Low-density Lipoprotein Particle Number (LDL-P)

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Category:

Turnaround Time: 1 - 3 days
CPT Code:

83704

Test Type: 2 mL Spun NMR LipoTube (preferred) or serum
Reference Range:

Level

Range (nmol/L)

Low

<1000

Moderate

1000−1299

Borderline high

1300−1599

High

1600−2000

Very high

>2000

Overview:

NMR LDL-P is a management tool used in appropriate high-risk patients (type 2 diabetes mellitus, metabolic syndrome, CVD risk equivalent, statin-treated patients) to adjudicate response to treatment and guide adjustment in therapy. It is used in conjunction with other lipid measurements and clinical evaluation to aid in the management of lipoprotein disorders associated with cardiovascular disease.

The NMR LipoProfile® test is an FDA-cleared blood test that directly measures the amount of LDL circulating in the body. “LDL” is low-density lipoprotein and has long been recognized as a major causal factor in the development of heart disease. Although the relationship of increased LDL particle number and plaque buildup in the artery wall has been known since the 1950s, a diagnostic test did not exist to measure LDL particle number (LDL-P). Historically, LDL cholesterol, or LDL-C, has been used to estimate LDL levels to assess a patient’s LDL-related cardiovascular risk and judge an individual’s response to LDL-lowering therapy. Today, a more reliable measure of LDL exists that directly counts the number of LDL particles a patient has using NMR technology.

Otvos JD, Mora S, Shalaurova I, Greenland P, Mackey RH, Goff DC Jr. Clinical implications of discordance between low-density lipoprotein cholesterol and particle number. J Clin Lipidol. 2011 Mar-Apr; 5(2):105-113. PubMed 21392724

Toth PP, Grabner M, Punekar RS, Quimbo RA, Cziraky MJ, Jacobson TA. Cardiovascular risk in patients achieving low-density lipoprotein cholesterol and particle targets. Atherosclerosis. 2014 Aug; 235(2): 585-591. PubMed 24956532

Collection Details:

Patient Preparation:

Patient should be fasting for 12 to 14 hours.

Collection Instructions:

NMR LipoTube (black-and-yellow-top tube) is the preferred container, plain red-top tube, lavender-top (EDTA-no gel) tube, or green-top (heparin-no gel) tube.

Collect specimen in NMR LipoTube (black-and-yellow-top tube), which is the preferred container. Plain red-top, green-top (heparin-no gel), or lavender-top (EDTA-no gel) tubes are also acceptable. Serum or plasma drawn in gel-barrier collection tubes other than the NMR LipoTube should not be used. The LipoTube is the only acceptable gel-barrier tube. Gently invert tube 8 to 10 times to mix contents and allow specimen to clot for 30 minutes upright at room temperature prior to centrifugation (Plasma tubes should not clot). Centrifuge specimen within two hours of collection at 1800xg for 10 to 15 minutes to separate serum/plasma from the red cells and to avoid red cell contamination during shipment. If the sample cannot be centrifuged immediately, the sample should be refrigerated (at 2ºC to 8ºC) and centrifuged within 24 hours of collection. Note: Centrifuging the specimen while still cold may negatively affect the migration of the gel to the serum/red cell interface and may increase the likelihood of specimens being contaminated with red cells during shipment. All specimens should be centrifuged by the client, prior to shipment to LabCorp, to ensure sample integrity. Do not open NMR LipoTube (black-and-yellow-top). Immediately after centrifugation, pipette separated red-top serum or green-top/lavender-top plasma into a transport tube and label accordingly (serum, heparin plasma, EDTA plasma). Keep samples refrigerated until shipment to the laboratory, and ship with frozen cool packs.

Refrigerate all acceptable tube types as soon as possible after centrifugation and within 24 hours of collection. Keep refrigerated prior to shipment, and ship on frozen cool packs. Do not store at room temperature. Do not freeze the sample. Sample is stable refrigerated for 12 days.