What is a cholesterol test. How does it measure different types of cholesterol. Why are cholesterol tests important for assessing heart disease risk. How to interpret cholesterol test results. What lifestyle changes can help improve cholesterol levels.

The Basics of Cholesterol and Its Impact on Health

Cholesterol is a waxy, fat-like substance found in every cell of the human body. While it’s essential for various bodily functions, excessive cholesterol levels can lead to serious health issues. Understanding cholesterol and its impact on health is crucial for maintaining overall well-being.

Cholesterol serves several important functions in the body:

• Helps build cell membranes
• Produces hormones like testosterone and estrogen
• Aids in the production of vitamin D
• Assists in the digestion of fats

Despite its importance, high levels of cholesterol in the blood can increase the risk of cardiovascular diseases. This is why regular cholesterol testing is vital for assessing heart health and preventing potential complications.

Types of Cholesterol: Understanding LDL, HDL, and Triglycerides

Not all cholesterol is created equal. There are different types of cholesterol, each playing a unique role in the body. Understanding these types is essential for interpreting cholesterol test results and managing overall health.

Low-Density Lipoprotein (LDL)

Often referred to as “bad” cholesterol, LDL is the primary source of arterial blockages. High levels of LDL cholesterol can lead to the buildup of plaque in the arteries, increasing the risk of heart disease and stroke.

High-Density Lipoprotein (HDL)

Known as “good” cholesterol, HDL helps remove excess cholesterol from the bloodstream. Higher levels of HDL are generally associated with better cardiovascular health.

Triglycerides

While not a type of cholesterol, triglycerides are often measured alongside cholesterol levels. These are a type of fat found in the blood that can contribute to arterial plaque formation when present in high amounts.

Can high triglyceride levels increase heart disease risk? Some studies suggest that elevated triglyceride levels may indeed raise the risk of heart disease, particularly in women. However, more research is needed to fully understand this relationship.

The Cholesterol Test: What to Expect and How to Prepare

A cholesterol test, also known as a lipid panel or lipid profile, is a blood test that measures the levels of different types of cholesterol and fats in your blood. This test provides valuable information about your risk of developing heart disease and helps guide treatment decisions.

Preparation for the Test

To ensure accurate results, your healthcare provider may ask you to fast for 9 to 12 hours before the test. This typically means no food or drinks other than water. Tests are often scheduled in the morning to accommodate this fasting requirement.

The Testing Process

During the test, a healthcare professional will:

1. Clean an area on your arm with an antiseptic
2. Insert a small needle into a vein to draw blood
3. Collect the blood sample in a vial or test tube
4. Apply pressure to the site and cover it with a bandage

The entire process usually takes less than five minutes and involves minimal discomfort. You may feel a slight sting when the needle is inserted and removed.

At-Home Cholesterol Testing

In addition to laboratory tests, at-home cholesterol testing kits are available. These kits typically involve pricking your finger to obtain a small blood sample. While convenient, it’s important to follow the instructions carefully and share the results with your healthcare provider, especially if your total cholesterol level exceeds 200 mg/dL.

Interpreting Cholesterol Test Results: What the Numbers Mean

Cholesterol test results are typically measured in milligrams (mg) of cholesterol per deciliter (dL) of blood. Understanding these numbers is crucial for assessing your cardiovascular health and determining if any lifestyle changes or treatments are necessary.

Total Cholesterol

This measure combines your LDL, HDL, and other lipid components. Generally, a total cholesterol level below 200 mg/dL is considered desirable.

LDL Cholesterol

Lower levels of LDL cholesterol are generally better for heart health. The optimal level depends on your overall health and risk factors, but generally:

• Below 100 mg/dL is optimal
• 100-129 mg/dL is near optimal
• 130-159 mg/dL is borderline high
• 160 mg/dL and above is high

HDL Cholesterol

Higher levels of HDL cholesterol are generally beneficial. For men, an HDL level of 60 mg/dL or higher is considered protective against heart disease, while levels below 40 mg/dL are considered a risk factor. For women, the numbers are slightly different, with 50 mg/dL being the cutoff for increased risk.

Triglycerides

Normal triglyceride levels are typically below 150 mg/dL. Levels above this may indicate an increased risk of heart disease, especially when combined with high LDL or low HDL levels.

Is there a difference between calculated and directly measured LDL levels? Your test results may show a “calculated” LDL level, which is an estimate based on your total cholesterol, HDL, and triglycerides. Alternatively, LDL can be measured directly from your blood sample. Both methods are valid, and your healthcare provider can explain which is most appropriate for your situation.

Factors Influencing Cholesterol Levels: Beyond Diet and Exercise

While diet and exercise play significant roles in managing cholesterol levels, several other factors can influence your cholesterol profile. Understanding these factors can help you and your healthcare provider develop a more comprehensive approach to managing your cardiovascular health.

Genetic Factors

Some individuals have a genetic predisposition to high cholesterol, a condition known as familial hypercholesterolemia. This inherited disorder can lead to very high LDL cholesterol levels and an increased risk of early heart disease.

Age and Gender

Cholesterol levels tend to rise as we age. Additionally, men generally have higher cholesterol levels than women before menopause. After menopause, women’s LDL levels often increase.

