LDL Particle Size

What is LDL Particle Size?

LDL Particle Size refers to the diameter distribution of your LDL cholesterol particles, typically measured in nanometers (nm) and categorized into patterns. Pattern A indicates predominantly large, buoyant LDL particles (≥20.5 nm), while Pattern B indicates predominantly small, dense LDL particles (<20.5 nm). Some labs also identify Pattern I (intermediate). Measured via specialized testing including nuclear magnetic resonance (NMR), ion mobility analysis, or gradient gel electrophoresis, particle size provides insights into cardiovascular risk beyond standard cholesterol measurements.

Small dense LDL particles (Pattern B) are significantly more atherogenic than large buoyant particles (Pattern A) for several reasons:they penetrate arterial walls more easily, bind more avidly to arterial wall proteoglycans, are more susceptible to oxidation, have reduced binding to LDL receptors (remaining in circulation longer), and are associated with increased inflammatory response. Pattern B is strongly associated with metabolic syndrome, insulin resistance, high triglycerides, and increased cardiovascular risk.

While particle number (LDL-P or ApoB) is generally considered more important than particle size for risk assessment, the combination provides comprehensive information. An individual with high LDL-P and small particle size faces particularly elevated risk. Importantly, particle size is modifiable—triglyceride lowering through diet, weight loss, or medication consistently shifts the distribution toward larger, less atherogenic particles. Some clinicians debate whether particle size provides independent risk information beyond particle number and triglycerides.

Optimal vs Standard Ranges

Scientific Evidence

Which Providers Test LDL Particle Size?

Full Provider Comparison

Provider	Includes	Annual Cost	Biomarkers
Superpower	✓	$199	100+ (150 with ratios)
WHOOP Advanced Labs	—	$349	65
Labcorp OnDemand	—	$398	30+
Life Extension	—	$486	40+
Everlywell	—	$444	288
Mito Health	—	$349	100+
InsideTracker	—	$761	54
Function Health	✓	$365	160+
Marek Health Base	—	$250	65
Marek Health Comprehensive	—	$495	70+
Marek Health Complete	—	$895	100+
Marek Health Executive	—	$1950	150+
Blueprint	—	$375	80+
Quest Health	—	$Varies	75+
Empirical Health	—	$190	100+
Oura Health Panels	—	$99	50
SiPhox Health	—	$124	60
Hims Labs Base	—	$199	50
Hims Labs Advanced	✓	$499	120+
Healthspan	✓	$4188	70-80+
Vitality Blueprint Standard	—	$375	85
Vitality Blueprint Elite	—	$700	128

Related Biomarkers

Other biomarkers in the Lipid Panel / Cardiovascular Health category: