Nephrology · Preventive Cardiology · Clinical Calculator

Lipid Panel Interpreter LDL, Non-HDL & Friedewald

Enter your fasting lipid values to receive a plain-language classification of each component, calculate non-HDL cholesterol, the TG/HDL insulin-resistance ratio, and evidence-based dietary guidance — in conventional (mg/dL) or SI (mmol/L) units.

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Instructions
  1. Obtain your most recent fasting lipid panel result (8–12 hours fasting). Non-fasting panels underestimate LDL and overestimate triglycerides.
  2. Select your unit system — Conventional (mg/dL) is standard in Philippine and US laboratories; SI (mmol/L) is used in European and Australian reports. The toggle adjusts all labels, hints, and internal calculations automatically.
  3. Enter your total cholesterol, LDL-cholesterol, HDL-cholesterol, and triglycerides exactly as reported on your lab slip. Enter your sex to apply the correct HDL threshold (<40 mg/dL for males, <50 mg/dL for females).
  4. Click Interpret My Lipid Panel to see classification of each value, calculated non-HDL-C, the TG/HDL ratio, and a plain-language verdict with suggested dietary focus areas.
  5. Note that the calculator interprets the values you provided — it does not use laboratory direct-measured LDL. If your triglycerides are >400 mg/dL, discuss a directly measured LDL with your physician.
  6. Bring results to your physician visit for personalized risk stratification and treatment planning.
When to Use

Use this tool any time you receive a fasting lipid panel — a standard blood test that measures total cholesterol, LDL-cholesterol, HDL-cholesterol, and triglycerides. The calculator goes beyond simply reporting each value: it classifies the entire profile, calculates non-HDL cholesterol (a better cardiovascular risk marker than LDL alone), and flags the TG/HDL ratio as a surrogate for insulin resistance and small-dense LDL pattern — a clinically important atherogenic phenotype especially common in Filipino patients with high carbohydrate intake.

Appropriate population

Adults aged 18 and older with a fasting lipid panel result. Particularly useful for patients with CKD (who have a characteristic mixed dyslipidemia with high TG, low HDL, and elevated small-dense LDL despite a normal or near-normal LDL value), diabetes, metabolic syndrome, or family history of premature cardiovascular disease. Also appropriate for healthy adults undergoing routine cardiovascular risk assessment.

⚠️

When NOT to rely on it

If triglycerides are above 400 mg/dL (4.52 mmol/L), the Friedewald-estimated LDL becomes unreliable — a directly measured LDL or the Sampson–Martin equation should be used instead. This calculator does not incorporate your age, blood pressure, diabetes status, or smoking history; it cannot compute your 10-year cardiovascular risk. Classification thresholds are for general adults; CKD-specific targets from KDIGO 2013 differ and should be applied by your nephrologist.

Pearls & Pitfalls
💡

Non-HDL-C is the better number to track

Non-HDL-C captures all atherogenic lipoproteins — LDL, VLDL, IDL, and Lp(a) — in a single calculation requiring no fasting and no additional test. The 2018 ACC/AHA guideline treats a non-HDL-C above 130 mg/dL as a risk-enhancing factor. For CKD patients, who often have elevated VLDL despite a "normal" LDL, non-HDL-C is especially informative. Target: less than 130 mg/dL for most adults.

🍚

In Filipinos: carbohydrates drive TG more than fat does

The typical Filipino pattern of high TG with low HDL and a TG/HDL ratio above 5 is overwhelmingly driven by de novo lipogenesis from high-carbohydrate intake — particularly white rice, sweetened beverages, and refined flour — not by dietary fat. Reducing refined carbohydrates often normalizes TG and raises HDL more effectively than statin therapy. Increase omega-3 intake through fatty fish (sardines, galunggong, mackerel) at least twice per week.

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Pitfalls

(1) Friedewald LDL is unreliable when TG ≥ 400 mg/dL — a directly measured LDL or Sampson–Martin LDL-C equation is needed. (2) A "normal" LDL does not exclude high cardiovascular risk in CKD — the atherogenic small-dense LDL particle pattern may be present even when LDL mass is normal; check non-HDL-C and TG/HDL ratio. (3) This calculator does not account for Lp(a) — an independent and largely genetically determined cardiovascular risk factor that is elevated in approximately 20–30% of Filipinos and is not captured by a standard lipid panel. (4) Statin dosing in CKD: simvastatin/ezetimibe dose should be reduced in eGFR <30; rosuvastatin is preferred in dialysis per KDIGO.

Important: This calculator is an educational aid and does not replace individualized cardiovascular risk assessment. Lipid-lowering therapy decisions depend on your absolute cardiovascular risk (age, blood pressure, smoking, diabetes, CKD stage), not solely on lipid levels. Do not start, stop, or adjust statin or fibrate therapy based on this tool alone. Discuss your results with your physician or nephrologist.

Lipid Panel Interpreter

Enter your fasting lipid values to receive a plain-language interpretation, non-HDL-C calculation, TG/HDL ratio, and a summary of your lipid profile pattern.

