What You Need to Know: MedlinePlus

What is cholesterol?

Cholesterol is a waxy, fat-like substance that’s found in all the cells in your body. Your liver makes cholesterol, and it is also in some foods, such as meat and dairy products. Your body needs some cholesterol to work properly. But if you have too much cholesterol in your blood, you have a higher risk of coronary artery disease.

How do you measure cholesterol levels?

A blood test called a lipoprotein panel can measure your cholesterol levels. Before the test, you’ll need to fast (not eat or drink anything but water) for 9 to 12 hours. The test gives information about your

• Total cholesterol – a measure of the total amount of cholesterol in your blood. It includes both low-density lipoprotein (LDL) cholesterol and high-density lipoprotein (HDL) cholesterol.
• LDL (bad) cholesterol – the main source of cholesterol buildup and blockage in the arteries
• HDL (good) cholesterol – HDL helps remove cholesterol from your arteries
• Non-HDL – this number is your total cholesterol minus your HDL. Your non-HDL includes LDL and other types of cholesterol such as VLDL (very-low-density lipoprotein).
• Triglycerides – another form of fat in your blood that can raise your risk for heart disease, especially in women

What do my cholesterol numbers mean?

Cholesterol numbers are measured in milligrams per deciliter (mg/dL). Here are the healthy levels of cholesterol, based on your age and gender:

Anyone age 19 or younger:

Men age 20 or older:

Women age 20 or older:

Triglycerides are not a type of cholesterol, but they are part of a lipoprotein panel (the test that measures cholesterol levels). A normal triglyceride level is below 150 mg/dL. You might need treatment if you have triglyceride levels that are borderline high (150-199 mg/dL) or high (200 mg/dL or more).

How often should I get a cholesterol test?

When and how often you should get a cholesterol test depends on your age, risk factors, and family history. The general recommendations are:

For people who are age 19 or younger:

• The first test should be between ages 9 to 11
• Children should have the test again every 5 years
• Some children may have this test starting at age 2 if there is a family history of high blood cholesterol, heart attack, or stroke

For people who are age 20 or older:

• Younger adults should have the test every 5 years
• Men ages 45 to 65 and women ages 55 to 65 should have it every 1 to 2 years

What affects my cholesterol levels?

A variety of things can affect cholesterol levels. These are some things you can do to lower your cholesterol levels:

• Diet. Saturated fat and cholesterol in the food you eat make your blood cholesterol level rise. Saturated fat is the main problem, but cholesterol in foods also matters. Reducing the amount of saturated fat in your diet helps lower your blood cholesterol level. Foods that have high levels of saturated fats include some meats, dairy products, chocolate, baked goods, and deep-fried and processed foods.
• Weight. Being overweight is a risk factor for heart disease. It also tends to increase your cholesterol. Losing weight can help lower your LDL (bad) cholesterol, total cholesterol, and triglyceride levels. It also raises your HDL (good) cholesterol level.
• Physical Activity. Not being physically active is a risk factor for heart disease. Regular physical activity can help lower LDL (bad) cholesterol and raise HDL (good) cholesterol levels. It also helps you lose weight. You should try to be physically active for 30 minutes on most, if not all, days.
• Smoking. Cigarette smoking lowers your HDL (good) cholesterol. HDL helps to remove bad cholesterol from your arteries. So a lower HDL can contribute to a higher level of bad cholesterol.

Things outside of your control that can also affect cholesterol levels include:

• Age and Sex. As women and men get older, their cholesterol levels rise. Before the age of menopause, women have lower total cholesterol levels than men of the same age. After the age of menopause, women’s LDL (bad) cholesterol levels tend to rise.
• Heredity. Your genes partly determine how much cholesterol your body makes. High blood cholesterol can run in families.
• Race. Certain races may have an increased risk of high blood cholesterol. For example, African Americans typically have higher HDL and LDL cholesterol levels than whites.

How can I lower my cholesterol?

There are two main ways to lower your cholesterol:

• Heart-healthy lifestyle changes, which include:
• Heart-healthy eating. A heart-healthy eating plan limits the amount of saturated and trans fats that you eat. Examples include the Therapeutic Lifestyle Changes diet and the DASH Eating Plan.
• Weight Management. If you are overweight, losing weight can help lower your LDL (bad) cholesterol.
• Physical Activity. Everyone should get regular physical activity (30 minutes on most, if not all, days).
• Managing stress. Research has shown that chronic stress can sometimes raise your LDL cholesterol and lower your HDL cholesterol.
• Quitting smoking. Quitting smoking can raise your HDL cholesterol. Since HDL helps to remove LDL cholesterol from your arteries, having more HDL can help to lower your LDL cholesterol.
• Drug Treatment. If lifestyle changes alone do not lower your cholesterol enough, you may also need to take medicines. There are several types of cholesterol medicines available, including statins. The medicines work in different ways and can have different side effects. Talk to your health care provider about which one is right for you. While you are taking medicines to lower your cholesterol, you should continue with the lifestyle changes.

NIH: National Heart, Lung, and Blood Institute

High cholesterol – Getting tested

High cholesterol does not cause symptoms. You can only find out if you have it from a blood test.

Your GP might suggest having a test if they think your cholesterol level could be high.

This may because of your age, weight or another condition you have (like high blood pressure or diabetes).

Non-urgent advice: Ask your GP surgery for a cholesterol test if:

• you have not had a test before and you’re over 40, overweight, or high cholesterol or heart problems run in your family

You’re more likely to have high cholesterol.

Information:

Coronavirus (COVID-19) update: how to contact a GP

It’s still important to get help from a GP if you need it. To contact your GP surgery:

• visit their website
• use the NHS App
• call them

Find out about using the NHS during COVID-19

Having a cholesterol test

There are 2 ways of having a cholesterol test.

Taking blood from your arm

Some blood will usually be taken from your arm with a needle.

This is sent to a lab to check your cholesterol level. You should get the result in a few days.

You might be asked not to eat anything for up to 12 hours before the test. But this is not always needed.

Finger-prick test

If you’re over 40, you may have a test during your NHS Health Check.

This is a check-up that can help spot early signs of problems like heart disease and diabetes.

