Lipid Panel

Non-HDL Cholesterol

Optimal Result: 0 - 130 mg/dL.

Your non-HDL cholesterol result refers to your total cholesterol value minus your HDL cholesterol. Your lipid panel results normally include four numbers:

- low-density lipoprotein (LDL) cholesterol;
- high-density lipoprotein (HDL) cholesterol;
- triglycerides; and
- total cholesterol.

Some researchers believe that measuring your non-HDL cholesterol levels gives a better assessment of the risk for heart disease than measuring only LDL. This is especially true if you have high triglycerides. Your non-HDL cholesterol level is found by subtracting your HDL cholesterol from your total cholesterol.

Although you might assume total cholesterol is simply the sum of your LDL and HDL, it also includes very-low-density lipoprotein (VLDL). These particles carry triglycerides to tissues and eventually become LDL. Like LDL, it also causes cholesterol to build up on the inside of arteries, creating artery-clogging plaque. Both are considered undesirable, so the higher your LDL and VLDL values, the higher your risk of heart disease.

Achieved non-HDL cholesterol levels seem more closely associated with coronary atheroma progression than LDL cholesterol.

References:

  • Non-HDL Cholesterol as a Metric of Good Quality of Care, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3066801/ 
  • Why Do Doctors Still Rely On LDL Instead Of Non-HDL Cholesterol? (http://www.cardiobrief.org/2017/10/15/why-do-doctors-still-rely-on-ldl-instead-of-non-hdl-cholesterol/)

  • Third Report of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (ATP III Final Report). National Institutes of Health 2002. NIH Publication No. 02-5215.
  • Liu J, Sempos CT, Donahue RP, Dorn J, Trevisan M, Grundy SM. Non-high-density lipoprotein and very-low-density lipoprotein cholesterol and their risk predictive values in coronary heart disease. Am J Cardiol. 2006;98:1363-1368.Abstract
  • Non-HDL Cholesterol and Triglycerides, Implications for Coronary Atheroma Progression and Clinical Events, http://atvb.ahajournals.org/content/36/11/2220

What does it mean if your Non-HDL Cholesterol result is too high?

- Reduction in total calories, especially saturated and trans fatty acids, in combination with exercise is recommended.

- Reducing sugar and carbohydrate consumption is often very effective in lowering triglycerides and non-HDL-C, particularly in patients with abdominal obesity or the metabolic syndrome.

- Moderate physical activity can help raise HDL-C and lower non-HDL-C.

- Quitting smoking will improve your HDL-C and reduce non-HDL-C. Several studies have shown that male and female smokers have significantly lower HDL-C levels than non-smokers.

- Medical therapy. This would include the use of a statin drug to serve as the foundation for LDL-C lowering followed by a second treatment to bring non-HDL-C to within the target range. 

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