Test Catalog

Test Id : LMPP

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Lipoprotein Metabolism Profile, Serum

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Overview

Test Catalog

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

Diagnosing dyslipoproteinemia

 

Quantifying cholesterol and triglycerides in very-low-density lipoprotein, low-density lipoprotein (LDL), high-density lipoproteins (HDL), and chylomicrons

 

Identifying lipoprotein-X

 

Classifying hyperlipoproteinemias (lipoprotein phenotyping)

 

Evaluating patients with abnormal lipid values (cholesterol, triglyceride, HDL, LDL) for specific phenotypes

Profile Information
A profile is a group of laboratory tests that are ordered and performed together under a single Mayo Test ID. Profile information lists the test performed, inclusive of the test fee, when a profile is ordered and includes reporting names and individual availability.

Test Id Reporting Name Available Separately Always Performed
TCS Cholesterol, Total, CDC, S No Yes
TRIGC Triglycerides, CDC, S No Yes
APLBS Apolipoprotein B, S Yes, (order APOLB) Yes
HDLS HDL Cholesterol, CDC, S No Yes
LMPP1 Lipoprotein Metabolism Profile 1 No Yes

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

TCS, TRIGD: Enzymatic Colorimetric

APLBS: Automated Turbidimetric Immunoassay

HDLS: Selective Precipitation, Enzymatic Colorimetric

LMPP1: Ultracentrifugation/Electrophoresis/Automated Enzymatic/Colorimetric Analysis

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

Lipoprotein Metabolism Profile

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

Beta-Quant LDL

Cardiac Lipoprotein Phenotyping

Cholesterol, LDL (Low Density Lipoprotein)

Fredrickson Phenotyping

HDC (High-Density Cholesterol)

HDL (High-Density Lipoprotein) Cholesterol

HDT (High-Density Triglyceride)

High-Density Cholesterol (HDC)

High-Density Lipoprotein (HDL) Cholesterol

High-Density Triglyceride (HDT)

Intermediate Density Lipoprotein

LDL (Low-Density Lipoprotein)

LDL (Low-Density Lipoprotein) Cholesterol

Lipid Phenotyping

Lipid Profile

Lipoprotein Electrophoresis

Lipoprotein Phenotyping

Low-Density Lipoprotein (LDL)

Low-Density Lipoprotein (LDL) Cholesterol

Lp(a) Cholesterol

LPX

VLDL (Very Low Density Lipoprotein)

Lipoprotein X

Lipoprotein Fractionation

LMPP

TESTLMPP

Chylomicron

Specimen Type
Describes the specimen type validated for testing

Serum

Necessary Information

Patient's age and sex are required.

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

Patient Preparation:

1. Fasting-overnight (12-14 hours)

2. Patient must not consume any alcohol for 24 hours before the specimen is collected.

Collection Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Submission Container/Tube: Plastic vial

Specimen Volume: 5 mL

Collection Instructions: Centrifuge and aliquot serum into a plastic vial.

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) 7 days
Frozen 60 days

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

Diagnosing dyslipoproteinemia

 

Quantifying cholesterol and triglycerides in very-low-density lipoprotein, low-density lipoprotein (LDL), high-density lipoproteins (HDL), and chylomicrons

 

Identifying lipoprotein-X

 

Classifying hyperlipoproteinemias (lipoprotein phenotyping)

 

Evaluating patients with abnormal lipid values (cholesterol, triglyceride, HDL, LDL) for specific phenotypes

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

Lipoprotein metabolism profile analysis adds practical information about the etiology of cholesterol and/or triglyceride elevation. In some patients, increased serum lipids reflect elevated levels of intermediate-density lipoprotein, very-low-density lipoprotein, lipoprotein a (Lp[a]), or even the abnormal lipoprotein complex, LpX. These elevations can be indicative of a genetic deficiency in lipid metabolism or transport, nephrotic syndrome, endocrine dysfunction, or even cholestasis. Identification of the lipoprotein associated with lipid elevation is achieved using the gold-standard methods, which include ultracentrifugation, selective precipitation, electrophoresis, and direct measurement of cholesterol and triglycerides in isolated lipoprotein fractions. Proper characterization of a patient's dyslipidemic phenotype aids clinical decisions and guides appropriate therapy.

 

Classifying the hyperlipoproteinemias into phenotypes places disorders that affect plasma lipid and lipoprotein concentrations into convenient groups for evaluation and treatment. A clear distinction must be made between primary (inherited) and secondary (liver disease, alcoholism, metabolic diseases) causes of dyslipoproteinemia. Lipoprotein profiling will identify the presence of Lp(a) and LpX and distinguish between the following dyslipidemias:

-Exogenous hyperlipemia (Type I)

-Familial hypercholesterolemia (Type IIa)

-Familial combined hyperlipidemia (Type IIb)

-Familial dysbetalipoproteinemia (Type III)

-Endogenous hyperlipemia (Type IV)

-Mixed hyperlipemia (Type V)

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.