Medical Conditions

Certain medical conditions can affect cholesterol levels, including:

• Diabetes
• Hypothyroidism
• Liver disease
• Kidney disease

Medications

Some medications can impact cholesterol levels. These include certain birth control pills, steroids, and some blood pressure medications.

Does stress affect cholesterol levels? While stress itself doesn’t directly cause high cholesterol, it can lead to behaviors that negatively impact cholesterol levels, such as unhealthy eating habits or reduced physical activity.

Lifestyle Modifications to Improve Cholesterol Levels

For many individuals, lifestyle changes can significantly improve cholesterol levels and reduce the risk of heart disease. These modifications often form the first line of defense against high cholesterol and can complement medical treatments when necessary.

Dietary Changes

Adopting a heart-healthy diet can have a profound impact on cholesterol levels. Key dietary strategies include:

• Reducing saturated and trans fats
• Increasing fiber intake through fruits, vegetables, and whole grains
• Incorporating healthy fats from sources like olive oil, nuts, and avocados
• Limiting dietary cholesterol intake

Regular Physical Activity

Exercise can help raise HDL cholesterol levels while lowering LDL and triglycerides. Aim for at least 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous-intensity aerobic activity per week.

Weight Management

Maintaining a healthy weight can help improve cholesterol levels. Even modest weight loss can have a positive impact on your lipid profile.

Smoking Cessation

Quitting smoking can improve HDL cholesterol levels and overall cardiovascular health.

How quickly can lifestyle changes affect cholesterol levels? While individual responses vary, some people may see improvements in their cholesterol levels within a few weeks of making significant lifestyle changes. However, it’s important to maintain these habits long-term for sustained benefits.

Medical Treatments for High Cholesterol: When Lifestyle Changes Aren’t Enough

While lifestyle modifications are often the first approach to managing high cholesterol, some individuals may require medication to achieve optimal cholesterol levels. Your healthcare provider may recommend medical treatment if lifestyle changes alone aren’t sufficient or if you’re at high risk for cardiovascular disease.

Statins

Statins are the most commonly prescribed cholesterol-lowering medications. They work by blocking a substance your body needs to make cholesterol, which leads to a reduction in LDL cholesterol and triglycerides, and a modest increase in HDL cholesterol.

Bile Acid Sequestrants

These medications work in the intestines by binding to bile acids, which leads to the liver using more cholesterol to produce bile acids, thereby lowering cholesterol levels in the blood.

Cholesterol Absorption Inhibitors

These drugs reduce the absorption of cholesterol from the small intestine, leading to lower blood cholesterol levels.

PCSK9 Inhibitors

This newer class of drugs helps the liver remove more LDL cholesterol from the blood. They are typically used in cases of very high cholesterol or when other treatments haven’t been effective.

Are there any natural supplements that can help lower cholesterol? Some natural supplements, such as red yeast rice, plant stanols and sterols, and soluble fiber supplements, have shown promise in helping to lower cholesterol levels. However, it’s crucial to consult with your healthcare provider before starting any supplement regimen, as some can interact with medications or have side effects.

The Role of Regular Cholesterol Testing in Preventive Healthcare

Regular cholesterol testing plays a crucial role in preventive healthcare. By monitoring cholesterol levels over time, individuals and their healthcare providers can track changes, assess the effectiveness of treatments or lifestyle modifications, and make informed decisions about heart health management.

Frequency of Testing

The frequency of cholesterol testing can vary depending on individual risk factors and current cholesterol levels. Generally:

• Adults with no risk factors may need testing every 4-6 years
• Adults with cardiovascular risk factors may need more frequent testing
• Children and adolescents typically need testing once between ages 9-11 and again between 17-21

Monitoring Treatment Effectiveness

For individuals undergoing treatment for high cholesterol, regular testing helps assess how well the treatment is working and whether adjustments are needed.

Early Detection of Changes

Regular testing can detect changes in cholesterol levels before they become severe, allowing for earlier intervention and potentially preventing the development of cardiovascular disease.

Can cholesterol levels change rapidly? While cholesterol levels can fluctuate slightly from day to day, significant changes usually occur over weeks to months. Factors like major dietary changes, starting or stopping medications, or sudden weight loss can cause more rapid shifts in cholesterol levels.

Understanding cholesterol and regularly monitoring your levels through testing are crucial steps in maintaining cardiovascular health. By working closely with your healthcare provider and making informed lifestyle choices, you can take control of your cholesterol levels and reduce your risk of heart disease. Remember, cholesterol management is a long-term commitment to your health, and with the right approach, you can achieve and maintain healthy cholesterol levels for years to come.

Cholesterol Levels: MedlinePlus Medical Test

What is a Cholesterol Test?

A cholesterol test is a blood test that measures the amount of cholesterol and certain fats in your blood. Cholesterol is a waxy, fat-like substance that’s found in your blood and every cell of your body. You need some cholesterol to keep your cells and organs healthy.

Your liver makes all the cholesterol your body needs. But you can also get cholesterol from the foods you eat, especially meat, eggs, poultry, and dairy products. Foods that are high in dietary fat can also make your liver produce more cholesterol.

There are two main types of cholesterol: low-density lipoprotein (LDL), or “bad” cholesterol, and high-density lipoprotein (HDL), or “good” cholesterol.