The test can be done by pricking your finger. A drop of blood is put on a strip of paper. This is put into a machine that checks your cholesterol in a few minutes.

What happens next

If you have high cholesterol, a doctor or nurse will talk to you about how you can lower it.

This might include things like changing your diet or taking medicine.

They may also work out your risk of having a heart attack or stroke in the next 10 years.

They can do this using your:

• cholesterol levels
• blood pressure
• height and weight
• age, sex and ethnicity

Lowering your cholesterol can help lower your risk of having a heart attack or stroke.

Cholesterol – Lab Tests Online AU

How is it used?

To screen for risk of developing cardiovascular disease (heart disease, stroke and related diseases) and to monitor treatment.

 

When is it requested?

Cholesterol testing is recommended when you have established heart disease (angina, heart attack), or if there is a family history of high cholesterol, or of heart disease at an early age; if you are less than 45 years of age and have risk factors which put you at an increased chance of developing heart disease, such as diabetes, high blood pressure, chronic renal failure or renal transplantation, Aboriginal or Torres Strait Islander, overweight or you are a smoker. In addition, cholesterol testing is performed if you are following a recommended diet or taking drugs to lower your cholesterol level, to monitor your response to treatment. Total cholesterol may be measured alone or in combination with other tests including HDL, LDL, and triglycerides – often called a lipid profile.

Reading your results

Lipid Profile – cholesterol (total, HDL and LDL) & triglycerides

The lipid profile is a group of tests used to assess your risk of cardiovascular diseases (heart disease, stroke and related diseases). It checks total cholesterol, triglycerides, HDL cholesterol and LDL cholesterol. The results are considered along with other important factors such as your age, gender, ethnicity and blood pressure and whether you have diabetes or smoke.
 
If you’ve had test results for cholesterol and triglycerides, this example form may help you understand them.
 
It is important to realise that the format and look of reports often differ between laboratories so your results form may not look exactly like this.
 

	*Requesting Doctor		*Patient
Name:	Michael Smith		Paul Harding
Address:	Rodwell Medical Centre, 12 Main Street, Rodwell NSW		58 Bramble Street, Rodwell NSW
Date of birth:			12-Nov-1990
Sex:			Male
*Date of report:		28-Feb-19	16-Mar-19
			Latest results	*Reference Interval	*Units
*Collection date:		28-Feb-19	16-Mar-19
*Collection Time:		8:30	9:00
*Request No:		123456	345678
Test names
Biochemistry
Cholesterol		9. 0 H	9.1 H	≤5.2	mmol/L
Triglycerides		1.2	1.5	≤ 2.5	mmol/L
HDL Cholesterol		1.1	1.2	1.00-2.50	mmol/L
LDL Cholesterol		7.4 H	7.2 H	≤ 3.5	mmol/L

Comment: LDL-Cholesterol ≥ 6.4 mmol/L:
Familial hypercholesterolaemia, an autosomal dominant cause of premature cardiovascular disease is highly likely (risk greater than I in 2).
Recommend http://www.athero.org.au/calculator to calculate diagnostic score and http://www. athero.org.au/fh/health-professionals/what-is-familial-hypercholesterolaemia-fh/ to assist with diagnosis and management, if required.

Who prepares your test results report?

In this report, four tests have been performed as a group. They each measure a different substance in the blood that can indicate a possible health problem if levels are shown to be too high or too low.

 

In this example case, the purpose of the first test was to check the lipid profile (cholesterol, triglycerides plus HDL and LDL) of this relatively young man.  Normally, this would not be done unless the person has known risk factors. In this case, Paul has a strong family history of early heart disease. His grandfather and two uncles have all died some years ago from heart attacks and recently, his 53-year old father has also had a fatal heart attack. His father had always been apparently healthy and had not had blood tests to check his lipids.   

 
What the results mean?

Two sets of results are shown from tests that have been performed just over two weeks apart.

 

• In the first column of results, showing tests performed on the 28th of February Paul was found to have very high total cholesterol and LDL cholesterol.
• The current results (16th March) have been done to confirm the initial results because they were so abnormal and because Paul had been drinking quite heavily prior to the first test. The second set of results are very similar to the first and have not changed after two weeks without alcohol.
• The comment on the report states that Paul has a high probability of having familial hypercholesterolaemia. This is an inherited condition in which people have a very high risk of developing early coronary artery disease. They need to have treatment.
• The results have been compared to a reference interval. This is shown on the far right (column 5).
• The reference intervals represent the levels of cholesterol and triglycerides which would be considered ‘healthy’ for the general population.  (Note that for these two substances, the range given is not the same as most ‘normal’ ranges which are derived from the results for most healthy people. In this case they are derived from studies showing the levels at which the risk of developing early coronary artery or other atherosclerotic disease is acceptably low. Because our modern diet and lifestyle are not ideal, the statistical ‘normal’ ranges would be higher than is desirable.)
• If your results are outside this range and flagged with an H (high) or L (low) this is just to draw your attention to them. If the total cholesterol, LDL cholesterol or triglyceride levels are flagged as high this suggests that you and your doctor should discuss strategies to reduce the levels.
• Your results need to be interpreted by your doctor who will consider them in the context of your whole medical history, as well as the results of any other investigations you have had.
• There are a number of other causes of high cholesterol results and also high triglyceride results. You should also look at the entry for lipid profile.

 
Who prepares your test results report?
 
Your tests will have been performed by scientists and/or pathologists (who are medical doctors).  The pathologist-in-charge who specialises in interpreting test results and observing and evaluating biological changes to make a diagnosis, will be responsible for your report. The pathologist is also available to discuss your results with your doctor.

What does the test result mean?

The cholesterol level measured in your blood will be considered along with other risk factors for heart disease (high blood pressure, smoking etc.) when assessing your overall risk of developing heart disease. This overall assessment is what will be used to decide whether or not you require further treatment in the form of lifestyle changes such as diet, exercise or drugs to lower your cholesterol level. 

A total cholesterol level of greater than 7.5 mmol/L is considered high risk. And also this level should be reviewed for family history and clinical features of familial hypercholesterolaemia which is an inherited condition.

If you are taking medication to lower your cholesterol, the target is to get your total cholesterol to a value less than 4.0 mmol/L.

