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New Test: Lipid Panel with Reflex to Direct LDL
The Department of Pathology & Laboratory Medicine will introduce a new lipid panel that includes reflex to Direct LDL-C when triglycerides are elevated above 400 mg/dL (test code: LIPSCD). In hypertriglyceridemia, values of LDL-C calculated by the Friedewald equation may be less accurate, particularly when LDL-C is <70 mg/dL, and the equation is invalid when triglycerides are greater than 400 mg/dL.

The new panel will include the following components:

Lipid Panel with Reflex to Direct LDL
Cholesterol, Total
LDL-C (calculated unless triglyceride >400 mg/dL, in which case Direct LDL-C
will be performed)
Non-HDL-C (calculated)
VLDL-C (calculated)

This test will replace the Lipid Panel, Extended (test code LIPSCR), which will be discontinued. The available in-house tests for lipid testing will include:

Test Code Test Name
Lipid Panel with Reflex to Direct LDL
Lipid Panel, Fasting
Lipid Panel, Non-Fasting
Direct LDL-C

Effective date: May 5, 2021

Specimen requirement and testing information:

Specimen: Collect 4.0 mL blood in a light green (lithium heparin), or gold, or red top tube. EDTA plasma is also acceptable. Spin down and separate plasma or serum from cells as soon as possible, and within 2 hours of sample collection.

Metamizole (Dipyrone) has been identified as an interferent which may cause a false low result for triglycerides. Patients treated with N-Acetyl Cysteine (NAC) for an acetaminophen overdose may generate a false low result for cholesterol.

Test methodology: Enzymatic, Spectrophotometric

Test code: LIPSCD

Plasma, or serum, after separation from cells:

Ambient: 8 hours
Refrigerated: 5 days
Frozen: For long term storage, temperature of -70°C recommended. Thaw only once.

Turnaround time (TAT):
STAT: 60 minutes
Routine: 2-4 hours
Set Up Days: Daily

Specimen required: 2.0 mL plasma
Minimum volume: 0.5 mL plasma

Rejection criteria:
Specimens that exceed stated stability, unlabeled/mislabeled/mismatched specimens, specimens submitted in leaking containers, hemolyzed or lipemic specimens

References ›

A summary of all tests offered by our laboratory services can be found here:


Bridgit O. Crews, PhD, DABCC
Clinical Chemistry & Toxicology & Point-of-Care Testing

Edwin S. Monuki, MD, PhD
Department of Pathology & Laboratory Medicine

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