Too much LDL cholesterol in your blood increases your risk for coronary artery disease and other heart diseases. High LDL levels can cause the buildup of a sticky substance called plaque in your arteries. Over time, plaque can narrow your arteries or fully block them. When this happens, parts of your body don’t get enough blood:

• If the blood flow to the heart is blocked, it can cause a heart attack.
• If the blood flow to the brain is blocked, it can cause a stroke.
• If the blood flow to the arms or legs is blocked, it can cause peripheral artery disease.

Other names for a cholesterol test: Lipid profile, Lipid panel

What is it used for?

A cholesterol test gives you and your health care provider important information about your risk of developing heart disease. If your test shows you have high cholesterol, you can take steps to lower it. This may decrease your risk of developing heart problems in the future. A cholesterol test measures:

• LDL levels. Also known as the “bad” cholesterol, LDL is the main source of blockages in the arteries.
• HDL levels. Considered the “good” cholesterol, HDL helps get rid of “bad” LDL cholesterol.
• Total cholesterol. The combined amount of LDL cholesterol and HDL cholesterol in your blood.
• Triglyceride levels. Triglycerides are a type of fat found in your blood. Some studies show that high levels of triglycerides may increase the risk of heart disease, especially in women.
• VLDL levels. Very low-density lipoprotein (VLDL) is another type of “bad” cholesterol. High VLDL levels have been linked to plaque buildup in the arteries. VLDL isn’t usually included in routine cholesterol tests because it’s difficult to measure. About half of VLDL is triglycerides, so your VLDL level can be estimated as a percentage of your triglyceride level.

Why do I need a cholesterol test?

Your provider may order a cholesterol test as part of a routine exam. You may also have a cholesterol test if you have a family history of heart disease or if your risk for heart problems is high because of:

• High blood pressure
• Type 2 diabetes
• Smoking
• Excess weight or obesity
• Lack of physical activity
• A diet high in saturated fat

Your age may also be a factor, because your risk for heart disease increases as you get older.

What happens during a cholesterol test?

A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.

You may be able to use an at-home kit to check your cholesterol levels. Your kit will include a device to prick your finger to collect a drop of blood for testing. Be sure to follow the kit instructions carefully. Also, be sure to tell your provider if your at-home test shows that your total cholesterol level is higher than 200 mg/dl.

Will I need to do anything to prepare for the test?

You may need to fast (not eat or drink) for 9 to 12 hours before your blood cholesterol test. That’s why the tests are often done in the morning. Your provider will let you know if you need to fast and if there are any other special instructions.

Are there any risks to the test?

There is very little risk to having a blood test. You may experience slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.

What do the results mean?

Cholesterol is usually measured in milligrams (mg) of cholesterol per deciliter (dL) of blood. The information below will help you understand what your test results mean. In general, low LDL levels and high HDL cholesterol levels are good for heart health.

The LDL listed on your results may say “calculated.” This means that your LDL level is an estimate based on your total cholesterol, HDL, and triglycerides. Your LDL level may also be measured “directly” from your blood sample. Either way, you want your LDL number to be low.

A healthy cholesterol level for you may depend on your age, family history, lifestyle, and other risk factors for heart disease, such as high triglyceride levels. Your provider can explain what’s right for you.

Learn more about laboratory tests, reference ranges, and understanding results.

Is there anything else I need to know about my cholesterol levels?

High cholesterol can lead to heart disease, the number one cause of death in the United States. You can’t change some risk factors for high cholesterol, such as age and your genes. But there are actions you can take to lower your LDL levels and reduce your risk, including:

• Eating a healthy diet. Reducing or avoiding foods high in saturated fat and cholesterol can help reduce the cholesterol levels in your blood.
• Losing weight. Being overweight can increase your cholesterol and risk for heart disease.
• Staying active. Regular exercise may help lower your LDL (bad) cholesterol levels and raise your HDL (good) cholesterol levels. It may also help you lose weight.

Talk to your provider before making any major change in your diet or exercise routine.