Is there anything else I should know?

Cholesterol testing is recommended as a screening test to be done for all adults with no risk factors for heart disease at least once every four to six years. It is frequently done in conjunction with a routine physical examination. 

Blood cholesterol is temporarily low during illness, immediately following a heart attack, or during stress (like surgery or accident). You should wait at least 6 weeks after any illness to have cholesterol measured.

There is some debate about whether very low cholesterol is bad. Low cholesterol is often seen when there is an existing problem like malnutrition, liver disease, or cancer. However there is no evidence that low cholesterol causes any of these problems.

Cholesterol is high during pregnancy. Women should wait at least six weeks after the baby is born to have cholesterol measured.

Some drugs that are known to increase cholesterol levels to a moderate extent, include oral corticosteroids, beta blockers, oral contraceptives, thiazide diuretics, oral retinoids and phenytoin. 

Familial hypercholesterolaemia (FH) is a severe form of elevated cholesterol levels that runs in families. It is often undetected until damage is done and the person develops cardiovascular disease. It can be easily screened for and treated early in life. Information about FH can be found at the FH Australia network site. Individual risk of having FH can be determined using their online calculator.

 

High cholesterol – Illnesses and conditions

If you’ve been diagnosed with high cholesterol, you’ll be advised to make changes to your diet and increase your level of exercise.

After a few months, if your cholesterol level hasn’t dropped, you may be advised to take cholesterol-lowering medication.

Changing your diet, stopping smoking and exercising more will also help to prevent high cholesterol developing.

The various treatments for high cholesterol are outlined below. 

Diet

Eating a healthy, balanced diet that’s low in saturated fats can reduce your level of “bad cholesterol” (LDL).

Try to avoid or cut down on the following foods, which are high in saturated fat:

• fatty cuts of meat and meat products, such as sausages and pies
• butter, ghee and lard
• cream, soured cream, crème fraîche and ice cream
• cheese, particularly hard cheese
• cakes and biscuits
• milk chocolate
• coconut oil, coconut cream and palm oil

The government recommends that a maximum of 11% of a person’s food energy should come from saturated fat. This equates to no more than:

• 30g of saturated fat a day for the average man
• 20g of saturated fat a day for the average woman

Children should have less.

Check the labels on the foods you’re eating to find out how much saturated fat you’re consuming.

Omega-3 fatty acids

Many experts believe that the fats found in avocados and oily fish, such as mackerel, salmon and tuna, are good for you.

These are known as omega-3 fatty acids and high doses can improve (lower) triglyceride levels in some people. However, too much omega-3 fatty acids can contribute to obesity.

For people with a high triglyceride level, at least two portions of oily fish a week is thought to be beneficial. However, there’s no evidence that taking omega-3 fatty acid supplements has the same benefit.

Cholesterol-lowering medication

There are several different types of cholesterol-lowering medication that work in different ways. Your GP can advise you about the most suitable type of treatment, and may also prescribe medication to lower high blood pressure (hypertension) if it affects you.

The most commonly prescribed medications are outlined below.

Statins

Statins block the enzyme (a type of chemical) in your liver that helps to make cholesterol. This leads to a reduction in your blood cholesterol level.

You’ll usually be started on a medication called atorvastatin. Other statins include simvastatin and rosuvastatin.

When someone has side effects from using a statin, it’s described as having an “intolerance” to it. Side effects of statins include headaches, muscle pain and stomach problems, such as indigestion, diarrhoea or constipation.

Statins will only be prescribed to people who continue to be at high risk of heart disease, because they need to be taken for life. Cholesterol levels start to rise again once you stop taking them.

Aspirin

In some cases, a low daily dose of aspirin may be prescribed, depending on your age (usually over 40 years old) and other risk factors.

Low-dose aspirin can help to prevent blood clots forming, particularly for someone who’s had a heart attack, has established vascular disease, or a high risk of developing cardiovascular disease (CVD).

You may also be advised to have periodic blood tests to ensure your liver is functioning well.

Ezetimibe

Ezetimibe is a medication that blocks the absorption of cholesterol from food and bile juices in your intestines into your blood. It’s generally not as effective as statins, but is less likely to cause side effects.

You can take ezetimibe at the same time as your usual statin if your cholesterol levels aren’t low enough with the statin alone. The side effects of this combination are generally the same as those of the statin on its own (muscle pain and stomach problems).

You can take ezetimibe by itself if you’re unable to take a statin. This may be because you have another medical condition, you take medication that interferes with how the statin works, or because you experience side effects from statins. Ezetimibe taken on its own rarely causes side effects.

For more information, you can read the National Institute for Health & Care Excellence (NICE) guidelines about the use of ezetimibe for treating high cholesterol.

Cholesterol Lab Testing | The Urgent Care

A complete cholesterol test — also called a lipid panel or lipid profile — is a blood test that can measure the amount of cholesterol and triglycerides in your blood. A cholesterol test can help determine your risk of the buildup of plaques in your arteries that can lead to narrowed or blocked arteries throughout your body (atherosclerosis). High cholesterol levels usually don’t cause any signs or symptoms, so a cholesterol test is an important tool. High cholesterol levels often are a significant risk factor for heart disease.

Why is it done?

• High cholesterol by itself usually has no signs or symptoms. A complete cholesterol test is done to determine whether your cholesterol is high and estimate your risk of developing heart disease.
• A complete cholesterol test, referred to as a lipid panel or lipid profile, includes the calculation of four types of fats (lipids) in your blood:
• Total cholesterol. This is a sum of your blood’s cholesterol content.
• High-density lipoprotein (HDL) cholesterol. This is sometimes called the “good” cholesterol because it helps carry away LDL cholesterol, thus keeping arteries open and your blood flowing more freely.
• Low-density lipoprotein (LDL) cholesterol. This is sometimes called the “bad” cholesterol. Too much of it in your blood causes the buildup of fatty deposits (plaques) in your arteries (atherosclerosis), which reduces blood flow. These plaques sometimes rupture and can lead to a heart attack or stroke.
• Triglycerides. Triglycerides are a type of fat in the blood. When you eat, your body converts any calories it doesn’t need into triglycerides, which are stored in fat cells. High triglyceride levels are associated with several factors, including being overweight, eating too many sweets or drinking too much alcohol, smoking, being sedentary, or having diabetes with elevated blood sugar levels.

