Lipid profile panel

The lipid profile panel, also called a lipidogram, comprises four blood lipid tests: total cholesterol, HDL cholesterol, LDL cholesterol and triglycerides. The result is a foundation for assessing heart attack and stroke risk and is also used to monitor cholesterol-lowering treatment.

Who the panel is for

• adults whose doctor is assessing cardiovascular risk;
• people who smoke or have high blood pressure, diabetes or excess body weight;
• people whose close relatives had high cholesterol or a heart attack or stroke at a younger age;
• people taking statins or other lipid-lowering medicines, usually several weeks after starting treatment or changing the dose, then as agreed with a doctor;
• people with an underactive thyroid, kidney disease or other conditions that may raise lipids.

How often to repeat testing depends on age, previous results and overall risk, so agree this with your doctor.

What the panel contains and shows

• Total cholesterol: all cholesterol in blood, the sum of cholesterol in lipoproteins, the particles transporting fats.
• LDL cholesterol: “bad” cholesterol. Its excess accumulates in artery walls over years, forming atherosclerotic deposits, making LDL the main treatment target.
• HDL cholesterol: “good” cholesterol, which transports excess cholesterol from tissues to the liver. Low HDL is associated with increased cardiovascular risk.
• Triglycerides: fats used by the body as an energy source. They rise after meals, with alcohol, excess body weight and diabetes.

From these values a doctor can also calculate non-HDL cholesterol, total cholesterol minus HDL, covering all particles capable of damaging blood vessels.

Preparation and sample

Blood is collected from a vein. Come fasting: about 12 hours without food, but water is permitted. Total, HDL and LDL cholesterol change little after a meal, but triglycerides rise, and fasting results are easier to compare with earlier results.

Avoid alcohol and a large, fatty meal the day before because they temporarily raise triglycerides. Take lipid-lowering medicines as usual unless your doctor tells you otherwise.

How to interpret the result

A reference interval is printed alongside each result, but with lipids your individual target matters more. There is no single “good” LDL value for everyone: the higher the overall cardiovascular risk, the lower the target. A doctor assesses risk according to age, sex, blood pressure, smoking, diabetes, kidney function and family history. European guidelines (ESC/EAS) specify these LDL cholesterol targets:

• low risk: below 3,0 mmol/L;
• moderate risk: below 2,6 mmol/L;
• high risk: below 1,8 mmol/L and at least half the baseline value;
• very high risk, for example after a heart attack or stroke: below 1,4 mmol/L and at least half the baseline value.

Fasting triglycerides below 1,7 mmol/L are considered desirable. Raised triglycerides and low HDL often accompany excess body weight, diabetes and metabolic syndrome. Very high triglycerides, above 10 mmol/L, increase pancreatitis risk and require prompt medical assessment.

Markedly high LDL cholesterol, above 5 mmol/L, particularly in younger people and with early heart disease in the family, may suggest hereditary (familial) hypercholesterolaemia. With raised cholesterol a doctor often also checks TSH, because an underactive thyroid raises LDL. A doctor always interprets the result with the whole picture in mind.

Extended lipid profile

A basic lipid profile does not show everything. Apolipoprotein B (ApoB) reflects the number of particles capable of damaging blood vessels and is more useful with raised triglycerides, diabetes or obesity, when LDL cholesterol may underestimate risk. The Extended lipid profile panel contains apolipoproteins A and B and liver enzymes AST, ALT and GGT in addition to the four basic tests. Read more about these tests in the articles ApoB and ApoA1 and Why is cholesterol alone no longer enough?

European guidelines also recommend measuring lipoprotein(a) at least once in a lifetime because its level is largely inherited and is not apparent in the lipid profile.

How to arrange testing

You can have blood taken without an appointment or referral at one of our branches across Croatia (listed under Contact). Prices for all tests and panels are available in the service price list.

Frequently asked questions

Is a lipidogram the same as a lipid profile?

Yes. Both names refer to the set of blood lipid tests: total cholesterol, HDL and LDL cholesterol and triglycerides.

Do I need to fast for cholesterol testing?

Yes. For a lipid profile, come fasting, for about 12 hours without food and with water only. Cholesterol changes little after a meal, but triglycerides rise, so a fasting result is more reliable and easier to compare with earlier results.

Is high HDL always good?

Higher HDL is generally favourable, but does not cancel the risk from high LDL cholesterol, smoking or high blood pressure. Treatment therefore focuses on lowering LDL cholesterol rather than raising HDL.

Can I lower cholesterol through diet?

Partly. Less saturated fat (fatty meat, full-fat dairy products, cakes), more vegetables, pulses, whole grains and nuts, regular physical activity and less alcohol lower LDL and triglycerides. Whether this is enough or medicines are also needed depends on your risk, so a doctor decides.