Scale family · Precision Clinical Services

LipoScale^® Test

Beyond cholesterol: particle number, size and distribution

An advanced lipoprotein test based on nuclear magnetic resonance that extends the standard lipid profile and provides information for a more complete professional assessment.

For internal medicine, endocrinology, cardiology, clinical nutrition and laboratories.

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The LipoScale® silhouette

A visual representation to understand the
lipoprotein profile

The LipoScale® silhouette summarises in a single image ten lipoprotein parameters associated with cardiovascular risk: particle number, size and composition. The circle represents the reference population and each person’s outline is drawn on top of it. When a parameter moves away from its target, the outline narrows towards the centre, like the lumen of an artery. At a glance, you can see which dimensions depart from the reference and by how much.

Typical silhouette of a cardiovascular risk profile

Low cardiovascular risk profile

Most parameters are at target (green dots) and the outline stays close to the reference circle, with no relevant discordance between axes.

The silhouette is interpreted alongside the clinical assessment of each patient.

Reference Observed profile

At target Watch Outside target

The clinical need

The same cholesterol does not always describe the same lipoprotein profile

Two people with similar standard values can differ in the number, size and distribution of their lipoproteins. LipoScale® extends that information to place lipoprotein metabolism within the clinical context.

What you see first

Two profiles that could look equivalent

The difference does not appear when you look at a single value. It emerges when particle number, size, composition and distribution are observed together.

ParameterCase ACase B

Age41 years39 years

BMI21.2 kg/m²21.6 kg/m²

LDL-C121 mg/dL107 mg/dL

HDL-C60 mg/dL68 mg/dL

Teaching comparison based on two real, anonymised cases. The silhouette summarises the lipoprotein profile, but it does not establish a clinical category on its own or replace professional assessment.

What LipoScale® adds

The silhouette makes the whole picture visible

With comparable standard values, the silhouettes of the two cases draw different patterns that need to be interpreted together.

Case A More LDL cholesterol, no particle remodelling

LDL cholesterol is slightly above target, but the rest of the silhouette stays on the reference: particle number, size and composition show no changes. The lipoprotein profile is consistent with what standard cholesterol already showed and adds no further risk signals: management can remain focused on LDL cholesterol, in line with current guidelines.

Case B Particle remodelling that LDL cholesterol does not show

With lower LDL cholesterol than case A, the silhouette narrows on several axes: more small LDL particles, smaller LDL and HDL particles and more triglycerides in HDL and VLDL. This is particle remodelling that LDL cholesterol alone does not show. It may prompt an assessment of insulin resistance and triglycerides, stronger lifestyle measures and closer follow-up, even when LDL cholesterol is close to target.

What the clinician receives

Results to observe the profile, interpret it and track its progress

LipoScale® combines lipid concentration with the number, size and distribution of the main lipoprotein classes and subclasses.

Lipid profile

Organises the standard profile and adds remnant cholesterol and non-HDL cholesterol in a single analysis.

Particle number

Quantifies the main classes and the distribution of large, medium and small particles.

Size and composition

Describes the mean size and the cholesterol and triglyceride content of the main lipoproteins.

Visual overview

Summarises key variables in a lipid silhouette and compares them with a general reference population.

LipoScale® report · Anonymised example

Quantitative and visual information in a single document

LipoScale^®

PatientCase 0175

Issue date—/—/—

ReferenceLS-2026-0175

BiosferTeslab

LipoScale® test

The LipoScale® test is an advanced lipoprotein test based on nuclear magnetic resonance (NMR) that directly determines the standard lipid profile, the particle number of the main lipoprotein classes and subclasses and their mean size (pages 1 and 2). The report also provides the patient’s lipid silhouette (page 1) and the cholesterol and triglyceride composition of the main lipoproteins (page 2).

Lipid profile¹

Parameter	Result	Target values
Total cholesterol	208 mg/dL	< 200
LDL cholesterol †	123 mg/dL	< 100
HDL cholesterol	68 mg/dL	> 40 ♂ / > 50 ♀
Triglycerides	82 mg/dL	< 150
Remnant cholesterol	17 mg/dL	< 30
Non-HDL cholesterol †	140 mg/dL	< 145

Particle number

Parameter	Result	Target values
VLDL	35 nmol/L	< 70
LDL †	1130 nmol/L	< 1150
Small LDL †	560 nmol/L	< 630
HDL	31 µmol/L	> 24

Particle size (diameter)

Parameter	Result	Target values
VLDL	42.2 nm	42.03–42.36
LDL	21.44 nm	> 20.91
HDL	8.31 nm	> 8.21

† High / very high risk: LDL cholesterol < 70 / < 55 mg/dL · non-HDL cholesterol < 130 / < 100 mg/dL · LDL particles < 1000 / < 700 nmol/L · small LDL particles < 550 / < 380 nmol/L.