Who should get a cholesterol test?

• All adults age 20 or older should have a cholesterol test once every five years. Ideally, you should begin having your cholesterol checked during your early 20s. You should have your cholesterol measured when you’re relatively healthy. An acute illness, a heart attack or severe stress can affect cholesterol levels.
• Cholesterol testing is especially important if you:
  – Have a family history of high cholesterol or heart disease
  – Are overweight
  – Are physically inactive
  – Have diabetes
  – Eat a high-fat diet
  – Are a man older than 45 or a woman older than 55

These factors put you at increased risk of developing high cholesterol and heart disease.

If you have high cholesterol levels, your doctor may want you to get tested more often. Discuss with your doctor how often you should have a cholesterol test if your cholesterol levels are abnormal.

Also, if you have a strong family history of early heart disease, your doctor may want to test other risk factors, such as lipoproteins, that aren’t part of the standard cholesterol profile.

Cholesterol is often high during pregnancy, so pregnant women should wait at least six weeks after giving birth to have their cholesterol measured. The same is true for people who’ve been ill or had a heart attack, surgery or an accident.

Some drugs are known to increase cholesterol levels, including anabolic steroids, beta blockers, epinephrine, oral contraceptives and vitamin D. Be sure the doctor who orders your tests is aware of all the drugs and supplements you’re taking.

Children and cholesterol testing

Children as young as age 2 can have high cholesterol, but not all children need to be screened for high cholesterol. The American Academy of Pediatrics recommends a cholesterol test only for children between the ages of 2 and 10 who have a known family history of high cholesterol or premature coronary artery disease. Your child’s doctor may recommend retesting if your child’s first test shows he or she has abnormal cholesterol levels. If you have a family history of coronary artery disease that develops at a young age, your doctor may recommend more frequent cholesterol tests beyond the recommended screenings.

The American Academy of Pediatrics also recommends testing if the child’s family history for high cholesterol is unknown, but the child has risk factors for high cholesterol, such as obesity, high blood pressure or diabetes.

There’s little risk in getting a cholesterol test. You may have some soreness or tenderness around the site where your blood is drawn. Rarely, the site may become infected.

If you are in need of a cholesterol test, call The Urgent Care.

New guidelines simplify cholesterol tests: no fasting needed

I’m supposed to have my cholesterol checked soon. It’s a simple test, but I’m not looking forward to it since it requires fasting overnight. And that means making a special early-morning trip to my doctor’s office.

But new international guidelines say it’s OK — even preferred — to skip the overnight fast.

To learn more about this small but oh-so-useful shift, I talked with cardiologist Dr. Samia Mora. She helped write the new guidelines, which were published this week in the European Heart Journal and summarized in JAMA Internal Medicine. Mora is director of the Center for Lipid Metabolomics at Brigham and Women’s Hospital and associate professor of medicine at Harvard Medical School.

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What was the point of fasting before having a cholesterol test?

Not eating for eight to 12 hours before having blood drawn for a cholesterol test was thought to give a more accurate assessment of total cholesterol, harmful LDL cholesterol, protective HDL cholesterol, and triglycerides, a type of fat-carrying particle. We now know better.

Related:

Expert view: New guidelines on cholesterol drugs are flawed

One problem with fasting is that we spend most of the day in the nonfasting state, so the way cholesterol tests are currently done doesn’t necessarily give a clear picture of “normal” levels. Another is that fasting is a hassle for everyone concerned — patients, clinicians, and even lab workers.

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What’s behind the new recommendation?

This change has been coming for some time. It is driven by data from a dozen-plus studies that include more than 300,000 people whose cholesterol and other lipids were measured when they hadn’t fasted. Their levels predicted cardiovascular risk, as well as, or possibly better than, fasting lipid levels.

Nonfasting levels might be better?

After you eat, your digestive system converts some of the carbohydrates and fats into triglycerides. Their level in the bloodstream rises, then gradually falls. If the triglyceride level rises too much, it’s a signal that the body has trouble metabolizing food. Think of eating as a stress test for metabolism. That’s something you can’t see if you’ve been fasting.

What does this shift mean?

Everyone wins with this change. People don’t like to fast overnight. Some find it difficult to do, others are even harmed by it, such as those who faint from fasting and people with diabetes who take medications to lower blood sugar. The new recommendation means you can have your blood drawn when it’s most convenient for you, rather than early in the day.

Related:

Cholesterol-lowering drugs may undermine effectiveness of flu vaccine, studies find

It may even mean one-stop shopping — you can have your blood drawn and then see your doctor, all in the same visit. It’s easier for clinicians, who don’t have to keep track of patients’ special lab visits. Eliminating the fasting requirement will benefit labs, too, since they won’t have to deal with the daily crush of patients first thing in the morning needing blood draws for cholesterol checks.

Does what you eat before the test matter?

Consuming a double cheeseburger, fries, and a milk shake right before having your blood drawn for a cholesterol test may lead to a follow-up fasting test if the triglycerides are very high. But eating normally has little effect on your lipid levels, including triglycerides.

Will this recommendation catch on in the United States?

Health care providers often do what they are used to doing, so it may take a while for some to change to nonfasting cholesterol tests. But we also need to realize that there are advantages to this evidence-based change. Switching to nonfasting cholesterol testing is actually the path of least resistance for patients and clinicians. It also provides a more accurate lipid profile for individual patients.

I believe that getting the word out to clinicians, lab directors, and patients will be enough to make the switch to nonfasting cholesterol tests in a fairly short time.

Blood Test: Lipid Panel (for Parents)

What Is a Blood Test?

A blood test is when a sample of blood is taken from the body to be tested in a lab. Doctors order blood tests to check things such as the levels of glucose, hemoglobin, or white blood cells. This can help them detect problems like a disease or medical condition. Sometimes, blood tests can help them see how well an organ (such as the liver or kidneys) is working.

What Is a Lipid Panel?

A lipid panel measures levels of different kinds of fats in the blood. 

