Cholesterol is an essential component of normally functioning cells, the cell membrane and it functions as a precursor in the biosynthesis of vitamin D, steroid hormones (cortisol and aldosterone, adrenal androgens), and sex hormones (testosterone, oestrogen, progesterone). Cholesterol is also a constituent of bile salt used in digestion to facilitate absorption of fat-soluble vitamins A, D, E, and K. The level of cholesterol plays a vital role in cardiovascular diseases process. Hyperlipidaemia leads to a higher risk of developing atherosclerotic cardiovascular disease (CVD).
Total Cholesterol
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Total Cholesterol
Cholesterol is a lipophilic molecule essential for human life, however, high cholesterol levels are often a significant risk factor for coronary artery disease. Total Cholesterol is usually one of a group of tests used to investigate the health of the heart.
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Clinical Details
Cholesterol is principally metabolized by the liver. Serum levels are controlled by the balance between blood uptake, cholesterol production and excretion in the intestine via bile acids. Low levels of cholesterol in the plasma may reflect an inherited deficiency of either LDL or HDL, or they may reflect impairment of liver function.
High levels can be categorized as
Primary: hereditary or genetic which causes a defect in lipid metabolism. Familial hypercholesterolaemia is the main cause of primary or genetic hypercholesterolaemia, and results in deficient uptake of LDL particles which accumulate in the blood stream.
Secondary: lifestyle such as poor diet, physical inactivity, increased weight and conditions producing secondary hyperlipidaemia, such as diabetes, hypothyroidism, chronic renal failure, chronic liver disease especially alcoholic, chronic biliary obstruction, primary biliary cirrhosis and certain drugs such as steroids, oestrogens.
Cholesterol correlates to the risk of cardiovascular disease and is a modifiable risk factor. Total cholesterol > 6.5mmol/L doubles the risk of Coronary Artery Disease (CAD) where as a level > 7.8mmol/L increases it fourfold. Reducing cholesterol by 20% reduces coronary risk by 10%. Lipid lowering therapy reduces the incidence of stroke and coronary artery disease. Lifestyle intervention must underpin all approaches in treatment.
The Irish heart foundation recommends the following targets:
Target Cholesterol and Triglycerides:
| Total cholesterol: | <5 mmol/l |
| LDL cholesterol: | <3 mmol/l |
| HDL cholesterol: | >1 mmol/l |
| Triglycerides: | < 2 mmol/l |
For people with heart disease or diabetes :
| Total cholesterol: | < 4.5 mmol/l |
| LDL cholesterol: | < 1.8 mmol/l |
There are several algorithms available to assess CVD risk and when to initiate treatment.
https://statindecisionaid.mayoclinic.org/index.php/statin/index?PHPSESSID=7t5s8vcrtmlilekvejb4pd91g4
https://academic.oup.com/eurheartj/article/41/1/111/5556353
https://www.escardio.org/Journals/ESC-Journal-Family/European-Journal-of-Preventive-Cardiology
Case Study
Delivering True Innovation
At Enfer Medical, we have integrated a cutting-edge and fully automated WASPLab® (Walk Away Specimen Processor) that has significantly enhanced our testing capabilities to ensure the highest of quality when processing patient samples.
Our Services
Service
Health & Wellness
General health and wellness testing can include a variety of tests, depending on the needs of the individual or recommendations of
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Service
Sexual Health
Regular STI screening facilitates early treatment and reduces the long-term consequences of infection.
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Respiratory Health
Rapid early pathogen identification has important treatment and infection control implications. See our range of tests here.
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Reproductive & Female Health
Hormonal analysis is hugely beneficial to identifying problems that can arise during the reproductive years.
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Sample Type &
Volume Required
5mL venous serum or plasma
Enfer Medical
Tests/Assays
Enfer Medical offers enzymatic colorimetric technology for the quantitative assay for Total Cholesterol. This test is CE-IVD certified.
Patient
Request Form
For clients using the Enfer Medical Client Portal, the Enfer Medical Patient Request Form (PRF) will be generated when you have completed your “Test Request” within the portal linked below.
Please note that samples suspected of containing high risk pathogens such as Mycobacterium tuberculosis should be clearly identified on the form and packed separately from other samples.
24 hours
Results are available next working day.
7 Days a Week
This assay is available seven days a week.
Packaging
The packaging/preparation of samples for delivery to the laboratory are required to be in adherence to all national regulations for the safe transport of biological materials. HSE guidance can be reviewed HERE.
There are specific packaging instructions and labelling requirements requiring triple packaging including:
- Primary leak-proof container – tube or vial containing the sample.
- Secondary watertight container, with absorbent material, intended to protect the primary container.
- Outer container protects the secondary container.
- Patient Request forms must be placed between the secondary container and the outer shipping container.
Further information on the packaging/preparation of samples for delivery to the laboratory is contained within the Enfer Medical Laboratory User Manual which clients are provided with.
Storage & Stability
Specimens must be tested within 7 days of collection and stored at 2-8°C.
Transporting
Samples
Samples
In addition to the packaging of samples, the transport/delivery of clinical samples to the laboratory is required to be in adherence to all national regulations for the safe transport of biological materials. Enfer Medical provides a fully compliant logistics service, aligned with clients’ testing requirements.
Prompt transport of specimens:
To ensure prompt testing of samples and release of results within the published test turnaround times, samples should arrive to the laboratory by 18:00. Test turnaround time is measured from receipt of the sample at the laboratory until the time the authorised results are reported to users.
Acceptance/Rejection
of Samples
of Samples
In rare cases specimens may not be suitable for testing on arrival to the laboratory. In that case the sample will be rejected at the receipt stage and the service user will be notified immediately and an explanation as to why the sample could not be processed will be provided. Reasons why samples cannot be processed include but are not limited to:
- Samples received beyond the stability limits and/or not at the correct temperature indicated for each test.
- Incorrect sample type received.
- Leaking samples, sample not received or sample insufficient for analysis as stated below within sample requirements.
- Non-compliant samples or request forms i.e. those missing sample date information, missing sample test request and/or missing sample site/type information.
- Samples received without the necessary patient identifiers.
Clients will be provided with guidance on Sample Receipt Anomalies.
Our Services
Service
Health & Wellness
General health and wellness testing can include a variety of tests, depending on the needs of the individual or recommendations of
Find Out More
Service
Sexual Health
Regular STI screening facilitates early treatment and reduces the long-term consequences of infection.
Find Out More
Service
Respiratory Health
Rapid early pathogen identification has important treatment and infection control implications. See our range of tests here.
Find Out More
Service
Reproductive & Female Health
Hormonal analysis is hugely beneficial to identifying problems that can arise during the reproductive years.
Find Out More
Result Values:
Quantitative results for Total Cholesterol are reported in numeric value in mmol/L. Please contact us for more information on the reference ranges used at Enfer Medical.
Accessing
Your Results
Following receipt at the Laboratory, results should be available on the next working day and will be reported to the referring clinician via the Enfer Medical Client Portal or in a format agreed with clients.
Established clients can login to the portal using the link above.