Specialized lipid profiles

Individuals with abnormal blood lipids and lipoproteins are at increased risk for cardiovascular disease. With the development of effective dietary, behavioral, and pharmaceutical treatments to optimize blood lipoproteins, accurate clinical assessment of blood lipids and lipoproteins are essential for patient management and research. This article discusses the use of a variety of lipid analyses currently available. The use of traditional lipoprotein measurements, including Friedewald calculation of low-density lipoprotein (LDL) cholesterol and ultracentrifugation methods to measure blood lipoproteins, are discussed. Newer analytic techniques, including the vertical analytic profile, nuclear magnetic resonance, direct LDL measurement, LDL size determination, and triglyceride-rich lipoprotein remnants, are also described. Despite the development of a number of lipid and lipoprotein assays, lipoprotein analysis with a Friedewald- calculated LDL measurement remains the lipoprotein analysis performed in approximately 93% of clinical laboratories. It remains to be determined if the alternative lipid and lipoprotein assays currently available will become more widely utilized in the future.