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

Method Name
A short description of the method used to perform the test

Nuclear Magnetic Resonance (NMR)

NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.

Yes

Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test

NMR Lipoprotein Profile, S

Aliases
Lists additional common names for a test, as an aid in searching

HDL particle number

HDL particles

LDL Cholesterol

LDL particle number

LDL particles

Lipoprotein particles

NMR

NMRLP

NMR profile

Nuclear magnetic resonance

Specimen Type
Describes the specimen type validated for testing

Serum Red

Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing

Patient Preparation:

1. Fasting overnight (12-14 hours) is required. On night before examination, evening meal should be eaten before 6 p.m. and should contain no fatty foods.

2. Patient must not consume any alcohol for 24 hours before the specimen is collected.

Collection Container/Tube: Red top

Submission Container/Tube: Plastic vial

Specimen Volume: 1.5 mL

Collection Instructions:

1. Allow isopropyl alcohol (from phlebotomy site prep) to dry thoroughly before venipuncture.

2. Centrifuge and aliquot serum.

Forms

If not ordering electronically, complete, print, and send a Cardiovascular Test Request Form (T724) with the specimen.

Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the Testing Laboratory

1 mL

Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected

Gross hemolysis Reject
Gross lipemia Reject
Gross icterus Reject

Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included

Specimen Type Temperature Time Special Container
Serum Red Refrigerated (preferred) 7 days
Frozen 14 days
Ambient 8 hours

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

Method Description
Describes how the test is performed and provides a method-specific reference

Lipoprotein particles are quantified in serum by nuclear magnetic resonance (NMR). The deconvoluting algorithm used is the AXINON Mayo LP Profiler software.(Instruction manual: AXINON System User Manual Version 1.3.2, 3/2018)

PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information

No

Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.

Tuesday and Friday

Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.

2 to 7 days

Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded

7 days

Performing Laboratory Location
Indicates the location of the laboratory that performs the test

Rochester

Fees
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.

  • Authorized users can sign in to Test Prices for detailed fee information.
  • Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
  • Prospective clients should contact their Regional Manager. For assistance, contact Customer Service.

Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.

This test was developed, and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.

CPT codes are provided by the performing laboratory.

83704

LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.

Test Id Test Order Name Order LOINC Value
NMRLP NMR Lipoprotein Profile, S In Process
Result Id Test Result Name Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
606167 LDL Particles, S 54434-6
606168 HDL Particles, S 49748-7
606169 LDL Cholesterol (NMR), S 2089-1

Test Setup Resources

Setup Files
Test setup information contains test file definition details to support order and result interfacing between Mayo Clinic Laboratories and your Laboratory Information System.

Excel | Pdf

Sample Reports
Normal and Abnormal sample reports are provided as references for report appearance.

Normal Reports | Abnormal Reports

SI Sample Reports
International System (SI) of Unit reports are provided for a limited number of tests. These reports are intended for international account use and are only available through MayoLINK accounts that have been defined to receive them.

SI Normal Reports | SI Abnormal Reports