NMR Lipid Profile

How much does an NMR Lipid Profile cost?

As of 2023, NMR LipoProfiles are only available from Dynacare, and cost $138.75.

What is the NMR LipoProfile test?

The NMR LipoProfile test is a newer method of assessing your risk of cardiovascular diseases (CVDs), which include heart diseases and stroke. It provides a more detailed look at your blood cholesterol levels compared to the traditional lipid panel test.

What's different about the NMR LipoProfile test compared to a regular cholesterol test?

A regular cholesterol test (lipid panel test) measures the overall cholesterol, triglycerides, LDL (often called "bad" cholesterol), and HDL (often called "good" cholesterol) in your blood. The NMR LipoProfile test measures not only these values, but also the number and size of lipoprotein particles, which are the particles that carry cholesterol in your blood.

Why are lipoprotein particles important?

Lipoprotein particles help transport cholesterol in the body. The number, size, and type of these particles can provide more information about your risk for heart disease. For example, having many small LDL particles (a type of lipoprotein) can indicate a higher risk for heart disease compared to having fewer, larger LDL particles.

What does it mean if I have high LDL-P (LDL particle) numbers?

A high LDL-P number means you have many LDL particles in your blood. Multiple studies have shown that a high LDL-P number is a strong predictor of future heart diseases, even more so than high levels of LDL cholesterol (LDL-C). So, having high LDL-P numbers might mean that you are at a higher risk for heart diseases.

Do I need an NMR LipoProfile test?

The NMR Lipoprofile does not currently guide medical decision making in current clinical practice guidelines for high cholesterol. Therefore, it is not a routinely suggested medical test. This test is available for individuals looking to have a greater understanding of their cholesterol profile.

The NMR LipoProfile test can be particularly useful for individuals who have low LDL cholesterol (LDL-C) but high LDL particles (LDL-P). This is known as discordance. It's also beneficial for those with a higher cardiovascular risk, such as individuals with type II diabetes, obesity, or hypertension.

How does the NMR LipoProfile test work?

The NMR LipoProfile test uses a technology called spectroscopy, which looks at how different particles in your blood emit signals. The size and type of lipoprotein particles produce unique signals, allowing the test to measure and differentiate them accurately. This information is then used to categorize your cardiovascular risk.

What other information can the NMR LipoProfile test provide?

In addition to the number and size of lipoprotein particles, the NMR LipoProfile test provides information on your LDL cholesterol, HDL cholesterol, total cholesterol, and triglycerides, just like a traditional lipid panel. It also measures the average sizes of LDL, HDL, and VLDL particles and assigns a risk category based on your LDL particle size. These categories can range from lower to higher risk for coronary heart disease.

How reliable is the NMR LipoProfile test?

he NMR LipoProfile test has been shown in several studies to be a strong predictor of future cardiovascular events. For example, data from the well-known Framingham study found a clear link between LDL particle number and increased heart disease risk. So, the test is considered a reliable tool in assessing cardiovascular risk.

What does it mean if I have low HDL particle numbers?

HDL, often called "good cholesterol", helps remove LDL, or "bad cholesterol", from your bloodstream. Therefore, having a high number of HDL particles is generally beneficial and protective against heart diseases. If you have low HDL particle numbers, it could mean you are at a higher risk of heart disease.

I'm already on medication for high cholesterol. Why would I need the NMR LipoProfile test?

Sometimes, even when LDL cholesterol (LDL-C) levels decrease with medication, the LDL particle (LDL-P) number remains high. This is known as discordance. Studies have found that individuals with this discordance often have a higher risk of cardiovascular diseases. Therefore, the NMR LipoProfile test could help identify if you fall into this category and if your current treatment needs adjustment.

What does the term "atherogenic risk" mean?

"Atherogenic risk" refers to the risk of developing atherosclerosis, a condition where plaque builds up in your arteries. This plaque is primarily made of fat, cholesterol, and calcium, and can restrict blood flow in your arteries, leading to serious heart problems.

How does the NMR LipoProfile test categorize cardiovascular risk?

The NMR LipoProfile test categorizes cardiovascular risk into three patterns based on the size of your LDL particles. Pattern A, which indicates a lower risk, is when you have predominantly large LDL particles. Pattern B signifies a higher risk and is when you have predominantly small LDL particles. Pattern AB is an intermediate category.

Can my LDL-P numbers change?

Yes, your LDL-P numbers can change based on lifestyle modifications such as diet, exercise, and medications. These numbers can be a dynamic way to track your response to treatments and lifestyle changes over time.

What should I do if my LDL-P numbers are high?

If your LDL-P numbers are high, it's crucial to discuss it with your doctor. They may recommend changes to your lifestyle, medications, or both, to lower your LDL-P numbers and reduce your risk of heart disease.

How can the NMR LipoProfile test affect the use of medications in managing cardiovascular risk?

Different medications used to manage cardiovascular risk have varied effects on lipid levels. For instance, statins result in the most significant reduction of both LDL-P and LDL-C, but they also lead to smaller percent reductions in LDL-P number than in LDL-C. Understanding these differences can be crucial for tailoring treatment strategies, and the NMR LipoProfile test can provide that information.

Can lifestyle modifications affect my NMR LipoProfile test results?

Yes, lifestyle modifications such as exercise, diet, and medication changes can improve your advanced lipoproteins. This can lead to a reduction in LDL-P number and small HDL particle (HDL-P) number, and an increase in the concentration of large HDL-P numbers.

Why is it surprising that the NMR LipoProfile test isn't more widely used in clinical care?

Despite the evidence supporting the NMR LipoProfile test's usefulness in predicting cardiovascular risk, current guidelines for managing lipid disorders focus on LDL-C levels or other lipoprotein cholesterol. The specificity of the NMR LipoProfile test, especially in cases where there's variability in LDL-C and LDL-P numbers, suggests it could be beneficial to consider expanding these guidelines.

References

Feingold KR. Utility of Advanced Lipoprotein Testing in Clinical Practice. [Updated 2023 Jan 3]. In: Feingold KR, Anawalt B, Blackman MR, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK355893/

Rodriguez-Garcia E, Ruiz-Nava J, Santamaria-Fernandez S, Fernandez-Garcia JC, Vargas-Candela A, Yahyaoui R, Tinahones FJ, Bernal-Lopez MR, Gomez-Huelgas R. Characterization of lipid profile by nuclear magnetic resonance spectroscopy (1H NMR) of metabolically healthy obese women after weight loss with Mediterranean diet and physical exercise. Medicine (Baltimore). 2017 Jul;96(27):e7040. doi: 10.1097/MD.0000000000007040. PMID: 28682864; PMCID: PMC5502137.

Emmanuel, Unde & Ibeson, Emeka & Nwosu, Ifeanyi & Montemarano, Nadine & Shani, Jacob & Shetty, Vijay. (2022). Clinical Relevance of Nuclear Magnetic Resonance LipoProfile. Frontiers in Nuclear Medicine. 2. 960522. 10.3389/fnume.2022.960522.