Summary

Non-HDL Cholesterol is a calculated value of all "bad" cholesterol types in your blood. It is used as a marker of cardiovascular diseases.

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Overview

Cholesterol is an essential substance for building cells and making vitamins and hormones. However, high levels of certain types of cholesterol can increase the risk of cardiovascular diseases, such as peripheral artery disease, stroke, or heart attack. Several types of lipoproteins carry cholesterol through the bloodstream, including low-density lipoprotein (LDL), very-low-density lipoprotein (VLDL), and high-density lipoprotein (HDL).

Non-HDL cholesterol is calculated by subtracting the "good" cholesterol, HDL, from your total cholesterol level.  Interestingly, research shows that non-HDL cholesterol is an even more reliable marker than LDL cholesterol.^[1-3]

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What should you know about this biomarker?

Each laboratory uses different equipment and workflows, so the results might vary in terms of the reference ranges or used units of measurement. In Macromo blood tests, we use mmol/l (millimole per liter), but you can also find values in mg/dl (milligrams per deciliter) on the internet.

Non-HDL cholesterol levels should ideally be below 3.8 mmol/l to minimize the risk of atherosclerosis and heart disease.^[4-6] For high-risk people, the levels should be even lower, below 1.8 mmol/l.

The equation used for the calculation of the result is written below: 

Non−HDL Cholesterol = Total Cholesterol - HDL Cholesterol

Your blood test can show distinct result possibilities:

• If your non-HDL cholesterol level is low, it is generally associated with a lower risk of cardiovascular disease. However, if you have any concerns, please consult a healthcare provider.
• If the non-HDL cholesterol level is within the normal range, it points out a healthy balance in your lipid profile. 
• If the non-HDL cholesterol level is above the recommended range, it indicates an elevated risk of atherosclerosis. Please consult your healthcare provider.

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Genetics

Although no single gene is identified to cause high cholesterol, genetics is still an important factor. It can affect the conditions that lead to increased cholesterol levels, including obesity, overeating, or diabetes. 

Genetic variations can influence non-HDL cholesterol levels. Polymorphisms in genes involved in lipid metabolism, such as LDLR, can affect the level of non-HDL cholesterol.

For example, familial hypercholesterolemia is a genetic disorder characterized by high LDL cholesterol levels, resulting in more elevated non-HDL cholesterol. Mutations in the LDLR gene can lead to this condition.^[7]

On the other hand, the heritability of HDL cholesterol is estimated to be 62–77%. However, some people may have lower levels due to genetic conditions, including Tangier disease or familial hypoalphalipoproteinemia.^[8,9]

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Recommendations

• Regular monitoring of non-HDL cholesterol levels is recommended, especially for individuals with a family history of cardiovascular disease or other risk factors.
• Engage in physical activity for at least 30 minutes a day, in the best case scenario - most days of the week.
• Aim for a diet low in saturated and trans fats. Incorporate more fruits, vegetables, whole grains, and lean proteins.
• Maintain a healthy weight. If overweight, work on gradual weight loss through balanced eating and regular physical activity.
• Smoking or using other tobacco products can increase LDL cholesterol and lower HDL cholesterol, negatively affecting non-HDL cholesterol levels.
• A healthcare provider may order additional tests or assessments to better understand the reason behind elevated non-HDL cholesterol levels.

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The information and tests provided on our website are for educational purposes only and are not a substitute for professional medical advice. Always consult with your healthcare provider before making health decisions. Our tests do not diagnose or treat diseases. Individual results may vary and should be discussed with a healthcare provider.