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Lipids
Total cholesterol (TC)
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This is the date the draft was written, not a medical review date.
Total cholesterol is the sum of cholesterol carried in all lipoproteins. It is a component of cardiovascular risk assessment, although LDL-C and non-HDL-C are more specific.
Reference interval
| Conventional (mg/dL) | SI (mmol/L) | |
|---|---|---|
| Adults | < 200 (upper limit) mg/dL | < 5.2 (upper limit) mmol/L |
Specimen: Serum or plasma (fasting not required) · Conventional × 0.0259 = SI
Causes of high values
Familial and polygenic hypercholesterolaemia, hypothyroidism, nephrotic syndrome, cholestasis, diabetes, obesity, high saturated-fat intake and drugs (corticosteroids, ciclosporin).
Causes of low values
Hyperthyroidism, malabsorption, malnutrition, severe liver disease, chronic inflammation, hypobetalipoproteinaemia and some cancers.
Pre-analytical and method notes
Desirable total cholesterol is conventionally below 200 mg/dL (5.2 mmol/L), but treatment decisions depend on overall cardiovascular risk, not on this value alone; targets differ between ACC/AHA and ESC guidance. Values fall during acute illness, pregnancy variation and recent myocardial infarction, so measure when stable. 1 mmol/L equals about 38.7 mg/dL.
References
- 2018 AHA/ACC Guideline on the Management of Blood Cholesterol. American Heart Association / American College of Cardiology (2018) — Tier 2 (guidelines / primary literature)
- 2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk. European Society of Cardiology / European Atherosclerosis Society (2019) — Tier 2 (guidelines / primary literature)
- Rifai N, Horvath AR, Wittwer CT. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. Elsevier, 6th edition (2018) — Tier 3 (textbook)
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