Test Catalog

Test Id : LDLD

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Low-Density Lipoprotein (LDL) Cholesterol, Beta-Quantification, Serum

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Overview

Test Catalog

Useful For
Suggests clinical disorders or settings where the test may be helpful

Evaluation of cardiovascular risk

 

Verification of estimated low-density lipoprotein cholesterol (LDL-C) in patients with hypertriglyceridemia or extremely low LDL-C

 

Diagnosis of familial hypobetalipoproteinemia and abetalipoproteinemia

Method Name
A short description of the method used to perform the test

Ultracentrifugation/Selective Precipitation/Enzymatic Colorimetric

NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.

Yes

Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test

LDL Cholesterol (Beta-Quant), S

Aliases
Lists additional common names for a test, as an aid in searching

Beta Quantification LDL

Cholesterol in Low-Density Lipoproteins (LDL)

Cholesterol, DLD (Low-Density Lipoprotein)

Direct LDL (Low-Density Lipoprotein)

LDL (Low-Density Lipoprotein) Cholesterol

LDL Cholesterol (LDLC)

LDL Cholesterol (order if only LDL indicated)

LDL Direct

Low (Low-Density Lipoprotein) Direct

Low-Density Lipoprotein (LDL)

Soft-LDLD

Beta Quant LDL

Abetalipoproteinemia

Hypolipoproteinemia

Familial hypercholesterolemia (FH)

Type III hyperlipoproteinemia/dysbetalipoproteinemia

Specimen Type
Describes the specimen type validated for testing

Serum

Necessary Information

Indicate patient's age and sex.

Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing

Collection Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Submission Container/Tube: Plastic vial

Specimen Volume: 3 mL

Collection Instructions: Centrifuge and aliquot serum into plastic vial. Send refrigerated.

Forms

If not ordering electronically, complete, print, and send a Cardiovascular Test Request Form (T724) with the specimen.

Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the testing laboratory. The minimum volume is sufficient for one attempt at testing.

2 mL

Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected

Gross hemolysis Reject
Gross lipemia OK
Gross icterus Reject

Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included

Specimen Type Temperature Time Special Container
Serum Refrigerated (preferred) 10 days
Frozen 60 days

Useful For
Suggests clinical disorders or settings where the test may be helpful

Evaluation of cardiovascular risk

 

Verification of estimated low-density lipoprotein cholesterol (LDL-C) in patients with hypertriglyceridemia or extremely low LDL-C

 

Diagnosis of familial hypobetalipoproteinemia and abetalipoproteinemia

Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

Low-density lipoprotein cholesterol (LDL-C) is acknowledged as being causally related with atherosclerotic cardiovascular disease. LDL-C remains the primary focus for cardiovascular risk assessment and effectiveness of risk reduction interventions including diet, physical activity, and pharmacologic therapies.

 

Low-density lipoproteins are a heterogeneous population of lipid particles classically defined as having a density of 1.006 to 1.063 kg/L obtained by preparative ultracentrifugation. The gold standard beta-quantification (beta-quant or BQ) method combines ultracentrifugation with precipitation and yields a direct quantitative measurement of LDL-C, intermediate-density lipoprotein cholesterol, and lipoprotein(a) cholesterol.

 

Extremely low concentrations of LDL-C are associated with abetalipoproteinemia and hypobetalipoproteinemia. In both cases, individuals will have very low total cholesterol and diminished or absent LDL-C, apolipoprotein B, and very low-density lipoprotein cholesterol. Patients may exhibit clinical signs and symptoms of polyneuropathy, intestinal fat malabsorption, hepatosteatosis, and fat-soluble vitamin deficiencies.

