LIPIDS
Are you looking at the ones that matter?
I did several complete/annual physicals this past week on existing patients but also some new patients. New patients brought their lab work with them and they were quick to tell me that their lipid panel was normal. I looked and they had what typically is drawn as a lipid panel: a test that looks at cholesterol, triglycerides, HDL cholesterol, VLDL cholesterol, and LDL cholesterol. That’s usually all that’s seen in a lipid panel but it leaves so much unknown about the cardiovascular system.
As a matter of fact, there are “lipid values “ that are much more important to look at, and these more specialized tests have been known to the medical profession for over 30 years. I’m wondering why providers don’t use them more because they give much more information. I’m shocked to see that even few cardiologists use these levels
. That’s why I wanted to talk today about the full lipid -NMR panel so next time your provider says they want to check your lipids, make sure they’re doing the full panel.
Here is a precise historical overview of the advanced lipid panel / NMR lipid testing, including when it originated, where it was developed, and by whom, with appropriate clinical context. Actually, the company that initially introduced this to the medical profession was based out of Raleigh, North Carolina.
The NMR lipid panel was developed in the early–mid 1990s in the United States, primarily at:
Northwestern University (Illinois)
in collaboration with physicists and lipid researchers
The key individual associated with its development is:
James D. Otvos, PhD
Physical chemist and NMR spectroscopy expert
The technology was later commercialized through LipoScience, Inc., which ultimately became part of LabCorp.
Timeline and Origins
1. Scientific Foundation (1970s–1980s)
Before clinical use, two independent scientific streams were developing:
Nuclear Magnetic Resonance (NMR) spectroscopy
Developed in physics/chemistry labs
Used to analyze molecular structures
Nobel Prize–winning technology (Bloch & Purcell, 1952)
Growing dissatisfaction with LDL-C
Researchers recognized:
LDL cholesterol concentration ≠ LDL particle burden
Many patients with “normal LDL” still had ASCVD events
This created the question:
“Is cholesterol content the wrong variable?”
2. Breakthrough Concept (Early 1990s)
At Northwestern University, Dr. James Otvos recognized that:
Lipoprotein particles produce distinct NMR spectral signals
Each subclass (VLDL, LDL, HDL) emits a unique resonance pattern
Signal amplitude correlates with particle number, not cholesterol mass
This was the pivotal insight.
Key innovation:
Using NMR signal deconvolution to directly quantify lipoprotein particle concentration.
This allowed measurement of:
LDL-P (LDL particle number)
HDL-P
VLDL-P
Particle size distributions
This had never been possible clinically before.
3. First Publications (1993–1995)
Early peer-reviewed publications demonstrated:
Accurate measurement of lipoprotein subclasses
Strong correlations between LDL-P and:
Insulin resistance
Metabolic syndrome
Cardiovascular risk
By 1995, NMR lipoprotein profiling was validated for clinical research use.
4. Commercialization (1994–1998)
Dr. Otvos co-founded:
LipoScience, Inc. (Raleigh, North Carolina)
Key milestones:
Late 1990s: First commercial NMR Lipoprotein Profile launched
Early adopters:
Academic cardiology centers
Preventive cardiology clinics
Endocrinology/metabolic researchers
Notably, North Carolina became the operational home of NMR lipid testing — a detail particularly relevant given your clinical geography.
5. Expansion Into Clinical Medicine (2000s)
During the 2000–2010 period:
Studies showed LDL-P predicted ASCVD events better than LDL-C
Discordance studies (LDL-C vs LDL-P) became central
NMR gained traction in:
Metabolic syndrome
Diabetes
Hypertriglyceridemia
Statin-treated patients
Major validating cohorts included:
Framingham Offspring Study
MESA (Multi-Ethnic Study of Atherosclerosis)
Women’s Health Study
6. LabCorp Acquisition (2014)
In 2014, LabCorp acquired LipoScience for approximately $575 million.
From that point forward:
NMR Lipoprofile became widely accessible
Integrated into:
Cardio IQ–style panels
Preventive cardiology workflows
Functional and integrative medicine practices
Key Individuals
James D. Otvos, PhD
Physical chemist
NMR spectroscopy specialist
Primary inventor of clinical NMR lipoprotein analysis
Founder and Chief Scientific Officer of LipoScience
He is widely considered:
The father of clinical NMR lipid particle testing
Why This Was Revolutionary
Traditional lipid panels measure:
Cholesterol mass inside particles
NMR measures:
Actual particle number
This solved the long-standing paradox:
“Why do patients with normal LDL still have heart attacks?”
Because:
Atherosclerosis is driven by particle entry into the arterial wall
Particle number (LDL-P / ApoB) determines exposure risk
Cholesterol content per particle varies widely
Relationship to ApoB
Important distinction:
ApoB testing existed earlier (1980s)
NMR provided particle subclass granularity, not just total atherogenic count
Think of it as:
Test
What it Measures
LDL-C
Cholesterol mass
ApoB
Number of atherogenic particles
NMR
Particle number plus size distribution
Bottom Line
Advanced / NMR lipid testing:
Developed: Early 1990s
Location: Northwestern University → Raleigh, NC
Inventor: James D. Otvos, PhD
Commercialized by: LipoScience
Now owned by: LabCorp
It represents one of the most important paradigm shifts in cardiovascular risk assessment in the last 40 years — particularly relevant for insulin resistance, metabolic syndrome, and “discordant lipid” patients that you routinely encounter in primary care and preventive medicine.
So next time you get your lipids tested make sure they’re doing the advanced/NMR lipid panel. It’s available through most major laboratories in the country.
Dr. P