References

1. American Heart Association [Internet]. Dallas (TX): American Heart Association Inc.; c2022. About Cholesterol; [last reviewed 2020 Nov 6; cited 2021 Dec 20]; [about 3 screens]. Available from: http://www.heart.org/HEARTORG/Conditions/Cholesterol/AboutCholesterol/About-Cholesterol_UCM_001220_Article.jsp
2. American Heart Association [Internet]. Dallas (TX): American Heart Association Inc.; c2022. HDL (Good), LDL (Bad) Cholesterol and Triglycerides; [last reviewed 2020 Nov 6; cited 2021 Dec 20]; [about 3 screens]. Available from: http://www.heart.org/HEARTORG/Conditions/Cholesterol/AboutCholesterol/Good-vs-Bad-Cholesterol_UCM_305561_Article.jsp
3. American Heart Association [Internet]. Dallas (TX): American Heart Association Inc.; c2022. How To Get Your Cholesterol Tested; [last reviewed: 2020 Nov 9; cited 2021 Dec 20]; [about 3 screens]. Available from: https://www.heart.org/en/health-topics/cholesterol/how-to-get-your-cholesterol-tested
4. American Heart Association [Internet]. Dallas (TX): American Heart Association Inc.; c2022. Prevention and Treatment of High Cholesterol; [last reviewed 2020 Nov 11; cited 2021 Dec 20]; [about 7 screens]. Available from: http://www.heart.org/HEARTORG/Conditions/Cholesterol/PreventionTreatmentofHighCholesterol/Prevention-and-Treatment-of-High-Cholesterol_UCM_001215_Article.jsp
5. American Heart Association [Internet]. Dallas (TX): American Heart Association Inc.; c2022. What Your Cholesterol Levels Mean; [last reviewed 2020 Nov 6; cited 2021 Dec 20]; [about 3 screens]. Available from: http://www.heart.org/HEARTORG/Conditions/Cholesterol/AboutCholesterol/What-Your-Cholesterol-Levels-Mean_UCM_305562_Article.jsp
6. FDA: US Food and Drug Administration [Internet]. Silver Spring (MD): U.S. Department of Health and Human Services; Cholesterol; [current as of 2018 Feb 4; cited 2019 Jan 25]; [about 4 screens]. Available from: https://www.fda.gov/medical-devices/home-use-tests/cholesterol
7. Healthfinder.gov. [Internet]. Washington D.C.: Office of Disease Prevention and Health Promotion; National Health Information Center; Get Your Cholesterol Checked; [updated 2021 Oct 7; cited 2021 Dec 20]; [about 7 screens]. Available from: https://health.gov/myhealthfinder/topics/doctor-visits/screening-tests/get-your-cholesterol-checked
8. Mayo Clinic [Internet]. Mayo Foundation for Medical Education and Research; c1998-2022. Cholesterol Test [cited 2021 Dec 20]; [about 3 screens]. Available from: https://www.mayoclinic.org/tests-procedures/cholesterol-test/about/pac-20384601
9. Mayo Clinic [Internet]. Mayo Foundation for Medical Education and Research; c1998-2022. High Cholesterol [cited 2021 Dec 20]; [about 3 screens]. Available from: https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/symptoms-causes/syc-20350800
10. Mayo Clinic [Internet]. Mayo Foundation for Medical Education and Research; c1998-2022.VLDL cholesterol: Is it harmful? [cited 2021 Dec 20]; [about 3 screens]. Available from: http://www. mayoclinic.org/diseases-conditions/high-blood-cholesterol/expert-answers/vldl-cholesterol/faq-20058275
11. National Heart, Lung, and Blood Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; High Blood Cholesterol: What You Need to Know; 2001 May [revised 2005 Jun; cited 2017 Jan 26]; [about 6 screens]. Available from: https://www.nhlbi.nih.gov/health-topics/all-publications-and-resources/high-blood-cholesterol-what-you-need-know
12. National Heart, Lung, and Blood Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Blood Cholesterol: Diagnosis [cited 2021 Dec 20]; [about 20 screens]. Available from: https://www.nhlbi.nih.gov/health-topics/blood-cholesterol
13. National Heart, Lung, and Blood Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Blood Cholesterol: Overview [cited 2021 Dec 20]; [about 4 screens]. Available from: https://www.nhlbi.nih.gov/health-topics/blood-cholesterol
14. National Heart, Lung, and Blood Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Blood Tests: What Are the Risks of Blood Tests? [cited 2021 Dec 20]; [about 5 screens]. Available from: https://www.nhlbi.nih.gov/health-topics/blood-tests
15. National Heart, Lung, and Blood Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Blood Tests: What To Expect with Blood Tests; [cited 2017 Jan 25]; [about 1 screens]. Available from: https://www.nhlbi.nih.gov/health-topics/blood-tests
16. Quest Diagnostics [Internet].Quest Diagnostics; c2000-2022. Test Summary: LDL Cholesterol; [reviewed 2020 Dec; cited 2021 Dec 20]; [about 3 screens]. Available from: https://testdirectory.questdiagnostics.com/test/test-guides/TS_LDL_Cholesterol/ldl-cholesterol?p=td

Understanding Your Blood Test Results – HDL and LDL and More

Understanding Your Blood Test Results – HDL and LDL and More | Edward-Elmhurst Health

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December 18, 2017
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by Alison Sage, D. O.

Categories: Healthy Driven Life

What, exactly, is the difference between HDL and LDL cholesterol (which one’s good)? And what are triglycerides?

Why should you care about how many white or red blood cells you have circulating?

Because your blood can tell you a lot about how healthy you are. There is so much information pumping through your veins. Doctors can see whether you’re diabetic, anemic or fighting an infection. They can gather clues to how well your liver, heart or thyroid is working.

Blood tests are often part of a routine check-up, as doctors analyze how your body is working. Unless you’re a medical professional, however, the results can be hard to decipher.
Let’s run down common lab tests. When you go to your primary care physician for a check-up, your doctor may want to do a blood draw to check your cholesterol, your blood count (how many red and white blood cells and platelets you have circulating), and a basic metabolic or chemistry panel.

