Test Catalog

Test ID: NMRLP    
Nuclear Magnetic Resonance Lipoprotein Profile, Serum

Useful For Suggests clinical disorders or settings where the test may be helpful

Assessment and management of a patient's risk for atherosclerotic cardiovascular disease


Identifying residual risk that may be present in some patients on cholesterol targeting treatment

Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

Low-density lipoprotein particle (LDL-P) concentration is positively associated with increased risk of atherosclerotic cardiovascular disease (ASCVD). LDL-P is heterogeneous and contains many lipids and proteins including phospholipids, triglycerides and cholesterol. LDL cholesterol is a surrogate biomarker of LDL-P.


LDL cholesterol (LDL-C) is the historical measure of atherogenic lipid burden. There is a large variance in the relative amount of cholesterol carried by each LDL-P. Consequently, subjects with similar LDL cholesterol values can have markedly different serum concentrations of LDL-P. Multiple studies have shown that serum concentrations of LDL-P more accurately reflect actual risk of ASCVD when LDL cholesterol values are discrepant.


High-density lipoprotein particle (HDL-P) concentration is inversely associated with risk of ASCVD. HDL cholesterol is also inversely associated with ASCVD since it is a surrogate marker for HDL-P. Like other lipoproteins, HDL-P is heterogeneous and particles contain highly variable proportions of proteins and lipids including phospholipids, sphingolipids and cholesterol.


Several large clinical studies have shown that HDL-P is more significantly associated with ASCVD risk than HDL cholesterol. Furthermore, HDL-P remains significantly associated with ASCVD even among subjects taking cholesterol-lowering medications. HDL-P more accurately reflects actual risk of ASCVD when HDL cholesterol values are discrepant.

Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

> or =18 years:


LDL Particles:

Desirable: <1,000 nmol/L

Above Desirable: 1,000-1,299 nmol/L

Borderline high: 1,300-1,599 nmol/L

High: 1,600-2,000 nmol/L

Very high: > or =2,000 nmol/L


HDL Particles:

Male: >30 mcmol/L

Female: >35 mcmol/L


LDL Cholesterol (NMR):

Desirable: <100 mg/dL

Above Desirable: 100-129 mg/dL

Borderline high: 130-159 mg/dL

High: 160-189 mg/dL

Very high: > or =190 mg/dL


Reference values have not been established for patients who are <18 years of age.

Interpretation Provides information to assist in interpretation of the test results

Elevated concentrations of low-density lipoprotein particle (LDL-P) are associated with increased risk of atherosclerotic cardiovascular disease.


LDL-P is a more accurate indicator of risk when LDL cholesterol (LDL-C) is discordantly low.


Lower concentrations of high-density lipoprotein particle (HDL-P) are associated with increased risk of atherosclerotic cardiovascular disease.

Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

Failure to follow specimen collection requirements may prevent measurable results.

Clinical Reference Recommendations for in-depth reading of a clinical nature

1. Mora S, Glynn RJ, Ridker PM: High-Density Lipoprotein Cholesterol, Size, Particle Number, and Residual Vascular Risk After Potent Statin Therapy. Circulation 2013;Sep 10;128(11):1189-1197. doi: 10.1161/CIRCULATIONAHA.113.002671

2. Lawler PR, Akinkuolie AO, Ridker PM, et al: Discordance between Circulating Atherogenic Cholesterol Mass and Lipoprotein Particle Concentration in Relation to Future Coronary Events in Women. Clin Chem 2017;Apr;63(4):870-879. doi: 10.1373/clinchem.2016.264515

3. Akinkuolie AO, Paynter NP, Padmanabhan L, Mora S: High-Density Lipoprotein Particle Subclass Heterogeneity and Incident Coronary Heart Disease. Circ Cardiovasc Qual Outcomes. 2014;Jan;7(1):55-63. doi: 10.1161/CIRCOUTCOMES.113.000675

4. Tehrani DM, Zhao Y, Blaha MJ, et al: Discordance of Low-Density Lipoprotein and High-Density Lipoprotein Cholesterol Particle Versus Cholesterol Concentration for the Prediction of Cardiovascular Disease in Patients with Metabolic Syndrome and Diabetes Mellitus. Am J Cardiol 2016;Jun 15;117(12):1921-1927. doi: 10.1016/j.amjcard.2016.03.040

5. Mackey RH, Greenland P, Goff DC, et. al: High-Density Lipoprotein Cholesterol and Particle Concentrations, Carotid Atherosclerosis, and Coronary Events. J Am Coll Cardiol 2012; Aug 7;60(6):508-516. doi: 10.1016/j.jacc.2012.03.060

6. Otvos JD, Shalaurova I, Freedman DS, Rosenson RS: Effects of pravastatin treatment on lipoprotein subclass profiles and particle size in the PLAC-I trial. Atherosclerosis. 2002;Jan;160:41-48

7. Khera AV, Demler OV, Adelman SJ, et al: Cholesterol Efflux Capacity, High-Density Lipoprotein Particle Number, and Incident Cardiovascular Events: An Analysis From the JUPITER Trial (Justification for the Use of Statins in Prevention: An Intervention Trial Evaluating Rosuvastatin). Circulation 2017;Jun 20;135(25):2494-2504. doi: 10.1161/CIRCULATIONAHA.116.025678