Reference Values
Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

The National Lipid Association and the National Cholesterol Education Program (NCEP) have set the following guidelines for LDL-C in adults (ages 18 years and up):

Desirable: <100 mg/dL

Above desirable: 100-129 mg/dL

Borderline high: 130-159 mg/dL

High: 160-189 mg/dL

Very high: > or =190 mg/dL

 

The Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents has set the following guidelines for LDL-C in children and adolescents (ages 2-17 years):

Acceptable: <110 mg/dL

Borderline high: 110-129 mg/dL

High: > or =130 mg/dL

Interpretation
Provides information to assist in interpretation of the test results

Mayo Clinic has adopted the National Lipid Association classifications, which are included as reference values on Mayo Clinic and Mayo Clinic Laboratories reports (see Reference Values). Lipids are most commonly measured to assess cardiovascular risk. Maintaining desirable concentrations of lipids lowers the risk of heart attacks or strokes.

 

Establishing appropriate treatment strategies and lipid goals requires consideration of low-density lipoprotein cholesterol (LDL-C) in context with other risk factors including age, sex, smoking status, family and personal history of heart disease. All guidelines recommend aggressive lipid lowering for patients with LDL cholesterol above 190 mg/dL.

 

Values below 20 mg/dL in untreated patients may be consistent with hypobetalipoproteinemia. Complications due to fat malabsorption may be present in affected individuals.

 

Undetectable LDL-C is highly suggestive of abetalipoproteinemia. Related polyneuropathy may exist in affected individuals.

Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

Result can be falsely decreased in patients with elevated levels of N-acetyl-p-benzoquinone imine (NAPQI)-a metabolite of acetaminophen), N-acetylcysteine (NAC), and metamizole.

Clinical Reference
Recommendations for in-depth reading of a clinical nature

1. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA. 2001;285(19):2486-2497

2. 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;8(5):473-488

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

4. Grundy SM, Stone NJ, Bailey AL, et al: 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019;139(25):e1046-e1081. doi:10.1161/CIR.0000000000000624

Method Description
Describes how the test is performed and provides a method-specific reference

Serum is combined with dextran sulfate and magnesium, ions precipitate the low-density lipoprotein and very low-density lipoprotein fractions, leaving the high-density lipoprotein (HDL) fraction in solution. The HDL cholesterol is then determined using an enzymatic cholesterol assay.(Package insert: HDL Cholesterol Precipitating Reagent Set [Dextran Sulfate]; Pointe Scientific, Inc; 12/2009)

 

Cholesterol esters are cleaved by the action of cholesterol esterase to yield free cholesterol and fatty acids. Cholesterol oxidase then catalyzes the oxidation of cholesterol to cholest-4-en-3-one and hydrogen peroxide. In the presence of peroxidase, the hydrogen peroxide formed effects the oxidative coupling of phenol and 4-aminophenazone to form a red quinone-imine dye. The color intensity of the dye formed is directly proportional to the cholesterol concentration. It is determined by measuring the increase in absorbance.(Package insert: Cholesterol Gen2 Reagent. Roche Diagnostics; V 16.0, 10/2023)

PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information

No

Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.

Monday through Thursday; Saturday, Sunday

Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.

2 to 4 days

Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded

7 days

Performing Laboratory Location
Indicates the location of the laboratory that performs the test

Rochester

Fees :
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.

  • Authorized users can sign in to Test Prices for detailed fee information.
  • Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
  • Prospective clients should contact their account representative. For assistance, contact Customer Service.

Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.

This test has been modified from the manufacturer's instructions. Its performance characteristics were determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.

CPT codes are provided by the performing laboratory.

83701

LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.

Test Id Test Order Name Order LOINC Value
LDLD LDL Cholesterol (Beta-Quant), S 18261-8
Result Id Test Result Name Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
LDLC LDL Chol (Beta-Quantification), S 18261-8

Test Setup Resources

Setup Files
Test setup information contains test file definition details to support order and result interfacing between Mayo Clinic Laboratories and your Laboratory Information System.

Excel | Pdf

Sample Reports
Normal and Abnormal sample reports are provided as references for report appearance.

Normal Reports | Abnormal Reports

SI Sample Reports
International System (SI) of Unit reports are provided for a limited number of tests. These reports are intended for international account use and are only available through MayoLINK accounts that have been defined to receive them.

SI Normal Reports | SI Abnormal Reports