• Lipid panel = cholesterol. Your doctor will order a lipid panel to get a picture of your cholesterol. Cholesterol is broken up into “good” (HDL) and “bad” (LDL). When LDL or “bad” cholesterol builds up in your arteries it can slow your blood flow, potentially leading to a heart attack or stroke. High cholesterol has no symptoms, so the blood test is vital. Triglycerides are a type of fat in your blood that’s different from cholesterol. If your triglycerides are high, they could contribute to hardening of your arteries the way high LDL cholesterol can. You want your HDL cholesterol to be higher than 45 milligrams (mg) of cholesterol per deciliter (dL) of blood. You want your LDL to be less than 130 mg/dL. Triglycerides should be less than 150 mg/dL, and your total cholesterol shouldn’t break 200 mg/dL. As Mayo Clinic reports, if you’re at an average risk of developing heart disease, it’s a good idea to get your cholesterol checked every five years starting at age 18.
• Complete blood count (CBC). This is a routine test to evaluate your general health. It can also detect a range of diseases, so doctors order this test to shed light on symptoms like fatigue or bruises. The CBC checks your levels of white blood cells, red blood cells and platelets. White blood cells help fight infection, so you’d have a higher number if that’s the case. A high or low number of red blood cells could indicate different diseases. Platelets, which help your blood clot, outside a normal range could also indicate disease.
• Basic vs. complete/comprehensive metabolic panel. The basic metabolic panel tests your blood glucose (blood sugar), kidney function, and levels of calcium, sodium and potassium. The complete metabolic panel includes all those tests plus liver function tests. These tests could be ordered as part of a routine check-up or if your doctor wants to check for specific diseases.
• Thyroid function. This test checks the level of thyroid stimulating hormone (TSH) in your blood. A high count could signify hypothyroidism; a low count, hyperthyroidism. Both conditions come with a host of symptoms, and this test can help your doctor rule out other diseases.

It’s important to find a physician you feel comfortable with and confident in, who partners with you in your personal health goals. Find the right Healthy Driven doctor for you.

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Blood test for cholesterol – lipidogram interpretation

We used to think of cholesterol as the number one enemy. But everything turned out to be not so simple – life without cholesterol is impossible, and it can be not only “bad”, but also “good”.

Doctor’s consultation

You can get the consultation of the necessary specialist online in the Doctis application

Laboratory

You can undergo a comprehensive examination of all major body systems

• Triglycerides (TG)
• Total cholesterol (CHOL).
• HDL Cholesterol (HDL)
• LDL Cholesterol (LDL)
• VLDL Cholesterol (VLDL)
• Index (coefficient) of atherogenicity

In order to determine the risk of developing vascular atherosclerosis, it is enough to take an analysis for a general
cholesterol. If the indicator is normal, you can not worry. True, in case nothing bothers you,
and behind him is a good heredity for cardiovascular diseases. If not, or the indicator
increased, it is important to pass a full-fledged lipid profile and find out the “balance of power” between various
fractions of cholesterol and consult a specialist in a timely manner.

Cholesterol test: basic indicators

Triglycerides (TG). Norm – 0.41−1.8 mmol / l

Triglycerides are the main depot of fats in our body, they are formed in the liver. Most
cases, elevated levels of triglycerides (the so-called blood chylosis) are the result of malnutrition with excess
fatty foods and carbohydrates, so you need to take the test no earlier than 9 hours after the last dose
food. The reason for the increase may be primary (hereditary) hyperlipidaemias and, much more frequently,
secondary hyperlipidemias, of which are malnutrition, obesity,
glucose tolerance and diabetes mellitus, hypothyroidism, gout, diseases of the liver, pancreas and kidneys.
It can also be caused by stress, alcohol abuse, and certain medications.
(beta-blockers, corticosteroids, diuretics and some others). A decrease in values ​​is fixed with insufficient
nutrition, hyperthyroidism, malabsorption, long-term vitamin C intake.

Total cholesterol (CHOL). Norm – 3.2-5.6 mmol / l

The most important lipid, which is a structural component of all cell membranes, a precursor of sex hormones,
corticosteroids, bile acids and vitamin D. Up to 80% of cholesterol is synthesized in the liver, the rest
enters our body with food. The content of cholesterol in the blood depends to a large extent
from age, so for a baby the upper limit of the norm is 5.25 mmol / l , and for a man over 70
– 6.86 mmol/l . Cholesterol is transported by messengers called lipoproteins
of which there are three main types – high density, low density and very low
density. An increase in total cholesterol, as well as triglycerides, occurs in primary and secondary
hyperlipidemias.

Despite the fact that in screening studies, averaged
the boundaries of total cholesterol (5.6 mmol / l) and its components, currently doctors use tables
norms according to gender and age. Therefore, if the indicators deviate, to decipher the analysis, refer to
doctor.

HDL cholesterol (HDL). Norm – not less than 0.9 mmol / l

This fraction of cholesterol is involved in the transport of cholesterol from peripheral tissues to the liver. This
means that they take cholesterol from the surface of blood vessels, including the legs, heart, brain, and carry
it to the liver. This means that HDL plays an important anti-atherogenic role, preventing the formation of cholesterol plaques and the development
atherosclerosis. And if the level of total cholesterol is increased due to HDL cholesterol, this is considered good
prognostic factor, and cholesterol should not be lowered. At the same time, the decrease in the level of “good”
cholesterol below 0. 90 mmol/l for men and 1.15 mmol/l for women is considered
risk factor for atherosclerosis.

