LipoScreen LDL Subfractions, Oxidised LDL & HDL Subfractions

Your Cholesterol Number Isn't Telling You the Whole Truth

Here is a fact that surprises most people: approximately half of all people who suffer a heart attack had cholesterol levels that were considered perfectly normal beforehand. Conversely, many people with elevated cholesterol never go on to develop heart disease at all.

So if the number your GP gives you after a routine cholesterol check isn't reliably predicting your risk — what is?

The answer lies not in how much cholesterol you have, but in what type it is, what it's doing inside your arteries, and how well your protective cholesterol is actually working. This test is designed to answer all three questions.

What a Standard Cholesterol Test Cannot Tell You

A routine NZ lipid panel gives you a total cholesterol figure, an LDL ("bad") cholesterol figure, an HDL ("good") cholesterol figure, and triglycerides. What it cannot tell you is:

What kind of LDL do you have? LDL cholesterol is not a single substance — it exists as a spectrum of particles ranging from large and relatively harmless to small, dense, and highly dangerous. Small, dense LDL particles are far more likely to penetrate the artery wall, bind to artery tissue, and trigger the development of plaque. A standard test gives you one combined LDL number with no indication of which type dominates your profile. Two people with identical LDL readings can have vastly different cardiovascular risk profiles depending on their particle type — and a standard test cannot distinguish between them.

Whether your LDL has been oxidised. When LDL cholesterol is exposed to oxidative stress — from factors such as smoking, poor blood sugar regulation, a diet high in trans fats, or low antioxidant intake — it undergoes a damaging chemical change that makes it significantly more atherogenic. Oxidised LDL is a more direct measure of the process actually driving arterial damage, and it is never assessed in standard testing.

Whether your HDL is genuinely protective. We've long been told that high HDL is simply "good." The reality is more nuanced. HDL exists in multiple subclasses — large, intermediate, and small — and emerging research suggests that not all HDL is cardioprotective. Large HDL particles are the most beneficial, actively transporting cholesterol away from arterial walls. Small HDL particles, by contrast, may actually be associated with increased cardiovascular risk. A standard test gives you a single HDL number with no information about what proportion is genuinely working in your favour.

What This Test Measures

This profile combines three advanced lipid assessments into a single comprehensive panel.

Part 1 — LipoScreen LDL Subfraction Analysis

LipoScreen separates and quantifies your LDL cholesterol into its full spectrum of particle subtypes — something no standard lipid test can do.

Large, buoyant LDL (LDL-1 and LDL-2) are the less harmful particles. They are too large to easily penetrate the artery wall and are associated with average cardiovascular risk.

Small, dense LDL (LDL-3 through LDL-7) are the particles that matter most from a risk perspective. They are small enough to penetrate the endothelial lining of arteries, they bind readily to arterial tissue, and they are significantly more susceptible to oxidation — making them a primary driver of atherosclerosis. Their presence at elevated levels defines a high-risk LDL profile, regardless of the total LDL number.

The test also measures VLDL (very low-density lipoprotein) and IDL (intermediate-density lipoprotein) subfractions — both of which are independently atherogenic and are elevated in metabolic conditions such as type 2 diabetes mellitus and insulin resistance.

From these measurements, your LDL Phenotype Pattern is determined:

• Type A — a predominantly large, buoyant particle profile. Considered normal.
• Type B — a predominantly small, dense particle profile. Considered abnormal and associated with significantly elevated coronary artery disease risk. This pattern is also characteristically seen in insulin-resistant states, including metabolic syndrome and type 2 diabetes mellitus.

Your Mean LDL Particle Size is also reported in Ångström. Particles below a certain size threshold are capable of penetrating the endothelial lining and initiating plaque formation — a detail entirely invisible in conventional testing.

Part 2 — Oxidised LDL

Oxidised LDL is one of the most clinically meaningful biomarkers in advanced cardiovascular assessment. It measures not merely the quantity of LDL in circulation, but the degree to which it has undergone oxidative damage — the process that makes LDL particles genuinely harmful to arterial tissue.

