What are these lipoprotein tests?
LDL (Low-Density Lipoprotein) Subfractions:
- LDL Particle Number (LDL-P): Total count of LDL particles
- LDL Size/Peak Size: Average diameter of LDL particles
- LDL Pattern: Classification as Pattern A (large, buoyant) or Pattern B (small, dense)
- LDL Small/Medium: Concentration of specific LDL subclasses
HDL (High-Density Lipoprotein) Subfractions:
- HDL-P: Total HDL particle count
- HDL Size: Average HDL particle diameter
- HDL Large: Concentration of large HDL particles
VLDL (Very Low-Density Lipoprotein) Subfractions:
- Large VLDL-P: Count of large VLDL particles
- VLDL Size: Average VLDL particle diameter
Do particle size or number results change my treatment?
No. Knowing your LDL/HDL/VLDL particle sizes or numbers rarely changes what your doctor will recommend.
Whether you have Pattern A (large, buoyant) or Pattern B (small, dense) LDL particles, the treatment approach remains the same:
- Lifestyle modifications (diet, exercise, weight management)
- Statin therapy when indicated based on overall cardiovascular risk
- LDL-C lowering remains the primary target
References
- Don’t routinely order expanded lipid panels (particle sizing, nuclear magnetic resonance) as screening tests for cardiovascular disease. American Academy of Family Physicians (AAFP) – Choosing Wisely. https://www.aafp.org/pubs/afp/collections/choosing-wisely/316.html
- LDL particle number and size and cardiovascular risk: anything new under the sun? Allaire J, et al. Current Opinion in Lipidology. 2017;28(3):261-266. https://pubmed.ncbi.nlm.nih.gov/28460374/
- Advanced Lipoprotein Testing and Subfractionation Are Not (Yet) Ready for Routine Clinical Use. Mora S, et al. Circulation. 2007;116(25):2812-2820. American Heart Association. https://www.ahajournals.org/doi/10.1161/circulationaha.108.819359

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