LDL cholesterol (LDL). Norm – 1.71−3.5 mmol / l

Low density lipoproteins are the main carrier of cholesterol in our body. It is he who spreads
fat synthesized in the liver to organs and tissues. It is believed that LDL cholesterol levels
significantly more influence on the development of atherosclerosis than the level of total cholesterol. That is why it became
called “bad” cholesterol. In conditions when the vascular wall is compromised by factors
risk (nicotine, high glucose, homocysteine, increased blood pressure), cholesterol from
LDL is deposited in it, forming an atherosclerotic plaque. For people with risk factors for atherosclerosis
(age – more than 45 years for men and 55 years for women, cases of early death from cardiovascular
diseases among relatives, smoking, diabetes mellitus, hypertension, obesity) cholesterol level
LDL should not exceed 3. 37 mmol/l , values ​​from 3.37 to 4.12
mmol/l is regarded as an average risk factor for the development of atherosclerosis, and is above 4.14
mmol/l – as high.

VLDL cholesterol (VLDL). Norm – 0.26−1.04 mmol / l

These lipoproteins are synthesized in the liver and small intestine and serve as LDL precursors, i.e.
also belong to carriers of “bad” cholesterol.

Index (coefficient) of atherogenicity

This is an indicator that can be calculated based on the results of the lipid profile.

An indicator in the range from 2.0 to 2.5 units is considered normal. Maximum values
the norms are 3.2 for women and 3.5 for men. Anything above is significant
risk of developing atherosclerosis and requires measures to reduce it, which can be both non-drug
(changing diet, losing weight, quitting smoking, fighting physical inactivity, taking various dietary supplements), so
and medication (taking drugs from various groups, mainly statins).
If necessary, the doctor will individually select the drug for you

The author of the article: Aleksey Yurievich Fedorov

Cholesterol

Cholesterol is a substance necessary for the body to build cell membranes, synthesize bile acids, produce hormones and vitamin D. From a chemical point of view, cholesterol is a fat-like substance – lipid (from the Greek “lipid” – fat).
Cholesterol in the human body is synthesized mainly in the liver. Being a fat-like substance, insoluble in water, it is transported through the blood vessels only as part of complexes with proteins – chylomicrons and lipoproteins. The main carriers of cholesterol in the body are lipoproteins. Lipoproteins (protein-lipid complexes) differ in size, density and lipid content.

By density, lipoproteins are divided into the following classes:

• very low density lipoproteins (VLDL)
• intermediate density lipoproteins (IDL)
• low density lipoproteins (LDL)
• high density lipoproteins (HDL)

The ratio of fats (lipids) and proteins in lipoproteins is different. The minimum amount of protein is found in chylomicrons. The increase in the density of lipoproteins is characterized by an increase in the content of the protein component in them, as shown in the table.

Percentage composition of blood plasma lipoproteins
(G.R. Thompson, 1991)

Lipoproteins differ in their role in the development of atherosclerosis. So, low and very low density lipoproteins are considered atherogenic (contributing to the development of atherosclerosis), and the cholesterol they contain is called “bad” cholesterol. VLDL and LDL transport cholesterol from the liver to the cells and tissues of the body.
High-density lipoproteins (HDL), on the contrary, are considered anti-atherogenic (preventing the development of atherosclerosis), and the cholesterol they contain is called “good” cholesterol. High-density lipoproteins (HDL) are called “atherosclerosis cops” abroad. The anti-atherogenic effect of HDL is manifested due to their ability to capture cholesterol, remove it from cells, tissues, including arterial walls, and transport it back to the liver.
There are three substrates (or “pools”) in the body where cholesterol is found. These are blood plasma, liver, or rather, liver cells (hepatocytes), and cells of other organs. Cholesterol, located in the liver, is in dynamic equilibrium with plasma cholesterol. Depending on the activity of liver cells, the amount (concentration) of cholesterol in blood plasma can vary significantly.
The content of the amount of cholesterol sufficient for the body is maintained by its constant synthesis
in liver cells. Cholesterol produced in the liver cells is called endogenous cholesterol. Cholesterol also enters the body with food. This is the so-called exogenous cholesterol. If there is a lot of exogenous cholesterol delivered to the liver, then with normal metabolism, the synthesis of endogenous cholesterol is limited.
As already noted, cholesterol is a fat-like substance that is insoluble in water; it is transported through the blood vessels only as part of complexes with proteins. These protein-lipid complexes (VLDL, LDL, LDL and HDL) are also formed in the liver and then enter the bloodstream.
In addition to these compounds, another type of fat associated with the risk of atherosclerosis is formed in the liver. These are triglycerides. They are transported to the muscles, accumulate there, and, if necessary, are broken down, becoming a source of energy.