• Total cholesterol, which is the amount of the different types of cholesterol added together. Cholesterol is a fatty substance that the body needs some of. But too much cholesterol can cause problems.
• High-density lipoprotein (HDL) cholesterol, often called “good” cholesterol. HDL helps the body get rid of extra cholesterol.
• Low-density lipoprotein (LDL) cholesterol, often called “bad” cholesterol. LDL that builds up in the bloodstream can clog blood vessels and increase the risk of heart disease.
• Triglycerides, which store energy until the body needs it. If the body holds on to too many triglycerides, blood vessels can get clogged and cause health problems.

Why Are Lipid Panels Done?

A lipid panel can show a person’s risk for developing heart disease or atherosclerosis (a hardening, narrowing, or blockage of the arteries). Fixing the lipid levels early on may lower the risk of heart disease and atherosclerosis.

How Should We Prepare for a Lipid Panel?

Your child may be asked to stop eating and drinking for 8 to 12 hours before the test, and not to exercise for 12 to 14 hours before. Tell your doctor about any medicines your child takes because some can affect the test results.

Wearing a T-shirt or short-sleeved shirt for the test can make things easier for your child, and you also can bring along a toy or book as a distraction.

How Is a Lipid Panel Done?

Most blood tests take a small amount of blood from a vein. To do that, a health professional will:

• clean the skin
• put an elastic band (tourniquet) above the area to get the veins to swell with blood
• insert a needle into a vein (usually in the arm inside of the elbow or on the back of the hand)
• pull the blood sample into a vial or syringe
• take off the elastic band and remove the needle from the vein

In babies, blood draws are sometimes done as a “heel stick collection. ” After cleaning the area, the health professional will prick your baby’s heel with a tiny needle (or lancet) to collect a small sample of blood.

Collecting a sample of blood is only temporarily uncomfortable and can feel like a quick pinprick.

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Can I Stay With My Child During a Lipid Panel?

Parents usually can stay with their child during a blood test. Encourage your child to relax and stay still because tensing muscles can make it harder to draw blood. Your child might want to look away when the needle is inserted and the blood is collected. Help your child to relax by taking slow deep breaths or singing a favorite song.

How Long Does a Lipid Panel Take?

Most blood tests take just a few minutes. Occasionally, it can be hard to find a vein so the health professional may need to try more than once.

What Happens After a Lipid Panel?

The health professional will remove the elastic band and the needle and cover the area with cotton or a bandage to stop the bleeding. Afterward, there may be some mild bruising, which should go away in a few days.

When Are Lipid Panel Results Ready?

Blood samples are processed by a machine, and it may take a few hours to a day for the results to be available. If the test results show signs of a problem, the doctor might order other tests to figure out what the problem is and how to treat it.

Are There Any Risks From Lipid Panels?

A lipid panel is a safe procedure with minimal risks. Some kids might feel faint or lightheaded from the test. A few kids and teens have a strong fear of needles. If your child is anxious, talk with the doctor before the test about ways to make the procedure easier.

A small bruise or mild soreness around the blood test site is common and can last for a few days. Get medical care for your child if the discomfort gets worse or lasts longer. 

If you have questions about the lipid panel, speak with your doctor or the health professional doing the blood draw.

How cholesterol is indicated in the blood test

We know that cholesterol is one of the main culprits of atherosclerosis and its complications: heart attack and stroke. Is it always necessary to sound the alarm when blood cholesterol is high?

We remind you that on our portal you can find the answers of Dr. Fedorov to questions about how to correctly decipher the indicators in general urine and blood tests, biochemical blood tests, blood tests for lipid profile, urinary sediment analysis.And also you can find out what some changes in the electrocardiogram mean.

If you have any questions, you can ask them using the Doctis application.

1. Why cholesterol is considered the number one enemy of our vessels?

In fact, cholesterol is more of a friend than an enemy. After all, it is impossible to imagine life without this “builder”, which is part of the cell wall of all our organs and tissues. In addition to the frame function, it has no less important: the main role in the production of bile acids, vitamin D, most hormones (cortisol, aldosterone, testosterone, estrogens, progesterone, etc.)etc.). However, a number of studies carried out from the 60s of the last century to the present day have convincingly proved the connection between hypercholesterolemia (increased cholesterol levels) and dyslipidemia (disturbances in the ratio of lipids in the blood due to an excess of some and a decrease in the concentration of others) with the risk of developing vascular atherosclerosis. …

Vascular atherosclerosis is caused by the deposition of cholesterol in the inner wall of blood vessels with the formation of atherosclerotic plaques that cause disruption of blood supply to the heart (angina pectoris, myocardial infarction), brain (ischemic stroke), lower extremities (intermittent claudication, gangrene) and other organs.

2. Why is good and bad cholesterol released?

Further research has shown that an increase in total cholesterol does not always indicate an increased risk of atherosclerosis. The fact is that cholesterol is not present in the blood in free form, it is associated with carriers – lipoproteins. It is transported to peripheral organs and tissues (including the vascular wall) by low and very low density lipoproteins (LDL and VLDL), and high density lipoproteins (HDL) are transported from the tissues to the liver.It turned out that a high level of total cholesterol due to LDL and VLDL is associated with an increased risk of atherosclerosis, and an increase due to HDL, on the contrary, helps to reduce this risk. And if the first situation requires lowering cholesterol levels and drug treatment, then the second does not need correction.

Cholesterol in the composition of LDL and VLDL is called “bad”, and in the composition of HDL – “good”. These cholesterol transporters are separately identified (LDL and HDL) in a comprehensive blood cholesterol test called a lipid profile.

3. What are triglycerides? What is the evidence of an increase in their level in the blood?

Triglycerides, along with cholesterol, are another “fat depot” of our body. But unlike the latter, they are not produced in the liver, but completely taken with food. Mainly from meat and dairy products with high fat content.

The level of triglycerides fluctuates during the day: after the first meal, their concentration in the blood rapidly increases and remains at this level for 9-12 hours.Therefore, a blood test for lipid profile should be taken no earlier than 12 hours after a meal.

The main thing, as evidenced by an increase in triglyceride levels, is an unhealthy diet with an excess of animal fats. In addition, triglyceride levels increase in diabetes mellitus and impaired glucose tolerance, fatty hepatosis and liver cirrhosis, pathology of the gallbladder and bile ducts, in some other diseases, as well as during pregnancy.

