Chylomicrons

Hormone/ Element

Report in 48Hrs

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Fasting Required

Details

Measures lipoprotein particles carrying dietary fats.

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Chylomicrons Test Information Guide

Why is it done?
- Detects and measures chylomicrons, which are lipoprotein particles that transport dietary fat (triglycerides, cholesterol) from the intestines to other tissues
- Ordered to evaluate severe hypertriglyceridemia (elevated blood triglycerides) and determine the underlying cause
- Used to diagnose chylomicronemia syndrome and primary lipoprotein lipase deficiency (Type I hyperlipoproteinemia)
- Performed when patients present with recurrent pancreatitis or symptoms suggestive of severe lipid metabolism disorders
- Used to distinguish between fasting and non-fasting triglyceride elevation to identify metabolic disorders
- Typically performed after fasting to provide baseline lipid metabolism assessment
Normal Range
- Normal/Reference Range: Chylomicrons should be absent or virtually undetectable (near zero) in fasting blood samples, with levels typically <10 mg/dL after 12-14 hours of fasting
- Units of Measurement: Typically reported in mg/dL or mmol/L; may be reported qualitatively as present/absent or as part of lipid panel triglyceride measurements
- How to Interpret Results: Negative/Absent = Normal: Chylomicrons are not present in fasting state, indicating normal lipid digestion and transport; Positive/Present = Abnormal: Presence of chylomicrons in fasting blood indicates impaired lipid metabolism or clearance; Elevated levels = Highly abnormal and clinically significant
- Clinical Significance: Presence of chylomicrons in fasting state is pathologic and requires further investigation; normal fasting absence confirms adequate lipoprotein lipase function and normal postprandial lipid clearance
Interpretation
- Chylomicrons Absent (Negative): Indicates normal lipid metabolism, adequate lipoprotein lipase and apolipoprotein C-II function, and proper dietary fat processing; patient has normal fasting lipid profile
- Chylomicrons Present/Elevated (Positive): Suggests Type I hyperlipoproteinemia (lipoprotein lipase deficiency), secondary lipase deficiency, or impaired chylomicron clearance; requires urgent investigation for pancreatitis risk
- Severely Elevated Chylomicrons (>1000-1500 mg/dL): Indicates severe chylomicronemia with high risk of acute pancreatitis, eruptive xanthomas, lipemia retinalis, and hepatosplenomegaly; requires immediate medical intervention
- Factors Affecting Results: Non-fasting state produces falsely elevated results; recent meal intake causes postprandial chylomicronemia (normal); medications (estrogens, beta-blockers, alcohol), diet high in fat, metabolic conditions (uncontrolled diabetes, hypothyroidism), and genetic mutations affect results; stress and recent illness may influence values
- Clinical Patterns: Persistently elevated fasting chylomicrons indicate genetic disorder; transiently elevated levels suggest secondary causes; association with markedly elevated triglycerides correlates with chylomicron presence; lipemic serum appearance (milky) correlates with severe elevation
Associated Organs
- Primary Organ Systems: Gastrointestinal system (intestines - site of chylomicron production); Liver (regulates lipoprotein metabolism and apolipoprotein production); Pancreas (produces lipase enzyme); Adipose tissue and skeletal muscle (uptake sites for triglycerides)
- Medical Conditions Associated with Abnormal Results: Type I Hyperlipoproteinemia (familial chylomicronemia); Lipoprotein lipase deficiency; Apolipoprotein C-II deficiency; Secondary chylomicronemia from uncontrolled diabetes, hypothyroidism, or nephrotic syndrome; Alcoholic hypertriglyceridemia; Estrogen use-related lipemia
- Diseases Diagnosed or Monitored: Genetic lipoprotein disorders; Metabolic syndrome; Severe hypertriglyceridemia; Acute pancreatitis risk assessment; Familial lipid disorders requiring genetic counseling
- Potential Complications of Abnormal Results: Recurrent acute pancreatitis with risk of chronic pancreatitis; Pancreatic insufficiency and malabsorption; Eruptive xanthomas (skin manifestations); Lipemia retinalis (eye involvement); Hepatosplenomegaly; Coronary artery disease acceleration; Thrombotic complications; Systemic inflammation; Metabolic derangements
- Multi-organ Impact: Severe chylomicronemia affects multiple organs simultaneously - pancreas (inflammation/necrosis), liver (lipid infiltration), adipose tissue (energy storage dysfunction), blood vessels (lipid deposition), eyes (retinal changes), and kidneys (lipid effects in nephrotic syndrome)
Follow-up Tests
- Recommended Follow-up Tests: Complete lipid panel including total cholesterol, LDL, HDL, and triglycerides; Lipoprotein lipase activity testing; Apolipoprotein B and apolipoprotein C-II levels; Genetic testing for familial chylomicronemia mutations
- Additional Diagnostic Tests: Serum amylase and lipase to assess pancreatic injury; Liver function tests to evaluate hepatic lipid infiltration; Glucose and HbA1c if diabetes suspected; TSH to rule out hypothyroidism; Tissue typing for disease risk stratification
- Imaging Studies: Abdominal ultrasound or CT to assess pancreatic changes, hepatic lipid infiltration, and complications; Ophthalmologic examination for lipemia retinalis; Vascular imaging if cardiovascular complications suspected
- Monitoring Frequency: Initial diagnosis: Repeat chylomicron and lipid testing within 1-2 weeks; Stable patients: Every 3-6 months; High-risk patients or during treatment changes: Every 1-2 weeks; Long-term monitoring: Every 6-12 months with stable medication regimen
- Complementary Tests: VLDL particle measurement; Post-heparin lipolytic activity; Postprandial lipemia testing; Family screening of relatives for genetic mutations; Metabolic testing to identify secondary causes
- Treatment Response Monitoring: Repeat testing 6-8 weeks after initiating fibrates, orlistat, or dietary modifications; Assess pancreatic enzyme normalization; Confirm triglyceride reduction below 500 mg/dL to minimize pancreatitis risk
Fasting Required?
- Fasting Requirement: YES - Fasting is REQUIRED for accurate chylomicron testing
- Fasting Duration: Minimum 12-14 hours of fasting before blood draw; Ideally overnight fast; Some protocols recommend 16-hour fast for optimal baseline assessment
- Special Instructions: Nothing by mouth (NPO) except water during fasting period; Avoid consuming any food or beverages containing calories; Do not chew gum or use mouthwash; Avoid smoking during fasting period as it may affect results; Schedule blood draw for early morning (8:00-9:00 AM) after overnight fast
- Medications: Continue regular medications unless specifically instructed otherwise; Inform laboratory staff of all medications, especially lipid-lowering drugs, estrogens, beta-blockers, corticosteroids, and thiazide diuretics; Do not discontinue any medication without medical approval
- Additional Preparation: Maintain stable diet for 2 weeks prior to testing (do not suddenly change fat intake); Avoid alcohol for 24 hours before test; Avoid strenuous exercise on the day of testing; Remain calm and avoid stress if possible; Bring photo ID and insurance card; Inform phlebotomist if you are a difficult stick or have had problems with previous blood draws
- Clinical Note: Non-fasting samples are not interpretable for chylomicron assessment; Results from non-fasting blood will show falsely elevated chylomicrons due to postprandial lipemia; If patient inadvertently ate before fasting blood draw, specimen should be recollected after proper fasting period; Some research protocols may collect non-fasting samples specifically to assess postprandial lipemia, but standard clinical testing requires fasting

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