Cholesterol exchange

Free cholesterol undergoes oxidation in the liver and organs that synthesize steroid hormones (adrenals, testes, ovaries, placenta). This is the only process of irreversible removal of cholesterol from membranes and lipoprotein complexes.
Every day, 2-4% of the total amount of cholesterol is spent on the synthesis of steroid hormones. In hepatocytes, 60–80% of cholesterol is oxidized to bile acids, which, as part of bile, are secreted into the lumen of the small intestine and participate in digestion (emulsification of fats).
Together with bile acids, a small amount of free cholesterol enters the small intestine, which is partially removed with feces, and the rest is dissolved and, together with bile acids and phospholipids, is absorbed by the walls of the small intestine. Bile acids provide the decomposition of fats into their constituent parts (emulsification of fats). After this function, 70-80% of the remaining bile acids are absorbed in the final section of the small intestine (ileum) and enter the portal vein system to the liver. It is worth noting here that bile acids have another function: they are the most important stimulant to maintain the normal functioning (motility) of the intestine.
Schematically, the exchange of cholesterol can be represented as follows. The liver loads very low-density lipoproteins (VLDL) with fat, which then travel through the blood vessels, unloading fat. Partially “unloaded” VLDL become low density lipoproteins (LDL).
Low-density lipoproteins (LDL), the main carriers of cholesterol as they move through the blood vessels, can stick
to the walls of blood vessels, narrowing their internal lumen.
High-density lipoproteins (HDL) release LDL particles with cholesterol adhering to the vessel wall and carry them back to the liver, where LDL particles are again loaded with cholesterol and turn into VLDL, or break down and are excreted from the body.
With the active consumption of fatty foods and disorders of fat metabolism, the liver produces an excess amount of very low density lipoproteins (VLDL) and low density lipoproteins (LDL). In the presence of endothelial damage and the absence of a sufficient amount of high-density lipoprotein (HDL), particles of low-density lipoprotein (LDL) with cholesterol begin to “stick” to the walls of blood vessels. Gradually, vasoconstriction develops, i.e., atherosclerosis, and then all the troubles: angina pectoris, heart attack, stroke and other complications of atherosclerosis.

Why determine the atherogenic index?

To assess the severity of atherogenic (promoting the development of atherosclerosis) properties of blood plasma and the risk of developing clinical manifestations of atherosclerosis, formulas are used to calculate the atherogenic index (AI) by the ratio of atherogenic and antiatherogenic fractions of lipoproteins. There are many ways to calculate the atherogenic index.
One of the most common in the world is the definition of the atherogenic index, as the ratio of total cholesterol (TC) to HDL cholesterol (TC/HDL cholesterol). It indicates the atherogenicity of the blood lipid spectrum at a level > 5.
In Russia, another ratio is widely used, called the atherogenic index of A. N. Klimov. This is the ratio of the sum of atherogenic low-density lipoprotein cholesterol (LDL-C) and very-low-density lipoprotein cholesterol (VLDL-C) to anti-atherogenic high-density lipoprotein cholesterol (HDL-C).

Atherogenic index (A.N. Klimova) = LDL cholesterol + VLDL cholesterol / HDL cholesterol = total cholesterol – HDL cholesterol / HDL cholesterol

Both formulas are given because they are the same. The fact is that total cholesterol (TC) consists of LDL cholesterol, VLDL cholesterol and HDL cholesterol.

For laboratories in a polyclinic or hospital, for ease of calculating the atherogenic index, it is enough to determine the levels of total cholesterol and HDL cholesterol in the patient’s blood. If the level of HDL cholesterol is subtracted from the level of total cholesterol, then we get the amount of cholesterol of atherogenic lipoproteins – LDL and VLDL.
The normal value of the atherogenic index A.N. Klimov – 3.0–4.0. An atherogenic index value above 4.0 indicates a high risk of atherosclerosis or the possibility of its progression up to the development of serious complications.

High cholesterol is a key risk factor for atherosclerosis

As early as the beginning of the 20th century, the St. Petersburg scientist, the founder of the cholesterol theory of atherosclerosis N. N. Anichkov said: “Without a high level of cholesterol in the blood, there is no atherosclerosis.” Most domestic and foreign researchers agree with this.
Since the beginning of the last century, atherosclerosis has been associated with high levels of cholesterol in the blood, a chemical compound necessary for the life of the human body. First of all, as already noted, it is necessary as a building material for cell membranes. In addition to forming a cell framework, the body uses cholesterol to synthesize many vital substances, such as hormones (corticosteroids, androgens, estrogens, etc.) and vitamins.
Thus, on the one hand, life without cholesterol is impossible, on the other hand, cholesterol is perhaps the main threat to modern man. This contradiction is apparent, since researchers have found that it is not cholesterol itself that is responsible for the occurrence and development of atherosclerosis, but an increased level of a number of its compounds with proteins – VLDL and LDL, combined with a reduced level of HDL.

Unfortunately, people, without noticing it, contribute to the development of atherosclerosis. As noted earlier, even in early childhood, fatty (or lipid) spots can form on the walls of blood vessels. If the level of cholesterol in the blood is normal, then fatty spots disappear over time and atherosclerotic plaques do not form. But in conditions of elevated cholesterol levels, or rather VLDL and LDL cholesterol, a person is at an increased risk of developing a disease that is formidable in its prognosis. And if he also smokes, is overweight and has high blood pressure, then the risk of developing atherosclerosis increases several times. All of these factors can lead to damage to the endothelium (inner lining) of blood vessels, where the process of formation of atherosclerotic plaques begins. Therefore, it is so important to know the ways of prevention and the basics of treatment of the “disease of the century”.
The risk of developing complications of atherosclerosis is especially high in severe congenital disorders of lipid metabolism, which are inherited and which, as a rule, affect all close relatives. Such cases are usually attributed to familial hypercholesterolemia caused by a hereditary defect in low-density lipoprotein receptors. The gene is localized on the 19th chromosome.
There are homozygous and heterozygous familial hypercholesterolemia. With heterozygous hypercholesterolemia, total cholesterol is 2-3 times higher than the normative values, and with homozygous hypercholesterolemia – 4-6 times or more. Both of these conditions are harbingers of the early development of clinical manifestations of atherosclerosis in the form of coronary heart disease and even myocardial infarction.
We treated a seventeen-year-old (!) girl who suffered from a severe form of coronary heart disease. Her parents also had earlier development of atherosclerosis. The father suffered a myocardial infarction at the age of 29, the mother was operated on for coronary heart disease at 35, and at 40 for coronary brain disease.
In the preface to a monograph on the surgical correction of lipid metabolism disorders, published in 1987, Academician A.N. Klimov writes about a girl with homozygous familial hypercholesterolemia, who at the age of 6 suffered a myocardial infarction, having blood plasma cholesterol values ​​10 times higher than normal.

