Cholesterol Tests

Advanced Lipid Testing

Advanced lipid testing gives doctors a wider range of information about your cholesterol than standard tests.

Advanced lipid testing can identify additional risk factors of coronary heart disease that standard blood-cholesterol tests typically do not. Advanced lipid testing can:

  • assess apolipoproteins, such as apo B, apo A1, and lipoprotein (a), or Lp(a)
  • identify subspecies, or components, of HDL and LDL (this particular test is not recommended at this time because it has not been shown to add value to the standard blood-cholesterol tests)
  • measure the number of LDL particles (nuclear magnetic resonance spectroscopy can indicate the total number of LDL particles; like a measure of apo B, this may be especially useful in people who have low HDL cholesterol or characteristics of metabolic syndrome)

In one study that compared four methods of advanced lipid testing, the tests arrived at the same results in only 8 percent of the cases. This suggests that the test you take affects your results.

 On the other hand, standard blood-cholesterol tests are standardized. Because of the variability in test results, advanced lipid testing is not routinely recommended at this time. Advanced lipid testing also requires an extra cost.  

Although it is not always readily available, apo B testing is standardized. In fact, it may be slightly more accurate than non-HDL cholesterol testing.

Some physicians suggest that it should replace LDL and non-HDL cholesterol as both a screening test and a target of treatment; however, because of the widespread use of the National Cholesterol Education Program (NCEP) guidelines and because LDL cholesterol is frequently a target for treatment in many large clinical trials, LDL cholesterol, and in certain circumstances non-HDL-cholesterol, is often more familiar and useful to doctors who can then compare their patients' LDL cholesterol values to those seen in clinical trials.

But measurement of apo B or total LDL particles can be useful in people who have low HDL cholesterol and metabolic risk factors. The NCEP guidelines suggest that people with triglyceride levels 200 mg/dL or greater (some doctors believe 150 mg/dL might be a more appropriate indicator) who also have metabolic risk factors should be treated until both LDL cholesterol and non-HDL cholesterol values are at goal.

Biomarkers testing can provide even more information about cholesterol and the risk of coronary heart disease, in addition to advanced lipid testing. Find out about these tests on the next page.

For more information on cholesterol, see:

  • Cholesterol Levels: We all know there's "good" and "bad" cholesterol. Find out why you need more of one kind of cholesterol and less of the other.
  • Causes of High Cholesterol: Diet and DNA are the main causes of high cholesterol. Learn why the numbers might be high in your case.
  • Consequences of High Cholesterol: High cholesterol can lead to a heart attack. Learn more  about high cholesterol and heart attack and what other conditions high cholesterol contributes to.
  • How to Lower Cholesterol: Like many conditions, eating right and exercising helps control cholesterol. Learn what that means for you.
  • How Cholesterol Works: Cholesterol is essential to the body. Find out why we need it and how much is too much.

This information is solely for informational purposes. IT IS NOT INTENDED TO PROVIDE MEDICAL ADVICE. Neither the Editors of Consumer Guide (R), Publications International, Ltd., the author nor publisher take responsibility for any possible consequences from any treatment, procedure, exercise, dietary modification, action or application of medication which results from reading or following the information contained in this information. The publication of this information does not constitute the practice of medicine, and this information does not replace the advice of your physician or other health care provider. Before undertaking any course of treatment, the reader must seek the advice of their physician or other health care provider.