4.What is the normal level of total cholesterol?

Blood cholesterol levels depend on age. In a newborn, its level does not exceed 3 mmol / l. Subsequently, sex differences appear in the content of cholesterol: in men at a young and middle age, its level rises faster than in women, and in old age, on the contrary, decreases. In the fairer sex, the cholesterol level before menopause increases rather slowly, but after the onset of menopause, it quickly “catches up” with the male concentration and can exceed it.This is due to the effect of sex hormones – androgens increase cholesterol levels, and estrogens, on the contrary, decrease.

The average age for blood cholesterol is considered to be 5.2 mmol / l. If your cholesterol level is more than 6.22 mmol / L, the risk of developing cardiovascular diseases is significantly increased.

The level in the “corridor” from 5.2 to 6.22 mmol / l is considered intermediate, to assess possible risks in this case, pay attention to the ratio of “bad” and “good” cholesterol, the concentration of triglycerides, and calculate the coefficient of atherogenicity.

5. What is the coefficient of atherogenicity?

This indicator allows you to visually assess the risk of developing cardiovascular diseases. Normally, the coefficient of atherogenicity is 2-3. With an increase from 3 to 4, the risk of developing atherosclerosis and associated cardiovascular diseases is assessed as moderate, more than 4 – high. In some cases, the atherogenic coefficient exceeds 7 – then they talk about an extremely high risk of cardiovascular diseases.

Knowing your cholesterol level and periodically taking a blood test for cholesterol is considered good form these days and a sign of a careful attitude to health.

Fortunately, today many even know how cholesterol is indicated in a biochemical blood test (CHOL), but, as practice shows, one test for total cholesterol is sufficient only when the indicator is within the normal range. If we are talking about even a slight increase, in order to fully assess the situation and choose the correct treatment tactics, it is necessary to pass a full analysis of the lipid profile, which includes, in addition to total cholesterol, HDL, LDL and VLDL cholesterol, as well as triglycerides. This comprehensive analysis makes it possible to calculate the atherogenic index, which is an important criterion for assessing the risk of atherosclerosis.

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Blood test for cholesterol – decoding of the lipidogram

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

In order to determine the risk of developing vascular atherosclerosis, it is enough to pass an analysis for total cholesterol. If the indicator is normal, you do not need to worry. True, if nothing bothers you, and you have a good heredity for cardiovascular diseases. If not, or the indicator is increased, it is important to pass a full-fledged lipid profile and find out the “balance of power” between the various fractions of cholesterol.

Triglycerides (TG). The norm is 0.41-1.8 mmol / l

Triglycerides are the main depot of fats in our body, they are formed in the liver. In most cases, an increased level of triglycerides (the so-called blood chylosis) is the result of an improper diet with an excess of fatty foods and carbohydrates, so you need to take the test no earlier than 9 hours after the last meal. The reason for the increase can be primary (hereditary) hyperlipidemias , and, much more often, secondary hyperlipidemias, among which are malnutrition, obesity, impaired glucose tolerance and diabetes mellitus, hypothyroidism, gout, liver, pancreas and kidney diseases.Also, the increase can be caused by stress, alcohol abuse, and taking certain medications (beta-blockers, corticosteroids, diuretics, and some others). A decrease in values ​​is recorded in case of insufficient nutrition, hyperthyroidism, malabsorption, prolonged intake of vitamin C.

Total cholesterol (CHOL). The norm is 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 blood cholesterol content largely depends on age, so for an infant the upper limit of the norm is 5.25 mmol / l , and for a man over 70 – 6.86 mmol / l . Cholesterol is carried by couriers 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 the average limits of total cholesterol (5. 6 mmol / l) and its constituents are accepted, currently doctors use tables of norms in accordance with gender and age.

HDL cholesterol (HDL). The norm is 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, and brain, and carry it to the liver.This means that HDL plays an important antiatherogenic role, preventing the formation of cholesterol plaques and the development of atherosclerosis. And if the level of total cholesterol is increased due to HDL cholesterol, this is considered a good prognostic factor, and you should not lower cholesterol. At the same time, a decrease in the level of “good” cholesterol below 0.90 mmol / L for men and 1.15 mmol / L for women is considered a risk factor for atherosclerosis.

LDL Cholesterol (LDL). The norm is 1.71-3.5 mmol / l

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

Cholesterol-VLDL (VLDL). The norm is 0.26-1.04 mmol / l

These lipoproteins are synthesized in the liver and small intestine and serve as precursors of LDL, that is, they 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. The maximum values ​​of the norm are 3.2 for women and 3.5 for men. Everything above indicates a significant risk of atherosclerosis and requires measures to reduce it, which can be both non-drug (changing diet, losing weight, quitting smoking, combating physical inactivity, taking various dietary supplements) and medication (taking medications from various groups, mainly statins).

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If you have high cholesterol – CITY HOSPITAL № 12 BARNAUL

What is cholesterol?

We often hear from TV screens, doctors and acquaintances that the consumption of foods containing cholesterol should be reduced. This is often objected that, they say, in fact, cholesterol is not terrible for the human body.Moreover, the cells of the body, especially the liver, produce it themselves, so cholesterol from food cannot harm us.

So bad or good is cholesterol and is it worth fighting with?

Cholesterol is a fat-like substance that is really vital for a person. Cholesterol is part of the membranes-membranes of all cells of the body, there is a lot of it in the nervous tissue, cholesterol is necessary for the formation of many hormones.

But! The body itself produces cholesterol in quantities more than sufficient to meet its own needs.However, a person also receives cholesterol from food. When cholesterol in the body, first of all, in the blood of a person becomes too much, then from a friend he turns into a mortal enemy.

How does cholesterol work when there is too much of it?

Excess cholesterol accumulates in the walls of blood vessels. Around these deposits, connective tissue or, in other words, scar tissue grows, calcium deposits are formed. This is how an atherosclerotic plaque is formed. It narrows the lumen of the vessel, reduces blood flow, and the addition of a blood clot leads to its blockage.

