Lipids/Total Cholesterol

[sarjasy]

Couple of questions. I know total cholesterol is all but irrelevant for treatment decisions, but what is the formula typically used for calculating it? Is is LDL + HDL + TG/5? Secondly, anyone know of a good write up on treatment decisions based on risk profile, LDL/HDL/TG levels, etc.

And, just for my own curiosity, are their any more direct/accurate ways of measuring cholesterol emerging, given that LDL, VLDL, and HDL are just molecular carriers?

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[wahaha]

In the laboratory, cholesterol is directly measured. The formula you are referring is a calculation of LDL. The correct formula is LDL=Total Cholesterol-(dHDL + Trig/5). LDL and HDL carry your cholesterol to and from cells, respectively. There are direct measurements for LDL given that the equation becomes invalid with a triglyceride level over 400. National Cholesterol education is a good source.

 

[Instatewaiter]

Couple of questions. I know total cholesterol is all but irrelevant for treatment decisions, but what is the formula typically used for calculating it? Is is LDL + HDL + TG/5? Secondly, anyone know of a good write up on treatment decisions based on risk profile, LDL/HDL/TG levels, etc.

And, just for my own curiosity, are their any more direct/accurate ways of measuring cholesterol emerging, given that LDL, VLDL, and HDL are just molecular carriers?

NMR and ultracentrifugation are 2 more direct ways to measure cholesterol particle size and number. They are not widely available and NMR is expensive.

Non-HDL is a good surrogate to measure particle number and LDL/atherosclerotic burden.

ApoB, lp(a), hs-CRP are somewhat novel markers that help define risk above and beyond what normal lipids will.