Non-HDL Cholesterol

Non-HDL Cholesterol

Non-HDL cholesterol is calculated by subtracting HDL from total cholesterol. Non-HDL better depicts the amount of atherogenic, or “bad” cholesterol circulating in the body. In addition to LDL, non-HDL includes very low-density lipoproteins (VLDLs) and remnant lipoproteins, which are significant contributors to atherosclerosis.
Non-HDL is not always necessary to report but becomes particularly useful in certain circumstances. For example, the total cholesterol value includes both HDL and LDL. An elevated HDL in the presence of low/normal LDL can make the total cholesterol value appear elevated. However, the non-HDL is normal in this case, which suggests that HDL was responsible for the increased total cholesterol value.
Secondly, non-HDL is important when triglyceride levels are elevated, which is common in conditions like diabetes, morbid obesity, and other metabolic disorders. HDL and LDL may be normal in this case, but because VLDL is elevated, the non-HDL value is also elevated. Relying solely on LDL might lead to mislabeling high-risk patients as low-risk.

Resources: American Heart Association: Cholesterol 101