When a vessel is blocked, the blood flow stops, and the tissue of the organ that fed this vessel gradually dies off without receiving oxygen and nutrients. If the blockage occurs in the heart, angina pectoris develops, and then myocardial infarction, if in the brain – cerebral stroke.

Sometimes the vessels of the legs are affected, then a person experiences unbearable pain and often loses the ability to move. The first bell, signaling the risk of developing these diseases, is high cholesterol.

Everyone over the age of 20 should know their cholesterol level. To do this, you just need to regularly – at least once every few years – do a blood test for the level of total cholesterol and its content in various transport forms – lipoproteins.

What do the numbers in the analysis mean?

In the blood test, you will see the level of cholesterol (cholesterol), as well as other numbers. The fact is that in human blood cholesterol is transported together with proteins, and such complexes are called lipoproteins.

Low density lipoproteins (LDL) and their very low density precursors (VLDL) are low in protein, large and high in cholesterol and fat triglycerides. Penetrating into the vessel wall, they transport excess cholesterol into the vascular cell. An increase in the level of these components in the blood leads to the early development of atherosclerosis.

High-density lipoproteins (HDL) – small in size, they contain a different protein than LDL. Penetrating into the vessel wall, they capture cholesterol and carry it to the liver.The lower the level of HDL, i.e. cholesterol in “good” complexes, the higher the risk of atherosclerosis.

Optimal levels of cholesterol and related parameters in the blood:

People who control their cholesterol have 30-40 percent fewer serious heart complications and 30 percent fewer deaths from any cause.

What to do if your blood cholesterol level is high?

The cholesterol content can be reduced. To do this, you need to improve your lifestyle. Be physically active, eat healthy, and quit smoking – it significantly increases the risk of atherosclerotic plaque formation.

First of all, it is necessary to reduce the consumption of solid animal fats, which simultaneously contain a lot of saturated fatty acids and cholesterol, there are a lot of them in butter, fatty dairy products, fatty cheeses, baked goods, fatty meat.

Fats should make up about 30 percent of the total caloric intake of food, of which saturated – no more than 10 percent (1/3 of all fats), and 2/3 of fats should come from the consumption of vegetable oils, fish oil. By following the guidelines below, you can reduce your blood cholesterol levels by 10-12 percent.

The allowed number of eggs is two per week. But you will also receive them as part of salads and pastries.

Use foods with reduced fat and cholesterol content in your diet more often: first of all, low-fat dairy products.

Choose wholemeal bread, whole grain pasta, and water-cooked porridge. Eat more vegetables and fruits.

For meat products, choose chicken, turkey and veal. Remove fat from meat and skin from poultry before cooking.

Increase your fish consumption, especially sea fish. It is better if fish is present in your diet every day.

Choose desserts without fat, cream and a lot of sugar. Stop for fruit salads and savory jellies.

Consume more foods containing soluble fiber: oatmeal, apples, plums, berries, beans. They lower the level of cholesterol in the body and increase its excretion.

Consume recently introduced so-called “functional” foods containing plant sterols and stanols: they reduce the absorption of cholesterol in the intestine and reduce the “bad” form of LDL cholesterol by 10-15 percent.

Do not fry in oil: boil, simmer, bake. Use pans with a coating that does not require added fat for cooking.

What to do if the diet does not work?

If, after 6-8 weeks of the diet, your total blood cholesterol level is less than 5 percent lower and your risk of atherosclerosis is still high, your doctor may prescribe medications to lower your blood cholesterol levels.

Do not under any circumstances self-medicate and do not fall for advertising of “miraculous” nutritional supplements. Your doctor may only recommend one type of supplement – soluble fiber preparations.However, it is worth remembering that they only complement and enhance the effect of a properly formulated diet.

In Russia, no more than 5 percent of residents know their own blood cholesterol levels. For comparison: in the US and Europe, this figure is almost 80 percent.

Studies show that lowering cholesterol levels by an average of 10 percent leads to a 20-50 percent reduction in the risk and mortality of major cardiovascular diseases.

Cardiologists all over the world believe that everyone over 20 should know their cholesterol level.

Check Your Cholesterol Level!

Materials created specifically for health centers. Find out more about health centers and how they work in your area.

Get tested: Cholesterol | MedLab

Description of the analysis:

Cholesterol (total cholesterol) is a vital substance of the lipid class that is part of cell membranes and plays an important role in metabolism. The normal functioning of cells, the synthesis of sex hormones, the digestion of food are processes that cannot normally proceed without cholesterol.

In the blood, cholesterol cannot be independently transferred due to the fact that it is insoluble in water, therefore it is transported as part of lipoproteins – complexes of proteins and cholesterol.

There are several types of lipoproteins in the blood: very low density, low density and high density. A blood test for total cholesterol takes into account the level of all of them combined.

Indications for prescribing a blood test for cholesterol

Most often, the analysis is used to assess the risk of developing vascular and heart diseases, metabolic disorders and diseases of the gastrointestinal tract.

Indications for prescription in cardiology:

• hypertension;
• ischemic heart disease;
• myocardial infarction.

Indications for appointment in gastroenterology:

• cholestasis;
• hepatitis;
• cirrhosis of the liver;
• obesity;
• malabsorption of nutrients.

Indications for prescription in endocrinology:

• diabetes mellitus;
• hypothyroidism;
• hyperthyroidism.

Indications for appointment in oncology:

• prostate cancer;
• pancreatic cancer;
• cancer of the bones.

In addition, cholesterol levels can change with extensive burns, chronic obstructive pulmonary disease, acute infectious processes, alcoholism and kidney damage.

Norm of blood cholesterol

“Normal” cholesterol level can be called rather conditionally: so for people at risk of heart disease, a higher level of cholesterol is natural.In general, the reference values ​​for healthy people are 2.8-5.2 mmol / l. For pregnant women, it is possible to exceed these limits – this is a variant of the norm.

Causes of high or low cholesterol

An increase in blood cholesterol is caused by stagnation of bile, kidney failure, weakening of the thyroid gland, as well as obesity and alcoholism. A decrease in blood cholesterol levels occurs in severe liver diseases, over-active work of the thyroid gland, infections and some types of anemia.

