Remnant Cholesterol Calculator.
Remnant cholesterol is the atherogenic fraction your standard panel doesn't print — and it predicts heart risk even when LDL looks fine. It's already in your numbers: total minus HDL minus LDL.
The atherogenic cholesterol your panel hides.
Standard lipid panels report total cholesterol, HDL, LDL, and triglycerides — but not remnant cholesterol, the cholesterol carried inside triglyceride-rich lipoproteins (VLDL, IDL, chylomicron remnants). You compute it by subtraction: total cholesterol − HDL − LDL. These remnant particles penetrate the artery wall and drive atherosclerosis much like LDL does.
The clinical point is residual risk: large studies (Nordestgaard, Varbo) show elevated remnant cholesterol independently predicts heart attack and stroke even when LDL is at goal on a statin. It rises with insulin resistance and high triglycerides, so the fix is metabolic — lower triglycerides through reduced refined carbohydrate, alcohol, and excess calories, plus exercise. (The simple subtraction is least reliable when triglycerides exceed ~400 mg/dL.)
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