The diagnosis of dyslipidemia is based on a blood test aimed at assessing the basic lipid profile that includes the determination of triglycerides (TG), total cholesterol (TC), HDL cholesterol (C-HDL), LDL cholesterol (C-LDL), and their ratios. Therefore, the clinical laboratory has a critical role in dyslipidemia diagnosis.
Although, in most cases, dyslipidemia is diagnosed incidentally during routine examinations, screening is recommended in all male adults ≥40 years and female adults ≥50 years or postmenopausal, especially in the presence of other cardiovascular risk factors.
In addition, all individuals with evidence of atherosclerosis in any vascular bed or with type 2 diabetes, regardless of age, are considered to be at elevated risk; therefore, the evaluation of lipid profile is recommended for such individuals. Individuals with a family history of premature cardiovascular disease, children of patients with severe dyslipidemia (combined familial hyperlipidemia), patients with hypertension and central obesity, defined as circumference ≥94 cm in men and ≥80 cm in women, or with a BMI ≥25 kg/m2, should be screened for dyslipidemia. Finally, chronic clinical conditions, such as autoimmune inflammatory diseases (lupus erythematosus and psoriasis) and renal failure, are associated with an increased risk of developing dyslipidemia and, therefore, affected patients should be screened. Evaluation of the lipid profile is also indicated in patients with peripheral artery disease or who have increased carotid intima-media thickness or carotid plaques.
Following the detection of elevated lipid levels, in at least two determinations carried out approximately 7 days apart, a period of correct diet and physical activity is recommended before making a diagnosis of dyslipidemia and possibly establishing therapy. If there is no improvement in the lipid profile at the end of this period, a familial form of dyslipidemia should be suspected.