Elevated oxidised LDL is associated with accelerated atherosclerosis, coronary artery disease, metabolic syndrome, and acute cardiac events. It is also seen more frequently in individuals with poorly controlled blood glucose. Factors that contribute to LDL oxidation include smoking, a diet high in trans fats, low intake of antioxidants, and chronic oxidative stress.

Because this marker reflects the activity of the atherogenic process rather than simply the amount of cholesterol present, it provides a uniquely direct window into cardiovascular risk that no standard panel can replicate.

Part 3 — HDL Subfraction Analysis

Most people know HDL as "good cholesterol" — and for good reason. Its primary role is reverse cholesterol transport: collecting excess cholesterol from the arterial walls and returning it to the liver for clearance. But like LDL, HDL is not a single uniform substance.

This component of the test separates HDL into three subclass groups:

Large HDL (Subfractions 1–3) — the most cardioprotective subclass, actively clearing cholesterol from arterial walls.

Intermediate HDL (Subfractions 4–7) — also considered anti-atherogenic.

Small HDL (Subfractions 8–10) — the subclass currently associated with increased coronary heart disease risk. A high proportion of small HDL relative to large and intermediate HDL may indicate that your HDL system is less protective than a standard HDL number would suggest.

Please note: The HDL Subfraction component of this test is currently classified for research purposes. It is provided as additional information to support a broader understanding of your lipid metabolism. Your practitioner will interpret these results in context.

Who Should Consider This Test?

This profile is particularly relevant if you:

• Want to understand your true cardiovascular risk beyond a basic cholesterol reading
• Have been told your cholesterol is elevated, but want to know whether it actually represents increased risk
• Have a family history of heart disease or stroke — particularly in a parent or sibling under the age of 60
• Live with or are at risk of type 2 diabetes mellitus, insulin resistance, or metabolic syndrome
• Carry excess weight, particularly abdominal adiposity
• Smoke, or have recently quit
• Eat a diet low in antioxidants or high in processed fats
• Are experiencing high levels of oxidative stress
• Are already on cholesterol-lowering medication and want a more complete picture of its effect

Complete Analyte List

LipoScreen LDL Subfractions: Cholesterol · Triglycerides · HDL · LDL · VLDL · IDL (IDL-1, IDL-2, IDL-3) · LDL Subfractions (LDL-1 through LDL-7) · LDL Phenotype Pattern · Mean Particle Size

Oxidised LDL: Oxidised LDL (IU/L)

HDL Subfractions: Cholesterol · Triglycerides · HDL · HDL Subfractions — Large (1–3), Intermediate (4–7), Small (8–10)

Preparation Instructions

Fasting is required. Fast for a minimum of 10 hours and no more than 12 hours before your blood draw. Water is permitted throughout. A morning appointment is strongly recommended.

Functional Medical Tests – Costs, Terms & Timeframes

All functional test kits incur only minimal administrative costs and include a pre-paid courier bag with full instructions for self-collection and submission. Kits are dispatched to one of our New Zealand distributors — FxMed or Nutriscript — who consolidate and forward samples via weekly shipments to accredited laboratories in the United States or Australia.

The standard turnaround time for results is 3–5 weeks from the date of sample submission. If you have not received your results within 5 weeks, please contact us so we can follow up on your behalf.

Please note: Occasional delays may occur due to customs clearance, international courier disruptions, or laboratory backlogs. These are outside our control, but we will assist in tracking and resolving any extended delays.

Once results are available, we receive them directly from the distributor and forward them to you on the same day. Laboratory reports typically include detailed interpretations, reference ranges, and explanatory notes.

We strongly recommend booking a follow-up consultation — either online or in person — to contextualise your results within your broader health strategy. This ensures accurate interpretation and integration into your personalised care plan.

Consultation fees are additional to the cost of the test kit.