Lipid Panel Interpretation

A lipid panel is not a single “cholesterol number.” It combines cholesterol carried in different lipoproteins with triglyceride information that can change both cardiovascular interpretation and urgency. Canadian reports use mmol/L. Begin with three questions: which component is abnormal, is the reported LDL-C reliable, and does the pattern alter cardiovascular or pancreatitis risk? For example, a non-fasting sample with total cholesterol 6.2 mmol/L, HDL-C 1.0 mmol/L, and triglycerides 2.4 mmol/L gives a non-HDL-C of 5.2 mmol/L. The triglyceride value also makes non-HDL-C or apoB more useful than LDL-C alone for judging atherogenic burden. Routine screening in Canada can be performed fasting or non-fasting. A fasting sample is specifically relevant when triglycerides are known to exceed 4.5 mmol/L; if the ordering clinician gives different preparation instructions, follow them. The sections that follow move from what each component represents, to how the laboratory result is refined, and finally to treatment and medication safety.