Units:
From fasting lipid panel. Normal: <200 mg/dL
Primary atherogenic target. Optimal: <100 mg/dL
Protective. Low if <40 (M) or <50 (F) mg/dL
Normal: <150 mg/dL. Fasting required for accuracy
LDL-C
HDL-C
Triglycerides
Non-HDL-C
TG/HDL Ratio

⚕ Non-HDL-C = Total Cholesterol − HDL-C. TG/HDL ratio is calculated and interpreted in mg/dL equivalents (thresholds: <3.5 = low IR risk; >5.0 = likely insulin resistance / small-dense LDL pattern). SI inputs are converted internally before classification. All interpretation thresholds per ACC/AHA guidelines. This tool provides general educational interpretation only — individual targets depend on your full cardiovascular risk profile. Consult your physician for personalized management.

Next Steps

Use the result to support — not replace — clinical judgment.

  • Interpret the value against the targets shown in the calculator and the Evidence section below, in the context of the full clinical picture.
  • Trend serial measurements rather than acting on a single result; confirm abnormal or unexpected values before changing management.
  • Apply the relevant KDIGO / specialty-guideline threshold and document the indication.
  • Escalate or refer to nephrology when results are out of range, rapidly changing, or discordant with the clinical picture — and discuss the implications with the patient.
Evidence & References

Formula & Equations

QuantityEquation / Threshold
Non-HDL CholesterolTotal Cholesterol − HDL-Cholesterol (both in the same unit)
TG/HDL RatioTriglycerides ÷ HDL-C (always calculated in mg/dL, regardless of selected unit)
LDL-C (Friedewald, mg/dL)Total cholesterol − HDL-C − (Triglycerides ÷ 5); valid only when TG <400 mg/dL
mmol/L → mg/dL (cholesterol)mmol/L × 38.67
mmol/L → mg/dL (triglycerides)mmol/L × 88.57

Classification thresholds (mg/dL)

ParameterClassificationThreshold
LDL-COptimal< 100
LDL-CNear Optimal100–129
LDL-CBorderline High130–159
LDL-CHigh160–189
LDL-CVery High≥ 190
HDL-C (male)Low (risk factor)< 40
HDL-C (female)Low (risk factor)< 50
HDL-CProtective (all)≥ 60
TriglyceridesNormal< 150
TriglyceridesBorderline High150–199
TriglyceridesHigh200–499
TriglyceridesVery High≥ 500
Non-HDL-COptimal< 130
Non-HDL-CBorderline130–159
Non-HDL-CHigh≥ 160
TG/HDL ratio (mg/dL)Low insulin resistance risk< 3.5
TG/HDL ratio (mg/dL)Borderline3.5–5.0
TG/HDL ratio (mg/dL)Insulin resistance likely> 5.0

Thresholds from the 2018 ACC/AHA Guideline on the Management of Blood Cholesterol (Grundy et al.) and the KDIGO 2013 Clinical Practice Guideline for Lipid Management in CKD (for CKD-specific targets). The Friedewald LDL formula was originally validated by Friedewald, Levy, and Fredrickson (1972). Non-HDL-C and TG/HDL ratio are increasingly preferred as primary targets because they capture atherogenic lipoprotein burden more completely than LDL alone.

Evidence & References

LDL-cholesterol thresholds in this calculator follow the 2018 ACC/AHA Guideline on the Management of Blood Cholesterol, which adopts a risk-based approach to LDL treatment decisions. Non-HDL-C is endorsed as an equivalent or superior primary target because it captures VLDL- and IDL-cholesterol in addition to LDL. The TG/HDL ratio as a surrogate for small-dense LDL and insulin resistance derives from Framingham Heart Study analyses (McLaughlin et al.) and is particularly applicable to patients of Asian ancestry, among whom even modest fasting triglyceride elevation signals significant atherogenic dyslipidemia. For CKD patients specifically, KDIGO 2013 recommends a simplified treat-all statin strategy for adults ≥50 years with CKD, emphasizing LDL reduction rather than achieving a specific target.

  1. Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem. 1972;18(6):499–502.
  2. Kidney Disease: Improving Global Outcomes (KDIGO) Lipid Work Group. KDIGO Clinical Practice Guideline for Lipid Management in Chronic Kidney Disease. Kidney Int Suppl. 2013;3(3):259–305.
  3. Grundy SM, Stone NJ, Bailey AL, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol. J Am Coll Cardiol. 2019;73(24):e285–e350.
  4. McLaughlin T, Reaven G, Abbasi F, et al. Is there a simple way to identify insulin-resistant individuals at increased risk of cardiovascular disease? Am J Cardiol. 2005;96(3):399–404.
  5. Sandhu S, Wiebe N, Fried LF, Tonelli M. Statins for improving renal outcomes: a meta-analysis. J Am Soc Nephrol. 2006;17(7):2006–2016.
Important: This calculator is an educational aid and does not replace individualized cardiovascular risk assessment. Lipid-lowering therapy decisions depend on your absolute cardiovascular risk (age, blood pressure, smoking, diabetes, CKD stage), not solely on lipid levels. Do not start, stop, or adjust statin or fibrate therapy based on this tool alone. Discuss your results with your physician or nephrologist.

Use this with

References 3 sources
  1. Friedewald 1972
  2. KDIGO Lipids 2013
  3. ACC/AHA Blood Cholesterol 2018
Dr. W Rivero, MD

W Rivero, MD, FPCP, DPSN

Specialist in Internal Medicine, Nephrology, and Clinical Nutrition. Practicing integrative and evidence-based nephrology across Quezon City, Pampanga, and Bulacan.

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