¹All parameters were determined using NMR spectroscopy. They may show some variability compared with other conventional analytical techniques.

Lipid silhouette

What does the lipid silhouette show?

The lipid silhouette represents 10 variables associated with cardiovascular risk, giving a quick, overall view of the patient’s lipid metabolism beyond the traditional parameters. Each dot can change colour:

The variable contributes to increasing the risk of cardiovascular disease. Its contribution increases when the value is:

> recommended value for S-LDL-P, LDL-C, LDL-TG, Rem C, VLDL-TG and HDL-TG/HDL-C
< recommended value for HDL-Ø, M-HDL-P, HDL-C and LDL-Ø

Otherwise: the lipid profile is associated with a lower cardiovascular risk.

Values similar to the recommended value.

The outline shows the patient’s position relative to the values of a general population of 6,000 individuals (reference circle).

S-LDL-PSmall LDL particle number

LDL-CLDL cholesterol

LDL-TGLDL triglycerides

Rem CRemnant cholesterol

VLDL-TGVLDL triglycerides

HDL-ØMean HDL particle diameter

M-HDL-PMedium HDL particle number

HDL-CHDL cholesterol

HDL-TG/HDL-CHDL triglyceride/HDL cholesterol ratio

LDL-ØMean LDL particle diameter

²LDL cholesterol is determined directly and does not include IDL cholesterol.³The traffic-light colours are set for patients at moderate/low risk.⁴Risk categories are defined in the ESC/EAS guidelines for the management of dyslipidaemias (2016). Moderate risk includes SCORE<5. High risk includes familial hypercholesterolaemia, uncomplicated diabetes, SCORE 5-10 or glomerular filtration 60-30. Very high risk includes secondary prevention, complicated diabetes, SCORE>10 or glomerular filtration<30.

Cholesterol content

VLDL-C 10 mg/dLtarget < 22

6 11 17

IDL-C 7 mg/dLtarget < 9

7 9 13

LDL-C 123* mg/dLtarget < 100

110 130 150

HDL-C 68 mg/dLtarget > 50 ♀ / > 40 ♂

48 56 64

Remnant-C 17 mg/dLtarget < 30

14 21 30

Non-HDL-C 140 mg/dLtarget < 145

130 150 180

HDL-TG/HDL-C 0.18target < 0.25

0.16 0.21 0.27

Triglyceride content

VLDL-TG 49 mg/dLtarget < 98

39 54 78

IDL-TG 9 mg/dLtarget < 12

8 10 13

LDL-TG 12 mg/dLtarget < 19

12 15 19

HDL-TG 12 mg/dLtarget < 12

9 12 15

Particle size (diameter)

VLDL-Ø 42.2 nmtarget 42.03–42.36

42.06 42.21 42.36

LDL-Ø 21.44 nmtarget > 20.91

20.91 21.11 21.29

HDL-Ø 8.31 nmtarget > 8.21

8.21 8.26 8.31

Particle number

Total VLDL-P 35 nmol/Ltarget < 70

27 38 56

Large VLDL-P 1.15 nmol/Ltarget < 1.62

0.73 0.99 1.35

Medium VLDL-P 3.19 nmol/Ltarget < 7.51

3.04 4.28 6.08

Small VLDL-P 30 nmol/Ltarget < 61

23 32 49

Total LDL-P 1130 nmol/Ltarget < 1150

1120 1300 1500

Large LDL-P 220* nmol/Ltarget < 180

170 200 230

Medium LDL-P 350* nmol/Ltarget < 340

310 400 500

Small LDL-P 560 nmol/Ltarget < 630

610 690 790

Total HDL-P 31 µmol/Ltarget > 24

24 28 32

Large HDL-P 0.27 µmol/Ltarget > 0.24

0.25 0.28 0.32

Medium HDL-P 12.3 µmol/Ltarget > 8.2

8.5 9.7 11

Small HDL-P 19 µmol/Ltarget > 15

15 18 21

Target values are set for patients at moderate/low cardiovascular risk. For patients at high cardiovascular risk the recommended values are LDL-C<100 mg/dL; non-HDL-C<130 mg/dL; LDL-P<1000 nmol/L and S-LDL-P<550 nmol/L. For patients at very high cardiovascular risk the recommended values are LDL-C<70 mg/dL; non-HDL-C<100 mg/dL; LDL-P<700 nmol/L and S-LDL-P<380 nmol/L.

