Non-HDL Cholesterol

•Observational— Better than LDL-C alone, weaker than apoB

What it measures

Non-HDL cholesterol = total cholesterol − HDL-C. It captures the cholesterol in all atherogenic particles (LDL + IDL + VLDL + remnants), not just LDL. Because it doesn’t depend on the Friedewald calculation, it remains accurate when triglycerides are elevated.

When to use it

• When apoB testing isn’t available, non-HDL is the next-best proxy.
• When LDL-C is unreliable (high triglycerides, post-meal sample).
• In children and adolescents where non-HDL may be more stable than LDL-C.

Targets

Generally LDL-C target + 30 mg/dL:

• Primary prevention: <130 mg/dL.
• Diabetes / multiple risk factors: <100 mg/dL.
• Established ASCVD: <85 mg/dL.

Limitations

Non-HDL still measures cholesterol mass, not particle count. Same discordance with apoB exists when small dense LDL predominates — just less than with LDL-C.

Related entries

ApoB, LDL-C, Triglycerides.