In hereditary hypercholesterolemia, the risk of developing coronary heart disease at a young age is 20 times higher than in people with a normal blood lipid profile.
How is lipid metabolism disturbed in hereditary hypercholesterolemia? As a result of gene mutations, the metabolism of low-density lipoproteins, the most atherogenic lipoproteins, is disrupted. This mechanism was discovered in the second half of the 20th century by American scientists Brown and Goldstein, for which they received the Nobel Prize. As they found out, on the surface of most body cells there are special protein molecules called “receptors”. Their task is to take not all lipoproteins from the blood stream, but only low-density lipoproteins (LDL), rich in cholesterol, and send them inside the cell. Freed from cholesterol, the receptors return back to its surface. Since there is a lot of cholesterol inside the cell, its synthesis by the cell itself is inhibited, which means that the number of receptors for low-density lipoproteins located on the membrane decreases. During the day, these receptors capture up to 1 g of cholesterol from blood plasma. Such capture by low-density lipoprotein receptors provides a normal level of cholesterol in the blood, preventing the development of atherosclerosis. The lack of such receptors is at the heart of hereditary familial hypercholesterolemia.
We will not dwell in great detail on the mechanism of the various types of familial hypercholesterolemia, but note that there are 5 types of mutations in which low density lipoprotein receptors do not work.

The frequency of heterozygous familial hypercholesterolemia is 1:500, homozygous familial hypercholesterolemia – 1:1,000,000 inhabitants of our planet, and people who have them will definitely get atherosclerosis, even if they follow a low-cholesterol diet. So that at a young age the most severe clinical manifestations of atherosclerosis (for example, myocardial infarction and others) do not occur, they are doomed to life-long medication that normalizes lipid metabolism.
Thus, the development of atherosclerosis is based on processes associated with impaired fat (lipid) metabolism. They are manifested by a different ratio of lipids and lipoproteins and are called dyslipidemias.
The most common dyslipidemias are caused by impaired synthesis and slowing down of lipid breakdown, a decrease in the activity of membrane transport systems that ensure the transfer of cholesterol and triglycerides from the cell.
Distinguish between primary and secondary dyslipidemia. Primary dyslipidemias are independent violations of the processes of synthesis and disintegration of lipoproteins, associated both with lifestyle features and with genetically determined metabolic defects. Secondary dyslipidemia occurs against the background of various diseases, including hormonal (hypothyroidism, pregnancy), metabolic (diabetes mellitus, obesity, gout), renal (nephrotic syndrome, chronic renal failure), toxic addictions (alcohol).

What cholesterol level is considered normal?

The first step in following the rules for lowering cholesterol is to check its level in the blood. Blood cholesterol analysis is performed in almost all clinics and hospitals free of charge or for a small fee.
A blood test for cholesterol in it usually does not require preliminary preparation, but this study is performed on an empty stomach, 10 hours after the last meal. A small amount of blood is taken, which is examined immediately by the express method or sent to the laboratory. If the study is carried out by the express method, then the answer is issued immediately. If a detailed analysis (lipidogram) is performed, the blood is sent to the laboratory, and the answer may be ready the next day or the day after.

Remember the level of your cholesterol and its components.

The simplest analysis is to determine the level of total cholesterol. Total cholesterol (TC) is made up of low-density lipoprotein (LDL), very-low-density lipoprotein (VLDL) and high-density lipoprotein (HDL) cholesterol:

TC = LDL-C + VLDL-C + HDL-C

Let’s talk about the standards of the blood lipid spectrum. The amount of cholesterol and lipoproteins is measured in millimoles per liter (mmol/l) or milligrams per deciliter (mg/dl). What level of lipid spectrum indicators is considered normal?

The standards are different for healthy people with a low risk of cardiovascular disease, and patients with cardiovascular disease.

So, the standards of the blood lipid spectrum for healthy people:

Total cholesterol (TC) < 5.0 mmol/L (< 190 mg/dL)
LDL cholesterol (LDL-C) < 3.0 mmol/L (< 115 mg/dL)
HDL cholesterol (HDL-C) > 1.0 mmol/l (> 40 mg/dl) in men
HDL cholesterol (HDL cholesterol) > 1.2 mmol/L (> 45 mg/dL) in women
Triglycerides (TG) < 1.7 mmol/L (< 150 mg/dL)

Norms of the blood lipid spectrum for patients with coronary heart disease and patients with diabetes:

Total cholesterol (TC) < 4.5 mmol/L (< 175 mg/dL)
LDL cholesterol (LDL-C) < 1.8 mmol/L (< 70 mg/dL)
HDL cholesterol (HDL-C) > 1.