Lipid Cascade With Reflex to Lipoprotein Particle Assessment by NMR (With Graph if reflex)*

The lipid cascade supports risk assessment and management of patients who present with cardiometabolic risk (CMR) factors (eg, elevated blood pressure, abdominal obesity, insulin resistance (IR), lipoprotein abnormalities, and elevated blood glucose).

Conventional lipid profile results are indirect estimates of the actual lipoproteins that transport cholesterol, many of which may be atherogenic. Additionally, basic lipid profile results do not: (1) account for the variability in cholesterol subfraction content; (2) measure lipoprotein particle size and number; or (3) provide information suggestive of changes associated with IR progression.

In patients with an LDL cholesterol result <130 mg/dL, the lipid cascade automatically reflexes to lipoprotein analysis by NMR to evaluate LDL particle number (additional charge on reflex). The lipid cascade provides a lipoprotein IR score as a qualitative indicator of the patient's insulin resistance and risk for diabetes. In patients with a triglyceride result >400 mg/dL, the lipid cascade automatically reflexes to a direct LDL (additional charge on reflex). If the direct LDL result is <130 mg/dL, the lipid cascade automatically reflexes to lipoprotein analysis by NMR.

If triglyceride level is >400 mg/dL, LDL cholesterol will not be calculated.