145
mg/dL
—
3.6
145
mg/dL
—
3.6
The Non-HDL Cholesterol Calculator determines the total atherogenic lipoprotein cholesterol burden by subtracting HDL from total cholesterol. Non-HDL cholesterol captures cholesterol carried by all atherogenic particles: LDL, VLDL, IDL (intermediate-density lipoprotein), and Lp(a) (lipoprotein(a)). This comprehensive atherogenic measurement is increasingly recognized as superior to LDL-C alone for cardiovascular risk assessment.
The calculation is straightforward: Non-HDL = Total Cholesterol - HDL. Unlike LDL estimation by the Friedewald equation, non-HDL does not require fasting or triglyceride values, making it reliable in non-fasting samples. This practical advantage is significant because non-fasting lipid testing is increasingly recommended for initial screening by both AHA and European guidelines.
Risk categories: Non-HDL below 100 mg/dL is optimal (corresponding roughly to LDL below 70). Below 130 is desirable (LDL below 100). Borderline high is 130-159, high is 160-189, and very high is 190+. Treatment targets are generally 30 mg/dL above the corresponding LDL target for each risk category.
Non-HDL cholesterol has demonstrated superior predictive ability compared to LDL-C in multiple studies including INTERHEART and AMORIS, particularly in patients with elevated triglycerides, metabolic syndrome, and diabetes where LDL may underestimate true atherogenic burden due to increased small dense LDL particles not fully captured by standard LDL measurement.
The NLA (National Lipid Association) recommends non-HDL as the primary lipid screening target, and the 2019 ESC/EAS guidelines include non-HDL goals for all risk categories. This metric is especially valuable in patients with triglycerides 200-499 mg/dL where Friedewald LDL becomes less accurate and apoB or direct LDL testing may not be readily available.
Non-HDL also serves as a practical surrogate for apolipoprotein B (apoB), which directly quantifies atherogenic particle number. The correlation between non-HDL and apoB is strong (r greater than 0.90), and non-HDL below 130 mg/dL corresponds approximately to apoB below 90 mg/dL, the desirable range for average-risk individuals.
Non-HDL = Total Cholesterol - HDL. Categories: Optimal (<100), Desirable (100-129), Borderline High (130-159), High (160-189), Very High (≥190). TC/HDL ratio also calculated.
Below 100: optimal for high-risk patients. 100-129: desirable for most adults. 130-159: consider intervention. 160+: likely needs medication. Treatment target = LDL goal + 30 mg/dL.
Inputs
Results
Non-HDL 105 and TC/HDL 2.6 = excellent atherogenic profile.
Inputs
Results
Non-HDL 208 = very high atherogenic burden, aggressive therapy needed.
All cholesterol except HDL: includes LDL, VLDL, IDL, and Lp(a). Represents total atherogenic lipoprotein cholesterol burden.
Captures all atherogenic particles, not just LDL. More predictive in patients with high triglycerides, diabetes, and metabolic syndrome.
No. Non-HDL is reliable non-fasting because it uses only total cholesterol and HDL, which are minimally affected by recent meals.
LDL target plus 30 mg/dL. For very high risk: below 100. For high risk: below 130. For moderate risk: below 160.
Non-HDL correlates strongly with apoB (r>0.90) and serves as a practical surrogate. Non-HDL 130 approximates apoB 90.
The NLA recommends non-HDL as primary screening target. Most guidelines include both, with non-HDL as secondary target after LDL.
Diet high in saturated fat, obesity, physical inactivity, diabetes, hypothyroidism, chronic kidney disease, genetic factors.
Statins lower non-HDL 30-50%. Dietary changes, fibrates, niacin, omega-3 for TG-driven elevation. Weight loss and exercise help.
Especially useful. Diabetes causes increased VLDL and small dense LDL that non-HDL captures but standard LDL may underestimate.
Indicates elevated VLDL/triglyceride-rich remnants. Common in metabolic syndrome. Non-HDL captures this residual risk LDL misses.
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