Total number of LDL particles;more accurate risk assessment
4 providers include this
Lipid Panel / Cardiovascular Health
Optimal:<1000 nmol/L, Moderate risk:1000-1299 nmol/L, High risk:≥1300 nmol/L
LDL Particle Number (LDL-P) measures the actual number of LDL particles in your blood, rather than the cholesterol content within those particles (which is what standard LDL-C measures). This distinction is crucial because particles cause atherosclerosis, not cholesterol per se. Measured via Nuclear Magnetic Resonance (NMR) spectroscopy or ion mobility analysis, LDL-P provides a direct particle count, expressed in nanomoles per liter (nmol/L).
LDL-P is particularly valuable because two people with identical LDL cholesterol levels can have vastly different particle numbers. Someone with many small cholesterol-poor particles will have high LDL-P despite moderate LDL-C, while someone with fewer large cholesterol-rich particles will have lower LDL-P. The patient with higher LDL-P faces significantly greater cardiovascular risk, as more particles mean more opportunities for atherosclerotic plaque formation.
Research consistently demonstrates that LDL-P predicts cardiovascular events better than LDL-C, particularly in metabolic syndrome, diabetes, and situations where LDL-C and LDL-P are discordant. When LDL-C and LDL-P disagree, LDL-P more accurately reflects true cardiovascular risk. Many advanced lipidology and longevity medicine practices now prioritize LDL-P or ApoB (which closely correlates with LDL-P) over traditional LDL-C for risk assessment and treatment monitoring.
| Range Type | Level | Significance |
|---|---|---|
| Better cardiovascular risk predictor than LDL-C | Identifies high-risk patients with normal LDL-C | Particularly valuable in metabolic syndrome and diabetes |
| Optimal LDL-P Ranges | Standard:<1000 nmol/L | Functional/Optimal:<700 nmol/L (longevity-focused);<500 nmol/L (aggressive prevention) |
| Clinical Concern:>1300 nmol/L | Standard guidelines suggest <1000 nmol/L for general population, <1000 nmol/L for high-risk. However, longevity practitioners often target <700 nmol/L, with aggressive prevention protocols aiming for <500 nmol/L. Levels >1600 nmol/L indicate very high risk. Note:Small dense LDL-P (<1000 nmol/L of small particles) is particularly important. | Statin Therapy |
| Statins effectively reduce LDL-P by 30-50% by inhibiting hepatic cholesterol synthesis and upregulating LDL receptors. High-intensity statins (atorvastatin 40-80mg, rosuvastatin 20-40mg) provide greatest particle reduction. Statins are particularly effective at reducing small dense LDL particles. | Ezetimibe Addition | Adding ezetimibe (10mg daily) to statin therapy provides additional 15-20% LDL-P reduction by blocking intestinal cholesterol absorption. The combination is more effective than high-dose statin alone and generally well-tolerated. Outcomes data supports cardiovascular benefit. |
Injectable PCSK9 inhibitors (evolocumab, alirocumab) dramatically reduce LDL-P by 50-60% when added to statins or used alone. Reserved for high-risk patients, those with genetic dyslipidemia, or when other therapies are insufficient. Provide the most potent LDL-P reduction available.
Lower carbohydrate intake and triglycerides to reduce small dense LDL particle formation. When triglycerides are elevated, VLDL metabolism produces excess small LDL particles. Carbohydrate restriction can shift particle distribution toward larger, less atherogenic particles while reducing total particle number.
Achieve healthy body weight and exercise regularly (150+ minutes weekly). Weight loss and exercise improve insulin sensitivity, reduce triglycerides, and decrease small dense LDL-P. Even without weight loss, exercise enhances LDL particle clearance and improves particle size distribution.
Very low LDL-P (<400 nmol/L) is safe and protective;no known adverse effects when achieved through appropriate medical therapy. Some longevity-focused individuals intentionally achieve these levels.
Genetic factors (hypobetalipoproteinemia), aggressive lipid-lowering therapy (desired in prevention), severe malnutrition, hyperthyroidism, chronic liver disease
Research demonstrating that LDL-P is particularly valuable in metabolic syndrome and diabetes, where high triglycerides and insulin resistance cause LDL-C to underestimate particle number and cardiovascular risk.
Source:Mora et al., "LDL Particle Number and CVD Risk in the Women's Health Study,"JAMA, 2007
Studies showing that monitoring LDL-P during lipid-lowering therapy identifies patients with inadequate particle reduction despite achieving LDL-C goals, allowing for therapy intensification and better risk reduction.
Source:Krauss, "Lipoprotein Subfractions and Cardiovascular Disease Risk,"Current Opinion in Lipidology, 2010
Research confirming that small dense LDL particles are particularly atherogenic, and that both total LDL-P and small LDL-P independently predict cardiovascular events, supporting advanced lipoprotein testing.
Source:Hoogeveen et al., "Small Dense LDL-C Concentrations Predict Risk for CVD,"Arteriosclerosis, Thrombosis, and Vascular Biology, 2014
None
Source:None
| Provider | Includes | Annual Cost | Biomarkers |
|---|---|---|---|
 Superpower | ✓ | $199 | 100+ (150 with ratios) |
 WHOOP Advanced Labs | — | $349 | 65 |
 Labcorp OnDemand | — | $398 | 30+ |
| — | $486 | 40+ | |
| — | $468 | 83 | |
| — | $349 | 100+ | |
 InsideTracker | — | $680 | 54 |
 Function Health | ✓ | $365 | 100+ |
| — | $250 | 65 | |
| — | $495 | 70+ | |
| — | $895 | 100+ | |
| — | $1950 | 150+ | |
| — | $399 | 100+ | |
| — | $Varies | 75+ | |
| — | $190 | 100+ | |
| — | $99 | 50 | |
| — | $125 | 60 | |
| — | $199 | 50 | |
| ✓ | $499 | 120+ | |
| ✓ | $4188 | 80+ | |
| — | $375 | 85 | |
| — | $700 | 129 |
4 providers include this biomarker in their panels
This information is for educational purposes only and is not medical advice. Always consult with a qualified healthcare provider about your specific health needs.
