The non-HDL cholesterol can be used as a measure of cardiovascular risk in primary care.


From the Friedwald formula.


total serum cholesterol =

= (HDL cholesterol) + (LDL cholesterol) + (VLDL cholesterol)


non-HDL cholesterol =

= (total serum cholesterol) - (HDL cholesterol)

= (VLDL cholesterol) + (LDL cholesterol)


A disadvantage of the Friedwald formula in primary care is that it requires an overnight fast. In primary care a fast of 8 or more hours may be a barrier.


The non-HDL cholesterol does not require

(1) fasting or

(2) measurement of triglycerides (which are used to estimate VLDL cholesterol).


Triglycerides tend to rise after eating. In most patients VLDL cholesterol can be estimated by dividing the serum triglyceride by 5. Because of the division by 5 a nonfasting non-HDL cholesterol may not differ that much from that of fasting specimen. However, the longer it has been since the person ate less variation there will be.


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