Cholesterol levels can rise with the use of anabolic steroids, corticosteroids or androgens, and fall with colchicine, statins, estrogens, erythromycin and antifungal drugs.

Preparation for examination

For an accurate result it is important:

• to be tested in the morning and strictly on an empty stomach;
• , on the eve of the study, give up fatty foods and alcohol;
• do not smoke or exercise half an hour before donating blood;
• analysis is undesirable after operations, heart attacks, acute diseases – it is better to wait at least 6 weeks.

Material for research: venous blood.

Research method: end point.

Term of readiness of the result: 1 working day.

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Registration for analyzes

Analysis of total Cholesterol – Pass a blood test: price, preparation, decoding

Reference values ​​(standard variant):

In accordance with the following international recommendations:

2019 ESC / EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk.The Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and European Atherosclerosis Society (EAS).

Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents, 2012.

National Cholesterol Education Program. ATP III Guidelines At-A-Glance. Quick Desk Reference, 2002 Public Health Service National Institutes of Health National Heart, Lung, and Blood Institute.

Comments on the total cholesterol test ( Cholesterol ):

Values ​​for children and adolescents under 19 years of age: optimal – less than 4.4; borderline 4.4, – 5.15; high – more than 5.15 mmol / l.

Values ​​for adults: optimal – less than 5.2; borderline 5.2 – 6.19; high more than 6.2 mmol / l.

For different patients with different risk factors, the acceptable concentration of cholesterol is different, the interpretation should be carried out by the attending physician based on all available data.

At a total cholesterol level of 5.0 mmol / L or more, to assess the risk of atherosclerosis, it is necessary to study total cholesterol in combination with triglycerides, HDL-cholesterol and LDL-cholesterol and determine the atherogenic coefficient, as well as calculate the individual risk of cardiovascular complications by scale SCORE.

Example result:

Please note that risk calculation is not possible in persons under 40 years of age and / or systolic blood pressure less than 120 mm Hg and / or total cholesterol value less than 4 mmol / L.

We draw your attention to the fact that the interpretation of the research results, the establishment of the diagnosis, as well as the appointment of treatment, in accordance with Federal Law No. 323-FZ “On the Fundamentals of Health Protection of Citizens in the Russian Federation” dated November 21, 2011, must be performed by a doctor of the appropriate specialization.

90,000 Determination of blood cholesterol level by the express method in Tyumen

The main indicator of the level of fat metabolism in the human body is the level of cholesterol in the blood. It is the increased level of cholesterol that sharply increases the risk of ischemic damage to the cardiovascular system.In addition, a violation of lipid balance in humans leads to the development of atherosclerosis – the source of many, unfortunately, fatal diseases. A blood test for cholesterol allows you to avoid unpleasant consequences and promptly correct the patient’s metabolism.

What are the basic prerequisites for donating blood for cholesterol?

Experts identify several main indications for determining the level of cholesterol in the blood by the express method. These indications include:

• pathology of the human endocrine system;
• liver diseases;
• risk of transient ischemic attack;
• kidney disease;
• the need to predict the risks of coronary artery disease and atherosclerosis.

It must be remembered that it is very convenient to donate blood for cholesterol by the express method. There is no need to wait for the tests to come from the biochemistry laboratory. This allows you to minimize the risks of the onset and development of those diseases that were listed above.

How to properly prepare for the determination of cholesterol by the express method

In order to correctly assess the level of cholesterol in the blood, it is necessary to prepare for the delivery of the analysis by the express method.In addition to the fact that proper preparation is important for the rapid method for determining blood cholesterol, these rules apply to other biochemical analyzes.

So, how do you prepare for how to determine blood cholesterol:

• the intake of various (even the lightest) alcoholic beverages is prohibited. The ban applies to a period of up to 2 days before the start of the analysis;
• , the analysis for cholesterol is taken strictly on an empty stomach.

If these rules are not followed, the blood test results will not correspond to the actual state of affairs in the body.

Get tested for cholesterol and keep healthy

Human life and health is the most valuable thing in the world. Having passed the analysis for cholesterol by the express method, you can significantly reduce the risk of life-threatening diseases. Just one test can help keep a person healthy.

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90,000 Total cholesterol, cholesterol for 1 day with up to 50% discount at Lab4U

Interpretation of research results
“Total cholesterol”

Interpretation of test results is for informational purposes only, is not a diagnosis and is not
replaces the advice of a doctor.Reference values ​​may differ from those indicated in
depending on the equipment used, the actual values ​​will be indicated on the form
results.

European Guidelines on Cardiovascular Disease Prevention,
2007) (target): cholesterol for practically healthy – <5.18 mmol / l; for persons with risk factors for cardiovascular diseases - <5.0 mmol / l; for patients with cardiovascular diseases - <4.5 mmol / l.

Unit of measure: mmol / l

Reference values:

Promotion:

Primary hyperlipoproteinemia:

• Familial or polygenic hyperlipoproteinemia (type IIA, IIB).
• Familial dysbetalipoproteinemia (type III).
• Familial combined hyperlipidemia.
• Hyperlipoproteinemia types I, IV, V.
• Hyper-alpha lipoproteinemia.

Secondary hyperlipoproteinemia:

• Liver diseases (intra- and extrahepatic cholestasis).
• Kidney disease (glomerulonephritis, nephrotic syndrome, chronic renal failure).
• Malignant tumors of the pancreas and prostate.
• Hypothyroidism.
• Gout.
• Ischemic heart disease.
• Diabetes mellitus.
• Pregnancy.
• Alcoholism.
• Isolated growth hormone deficiency.
• Foods rich in cholesterol and unsaturated fatty acids.

Decrease:

• Cachexia, fasting.
• Malabsorption syndrome.
• Major burns.
• Severe acute diseases and infections.
• Necrosis of hepatocytes (end stage liver cirrhosis, hepatocarcinoma).
• Sepsis.
• Hyperthyroidism.
• Hypo-α – and β-lipoproteinemia.
• Megaloblastic anemia.
• Thalassemia.
• Chronic obstructive pulmonary disease.
• Rheumatoid arthritis.
• Intestinal lymphoangiectasia.
• Taking drugs that lower cholesterol levels.
• Foods with low cholesterol content.

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