2-9 years

10-17 years

> or =18 years

Total cholesterol

*

Acceptable: <170 mg/dL

Borderline high: 170-199 mg/dL

High: > or =200 mg/dL

**

Desirable: <200 mg/dL

Borderline high: 200-239 mg/dL

High: > or = 240 mg/dL

Triglycerides

*

Acceptable: <75 mg/dL

Borderline high: 75-99 mg/dL

High: > or =100 mg/dL

*

Acceptable: <90 mg/dL

Borderline high: 90-129 mg/dL

High: > or =130 mg/dL

**

Normal: <150 mg/dL

Borderline high: 150-199 mg/dL

High: 200-499 mg/dL

Very high: > or =500 mg/dL

Low-density lipoprotein (LDL) cholesterol

*

Acceptable: <110 mg/dL

Borderline high: 110-129 mg/dL

High: > or =130 mg/dL

***

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

LDL triglycerides

< or =50 mg/dL

< or =50 mg/dL

Apolipoprotein B

*

Acceptable: <90 mg/dL

Borderline high: 90-109 mg/dL

High: > or =110 mg/dL

***

Desirable: <90 mg/dL

Above Desirable: 90-99mg/dL

Borderline high: 100-119 mg/dL

High: 120-139 mg/dL

Very high: > or =140 mg/dL

High-density lipoprotein (HDL) cholesterol

*

Low: <40 mg/dL

Borderline low: 40-45 mg/dL

Acceptable: >45 mg/dL

***

Males: > or =40mg/dL

Females: > or =50mg/dL

Very low-density lipoprotein (VLDL) cholesterol

<30 mg/dL

<30 mg/dL

VLDL triglycerides

<90 mg/dL

<120 mg/dL

Beta VLDL cholesterol

<15 mg/dL

<15 mg/dL

Beta VLDL

triglycerides

<15 mg/dL

<15 mg/dL

Chylomicron cholesterol

Undetectable

Undetectable

Chylomicron triglycerides

Undetectable

Undetectable

Lp(a) cholesterol

<5 mg/dL

<5 mg/dL

LpX

Undetectable

Undetectable

 

Reference values have not been established for patients who are less than 2 years of age.

*Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents

**National Cholesterol Education Program (NCEP)

***National Lipid Association

Interpretation
Provides information to assist in interpretation of the test results

Patients with increased lipoprotein a (Lp[a]) cholesterol values have been associated with increased risk for the development of atherothrombotic disease. Aggressive low-density lipoprotein reduction is the recommended treatment approach in most patients with increased Lp(a).

 

Lipoprotein-X (LpX) is an abnormal lipoprotein that appears in the sera of patients with obstructive jaundice and is an indicator of cholestasis. The presence of LpX will be reported if noted during Lp(a) cholesterol analysis.

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

Cholesterol results 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. 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: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019 Jun 18;139(25):e1082-e1143

2. Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents; National Heart, Lung, and Blood Institute: Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents: summary report. Pediatrics. 2011 Dec;128 Suppl 5:S213-S256

3. Rosenson RS, Najera SD, Hegele RA: Heterozygous familial hypercholesterolemia presenting as chylomicronemia syndrome. J Clin Lipidol. 2017 Jan-Feb;11(1):294-296. doi: 10.1016/j.jacl.2016.12.005

4. Hopkins PN, Brinton EA, Nanjee MN: Hyperlipoproteinemia type 3: the forgotten phenotype. Curr Atheroscler Rep. 2014 Sep;16(9):440. doi: 10.1007/s11883-014-0440-2

5. Gotoda T, Shirai K, Ohta T, et al: Diagnosis and management of type I and type V hyperlipoproteinemia. J Atheroscler Thromb. 2012;19(1):1-12

6. Gonzales KM, Donato LJ, Shah P, Simha V: Measurement of apolipoprotein B levels helps in the identification of patients at risk for hypertriglyceridemic pancreatitis. J Clin Lipidol. 2021 Jan-Feb;15(1):97-103. doi: 10.1016/j.jacl.2020.11.010

7. Fatica EM, Meeusen JW, Vasile VC, Jaffe AS, Donato LJ: Measuring the contribution of Lp(a) cholesterol towards LDL-C interpretation. Clin Biochem. 2020 Dec;86:45-51. doi: 10.1016/j.clinbiochem.2020.09.007

8. Arnett DK, Blumenthal RS, Albert MA, et al: 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019 Sep 10;140(11):e596-e646

 

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

Electrophoretic separation of lipoproteins followed by lipid staining and densitometry measurement.(Package insert: SPIFE Vis Cholesterol Reagent. Helena Laboratories; 09/2015

 

Cholesterol:

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 13.0, 02/2019)

 

Triglyceride:

Samples analyzed for triglycerides are measured by an automated enzymatic method. The chemistry includes hydrolysis of the triglycerides and phosphorylation of the resulting glycerol.(Package insert: Triglycerides Reagent, Roche Diagnostics; 11/2017)

 

Apolipoprotein B:

Anti-apolipoprotein B antibodies react with the antigen in the sample to form antigen:antibody complexes, which, following agglutination, can be measured turbidimetrically.(Package insert: Tina-quant Apolipoprotein B. Roche Diagnostics; 07/2020)

 

High-Density Lipoprotein:

Sample 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)

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, 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

14 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.

80061-Lipid panel (includes: HDL [CPT Code 83718], total cholesterol [CPT Code 82465], and triglycerides [CPT Code 84478] if all performed)

82172-Apolipoprotein B

83700-Lp(a) cholesterol electrophoresis

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
LMPP Lipoprotein Metabolism Profile In Process
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.
TCS Cholesterol, Total, CDC, S 2093-3
HDLS HDL Cholesterol, CDC, S 2085-9
TRIGC Triglycerides, CDC, S 2571-8
APLBS Apolipoprotein B, S 1884-6
2839 LDL Cholesterol 2089-1
2840 LDL Triglycerides 3046-0
2844 VLDL cholesterol 2091-7
2847 VLDL triglycerides 3047-8
2842 Beta VLDL Cholesterol 66499-5
2843 Beta VLDL triglycerides 3045-2
2855 Chylomicron cholesterol 34467-1
2856 Chylomicron triglycerides 35363-1
2849 Lp(a) Cholesterol 35388-8
23924 LpX 42178-4
23937 Interpretation 59462-2

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