Percentiles in the reference population of 6,000 individuals (general population), men and women across a wide age range (15 to 85 years). *High/low relative to the reference population.

The bars show the 25th, 50th and 75th percentiles in the reference population. Variables with a clear relationship with the risk of developing cardiovascular (CV) disease are shown on a colour scale, while those without information on cardiovascular risk appear in grey. Red indicates increased risk of CV disease and green reduced risk of CV disease.

Extracts from a real, anonymised report. The visual structure is shown as a reference for the type of deliverable; the results require professional interpretation within their clinical context.

Professional applications

Where LipoScale® can add value

Professional profiles

Six settings where advanced analysis adds value.

Internal medicine · Cardiometabolic context: Looking deeper when the standard profile does not explain the whole picture; Advanced characterisation can complement the assessment of complex dyslipidaemia, residual risk and metabolic conditions that call for a more detailed analysis.; Review discordance between cholesterol and particle number
Add context in obesity, metabolic syndrome or diabetes
Set a reference point for follow-up
Endocrinology · Metabolism and dyslipidaemia: Connecting the lipoprotein profile with the metabolic context; Adds a further layer in people with insulin resistance, lipid disorders or metabolic changes linked to an intervention.; Characterise the starting point
Observe lipoprotein patterns beyond LDL-C
Compare progress within clinical follow-up
Cardiology and lipid units · Vascular risk: An advanced analysis for profiles that need higher resolution; Can provide complementary information in secondary prevention, premature cardiovascular disease or a family history, always alongside the rest of the assessment.; Explore potentially discordant profiles
Put residual lipoprotein risk in context
Monitor changes during treatment
Nutrition and dietetics · Intervention and follow-up: Turning an intervention into observable progress; Comparing measurements can help assess how lipoprotein metabolism changes within a professional nutrition or lifestyle programme.; Define a baseline reference
Support the communication of goals
Review the response after an intervention
Clinics and laboratories · Service integration: Bringing an advanced test into a professional workflow; Biosfer Teslab can help define the request, results and scientific support workflow according to each organisation’s model of care.; Define indications and the request workflow
Integrate a structured report
Scale the service while keeping traceability
Patient · Understanding and continuity: An understandable picture to discuss with the clinician; The silhouette and the report help to show that the lipoprotein profile has more dimensions than a single value, without replacing clinical interpretation.; Better understand the starting point
Discuss priorities with the clinician
See changes between measurements

How it fits into the consultation

Comparable measurements throughout follow-up.

01 Baseline reference
A first measurement establishes the patient’s starting lipoprotein profile.
02 Intervention
The clinician defines the therapeutic, nutritional or lifestyle approach.
03 Follow-up
A new measurement allows changes to be reviewed in a comparable, structured way.
04 Progress
Comparing measurements helps assess the response and adjust follow-up.

Scientific evidence

Built on research into lipoprotein metabolism.

Clinical consensus · SEA · 2020

Clinical use of NMR to assess lipoprotein metabolism

Consensus document from an expert group of the Spanish Society of Arteriosclerosis, with specific reference to LipoScale.

View publication

PRESARV-SEA · 2021

Physicochemical properties and premature cardiovascular disease

Study of advanced lipoprotein parameters obtained by NMR and their relationship with premature cardiovascular disease.

View publication

Method · J Lipid Res · 2015

Liposcale: a novel advanced lipoprotein test based on 2D diffusion-ordered 1H NMR spectroscopy

Methods paper that describes and validates the test.

View publication

LipoScale® in your practice

See how it fits into your practice

Tell us about your clinical profile, the expected volume and how you want to use the information. We will propose the right workflow.

Request information →

LipoScale® Test

A visual representation to understand thelipoprotein profile

The same cholesterol does not always describe the same lipoprotein profile

Two profiles that could look equivalent

The silhouette makes the whole picture visible

Lipid profile

Particle number

Size and composition

Visual overview

Lipid silhouette

What does the lipid silhouette show?

Professional profiles

How it fits into the consultation

Scientific evidence

Clinical use of NMR to assess lipoprotein metabolism

Physicochemical properties and premature cardiovascular disease

Liposcale: a novel advanced lipoprotein test based on 2D diffusion-ordered 1H NMR spectroscopy

See how it fits into your practice

LipoScale^® Test

A visual representation to understand the
lipoprotein profile