Panel test results mean?

Healthy lipid levels, in general, aid in the maintenance of a healthy heart and reduce the risk of heart attack or stroke. A health practitioner would analyze the results of each component of a lipid profile, as well as other risk factors, to assess a person's total risk of coronary heart disease, if therapy is required, and, if so, which treatment will best serve to reduce the person's risk of heart disease.

The Adult Treatment Panel III of the National Cholesterol Education Program published guidelines for measuring lipid levels and selecting treatment in 2002. The American College of Cardiology and the American Heart Association announced updated cholesterol therapy guidelines in 2013 to minimize the risk of cardiovascular disease in adults. These guidelines suggest a different treatment method than the NCEP guidelines. Cholesterol-lowering medications are now chosen based on the 10-year risk of atherosclerotic cardiovascular disease and other criteria, rather than on LDL-C or non-HDL-C objectives.

The revised guidelines include an evidence-based risk calculator for ASCVD that may be used to identify people who are most likely to benefit from treatment. It's for adults between the ages of 40 and 79 who don't have a heart condition. The computation takes into account a number of characteristics, including age, gender, race, total cholesterol, HDL-C, blood pressure, diabetes, and smoking habits. The new guidelines also suggest comparing therapeutic response to LDL-C baseline readings, with decrease criteria varying depending on the degree of lipid-lowering medication therapy.

Unhealthy lipid levels, as well as the presence of additional risk factors like age, family history, cigarette smoking, diabetes, and high blood pressure, may indicate that the person being examined needs to be treated.

The NCEP Adult Treatment Panel III guidelines specify target LDL cholesterol levels based on the findings of lipid testing and these other main risk factors. Individuals with LDL-C levels over the target limits will be treated, according to the guidelines.

According to the American Academy of Pediatrics, screening youths with risk factors for heart disease with a full, fasting lipid panel is advised. Fasting is not required prior to lipid screening in children who do not have any risk factors. For non-fasting lipid screening, non-high-density lipoprotein cholesterol is the preferred test. Non-HDL-C is computed by subtracting total cholesterol and HDL-C from total cholesterol and HDL-C.

What do my Direct LDL test results mean?

Increased LDL levels, as determined by the direct LDL-C test, suggest a higher risk of heart disease. Reduced levels imply a reduction in the risk of heart disease as a result of lipid-lowering lifestyle adjustments and/or pharmacological therapy.

Low LDL levels are usually not a cause for worry and are not monitored. They can appear in persons who have a hereditary lipoprotein insufficiency, as well as in people who have hyperthyroidism, infection, or inflammation.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.

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.

Also known as: Coronary Risk Panel with Reflex to Direct LDL , Lipid Profilewith Reflex to Direct LDL , 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


Non HDL Cholesterol


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.
*Process times are an estimate and are not guaranteed. The lab may need additional time due to weather, holidays, confirmation/repeat testing, or equipment maintenance.

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