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Test Code SDLDL Small Dense Low Density Lipoprotein Cholesterol, Serum


Specimen Required


Patient Preparation: Fasting overnight (8-12 hours) required

Supplies: Sarstedt Aliquot Tube, 5 mL (T914)

Collection Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Submission Container/Tube: Plastic vial

Specimen Volume: 1 mL

Collection Instructions:

1. Centrifuge and aliquot serum into a plastic vial.

2. Send frozen.


Useful For

Aiding in risk management of lipoprotein disorders associated with cardiovascular disease when used in conjunction with other lipid measurements and clinical evaluation

Method Name

Enzymatic Colorimetric

Reporting Name

Small Dense LDL Cholesterol, S

Specimen Type

Serum

Specimen Minimum Volume

0.5 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Serum Frozen (preferred) 30 days
  Refrigerated  72 hours
  Ambient  8 hours

Reject Due To

Gross hemolysis Reject
Gross lipemia Reject
Gross icterus Reject

Clinical Information

Low-density lipoprotein cholesterol (LDL-C) has long been known to be causally associated with atherosclerotic plaque development and progression and is the main target of lowering cardiovascular disease risk. Subfractions of LDL, particularly the concentration of small dense LDL-C, have been shown to also be associated with increased risk for coronary heart disease (CHD). It is thought that the smaller particles are especially pro-atherogenic given their higher probability to transverse the arterial wall and a longer circulating half-life, likely from a lower binding affinity to the LDL receptor. Several epidemiological and pathological studies have reported an association between the concentration of small dense LDL-C and CHD. Results should be used in conjunction with the patient's medical history and other laboratory and clinical results.

Reference Values

≥18 years: <50 mg/dL

Reference values have not been established for patients who are younger than 18 years.

Interpretation

Results of 50 mg/dL or greater indicate increased risk of incident coronary heart disease (CHD) (myocardial infarction, fatal CHD, or cardiac procedure).

Cautions

Results should not be used as a replacement for low-density lipoprotein cholesterol and should not be used in risk calculators.

 

In very rare cases, gammopathy, in particular type IgM (Waldenstrom macroglobulinemia), may cause unreliable results.

Clinical Reference

1. Tsai MY, Steffen BT, Guan W, et al. New automated assay of small dense low-density lipoprotein cholesterol identifies risk of coronary heart disease: the multi-ethnic study of atherosclerosis. Arterioscler Thromb Vasc Biol. 2014;34(1):196-201. doi:10.1161/ATVBAHA.113.302401

2. Hoogeveen RC, Gaubatz JW, Sun W, et al. Small dense low-density lipoprotein-cholesterol concentrations predict risk for coronary heart disease: the atherosclerosis riskiIn ommunities (ARIC) study. Arterioscler Thromb Vasc Biol. 2014;34(5):1069-1077. doi:10.1161/ATVBAHA.114.303284

3. Hirano T, Ito Y, Yoshino G. Measurement of small dense low-density lipoprotein particles. J Atheroscler Thromb. 2005;12(2):67-72

4. Ogita K, Ai M, Tanaka A, et al. Circadian rhythm of serum concentration of small dense low-density lipoprotein cholesterol. Clin Chim Acta. 2007;376(1-2):96-100

5. Balling M, Nordestgaard BG, Langsted A, Varbo A, Kamstrup PR, Afzal S. Small dense low-density lipoprotein cholesterol predicts atherosclerotic cardiovascular disease in the Copenhagen general population study. J Am Coll Cardiol. 2020;75(22):2873-2875. doi:10.1016/j.jacc.2020.03.072

Method Description

This test system is a multi-step method measured on automated chemistry analyzers. The assay consists of two steps and is based on the technique of using well-characterized surfactants and enzymes that selectively react with certain groups of lipoproteins.(Package insert: Small dense LDL Seiken. Roche Diagnostics; V 2.0, 11/2021)

Day(s) Performed

Monday through Friday

Report Available

1 to 3 days

Specimen Retention Time

7 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information

83722

LOINC Code Information

Test ID Test Order Name Order LOINC Value
SDLDL Small Dense LDL Cholesterol, S 90364-1

 

Result ID Test Result Name Result LOINC Value
SDLDL Small Dense LDL Cholesterol, S 90364-1

NY State Approved

Yes

Forms

If not ordering electronically, complete, print, and send a Cardiovascular Test Request (T724) with the specimen.