High-density Lipoprotein Cholesterol (HDL-C)

CPT Test code: 83718

Related Information:	Lipid Panel Lipid Panel With LDL:HDL Ratio Lipid Panel With Total Cholesterol:HDL Ratio Lipids Appendix: Cardiovascular Disease Risk Assessment Tools
Specimen:	Serum (preferred) or plasma
Volume:	1 mL
Minimum Volume:	0.5 mL
Container:	Gel-barrier tube, transport tube, green-top (heparin) tube, or lavender-top (EDTA) tube
Collection:	Separate serum or plasma from cells within 45 minutes of collection.
Storage Instructions:	Maintain specimen at room temperature.¹
Patient Preparation:	Patient should be on a normal diet and maintain a stable weight for a week prior to testing. Any drugs should be discontinued for three to four weeks if possible. Test should not be performed until three months after a myocardial infarction or similar traumatic episode, such as severe infection or inflammation. Fasting is not necessary.
Causes for Rejection:	Improper labeling
Reference Interval:	<40 mg/dL is the cutpoint for increased CHD risk; high HDL cholesterol levels (≥60 mg/dL) decrease CHD risk.
Use:	Monitoring of HDL-cholesterol in serum is of clinical importance since an inverse correlation exists between serum HDL-cholesterol concentrations and the risk of atherosclerotic disease. Elevated HDL-cholesterol concentrations are protective against coronary heart disease, while reduced HDL-cholesterol concentrations, particularly in conjunction with elevated triglycerides, increase the cardiovascular risk.^2,3 Strategies have emerged for treating cardiovascular disease by increasing HDL-cholesterol levels.^4,5
Additional Information:	Total cholesterol and triglycerides are required as well for determination of lipid risk factors for coronary artery disease. These tests with HDL-C and LDL-C are the usual lipid profile. HDL-C is especially apt to be low in male subjects who are obese and sedentary, in those who smoke cigarettes, and in those who have diabetes mellitus. Uremia is also associated with lower HDL-C. Exercise, appropriate diet and moderate ethanol intake increase HDL-C. HDL-C is useful with cholesterol in forecasting protection against coronary artery disease in the industrialized countries, possible because of ingestion of high fat diets. Those at least risk for development of coronary arterial disease have low cholesterol, low triglycerides, and high HDL-C. Factors contributing to decreased HDL-C include: • Genetic factors: primary hypoalphalipoproteinemia⁶ • Cigarette smoking⁷ • Obesity⁷ • Hypertriglyceridemia⁷ • Lack of exercise • Steroids − androgens, progestogens, anabolic • Thiazides • Beta-adrenergic blockers • Probucol • Neomycin
Footnotes:	1. LabCorp internal studies. 2. Nauck M, Wiebe D, Warnick G, “Measurement of High-Density-Lipoprotein,” Handbook of Lipoprotein Testing, 2nd ed, Rifai N, Warnick CR, Dominiczak MH, eds, Washington, DC: AACC Press, 2001, 221-4. 3. Dominiczak M, McNamara J, “The System of Cardiovascular Prevention,” Handbook of Lipoprotein Testing, 2nd ed, Rifai N, Warnick CR, Dominiczak MH, eds, Washington, DC: AACC Press, 2001, 103-25. 4. Linsel-Nitschke P, Tall AR, “HDL as a Target in the Treatment of Atherosclerotic Cardiovascular Disease,” Nat Rev Drug Discov, 2005, 4(3):193-205.PubMed 15738977 5. Ng DS, “Treating Low HDL − From Bench to Bedside,” Clin Biochem, 2004, 37(8):649-59.PubMed 15302606 6. Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) Final Report, Circulation, 2002, 106(25):3143-421.PubMed 12485966 7. Frohlich JJ, Pritchard PH, “The Clinical Significance of Serum High Density Lipoproteins,” Clin Biochem, 1989, 22(16):417-23.PubMed 2692872