The human body needs fats – both vegetable and fatty – for normal, effective functioning. Cholesterol (chol) is an organic compound - a lipophilic alcohol, which is produced by liver cells (up to 80%), the rest is taken by the body from incoming food. Since we are dealing with alcohol, then correct name this substance according to chemical classification nevertheless, “cholesterol”, it is more often found in more scientific literature and articles.

Cholesterol is the builder of our cells; it takes an active part in strengthening cell membranes and also contributes to the creation of many important hormones. They are very important for the brain, cholesterol also supplies all tissues of our body with antioxidants.

Is cholesterol really that bad?

Probably everyone has heard the expression “high cholesterol levels in the blood.” According to statistics, more than half of all deaths occurring due to heart problems were caused by a high lipid limit of one of its compounds. Cholesterol is insoluble in water, so to move it around human body, it surrounds itself with a shell of proteins - apolipoproteins. Such complex compounds are called lipoproteins. They circulate through the body's blood in several types of cholesterol:

1. VLDL cholesterol (very low density lipoproteins) - from which the liver forms LDL;
2. IDL (intermediate density lipoproteins) – there is a very small amount of them, this is a product of the production of VLDL;
3. LDL (low density lipoprotein);
4. HDL (lipoproteins high density).

They differ in the number of components included in the composition. The most aggressive of these lipoproteins is the LDL compound. When the HDL level drops sharply and LDL is elevated, very dangerous situations for the heart arise. In such cases blood arteries may begin to harden, giving impetus to the development of atherosclerosis.

More about LDL and HDL

The function of LDL (ldl) (called “bad” lipid composition) is to take cholesterol from the liver, which creates it, and transport it through the arteries. There the lipid is deposited in plaques on the walls. This is where the “good” lipid component of HDL comes into play. It takes cholesterol from the walls of the arteries and carries it throughout the body. But sometimes this LDL undergoes oxidation.

The body reacts - the production of antibodies that react to oxidized LDL. HDL cholesterol works to prevent LDL from oxidizing, it removes excess cholesterol from the walls and returns it back to the liver. But the body secretes so many antibodies that it begins inflammatory processes and PAP can no longer cope with the job. As a result, the lining of the arteries is damaged.

Cholesterol control

To do this, a blood test for chol (lipid profile) is done. A blood test is taken from a vein early in the morning. The analysis requires preparation:

• you cannot eat food for 12 hours before donation;
• for two weeks do not eat too fatty foods;
• refrain from physical activity for about a week;
• half an hour before the test, forget about cigarettes and don’t smoke.

Analysis of cholesterol levels in the blood is carried out using rather labor-intensive methods of photometry and sedimentation. These methods are the most accurate and sensitive. A lipidogram is an analysis of the following lipoproteins in the blood:

1. Total cholesterol;
2. HDL cholesterol (or alpha cholesterol) – it reduces the possibility of atherosclerosis;
3. LDL cholesterol (or beta cholesterol) – if it is elevated, the risk of disease increases;
4. Triglycerides (TG) are transport forms of fats. If their norm is exceeded, in high concentration- This is a signal about the onset of the disease.

In addition to atherosclerosis, high level cholesterol can also provoke a number of other diseases associated with the heart and musculoskeletal tissue.

Osteoporosis

An increased level of lymphocytes stimulates the formation of a substance that begins to destroy bones. Their activity awakens oxidized lipoproteins, the action of which leads to an increase in lymphocytes. Elevated lymphocytes begin to actively produce substances that lead to a decrease in bone density.

An increase in lymphocytes gives impetus to the development of osteoporosis. This is another reason to carefully monitor that the cholesterol level in the blood does not exceed permissible level. A lipidogram is recommended to be done once every five years for all adults over the age of 20. If a person follows a fat-restricted diet or takes medicines, which make the cholesterol level in the blood low, such an analysis is carried out several times annually.

Hypercholesterolemia

When blood cholesterol is elevated, the condition is called hypercholesterolemia. It helps to make such a diagnosis by deciphering the data when analyzing the lipid profile.

Index	Norm	Increased risk of developing atherosclerosis	The disease already exists
Total cholesterol	3.1-5.2 mmol/l	5.2-6.3 mmol/l	up to 6.3 mmol/l
HDL Women	more than 1.42 mmol/l	0.9-1.4 mmol/l	up to 0.9 mmol/l
HDL Men	more than 1.68 mmol/l	1.16-1.68 mmol/l	up to 1.16 mmol/l
LDL	less than 3.9 mmol/l	4.0-4.9 mmol/l	more than 4.9 mmol/l
Triglycerides	0.14-1.82 mmol/l	1.9-2.2 mmol/l	more than 2.29 mmol/l
Atherogenic coefficient	depends on age

Atherogenic coefficient (AC) is the ratio of HDL and LDL in the blood. To calculate it correctly, subtract HDL cholesterol from total cholesterol. Divide the resulting figure by the HDL value. If:

• KA less than 3 is the norm;
• KA from 3 to 5 – high level;
• KA more than 5 – greatly increased.

The norm of KA in women can vary differently. Affect cholesterol in women different reasons. For a low density indicator, the analysis requires a small age of women. But for very elderly women with heart disease, if the level of KA is elevated, this is the norm. Also, these density indicators depend on menopause, age, hormonal levels women.

Atherogenicity coefficient in women

Age (years)	Norm for women
16-20	3,08-5,18
21-25	3,16-5,59
26-30	3,32-5,785
31-35	3,37-5,96
36-40	3,91-6,94
41-45	3,81-6,53
46-50	3,94-6,86
51-55	4,20-7,38
56-60	4,45-7,77
61-65	4,45-7,69
66-70	4,43-7,85
71 and older	4,48-7,25

Is analysis always correct?

There are reasons why the spectrum of lipoprotein parameters may fluctuate regardless of the development of atherosclerosis.

If LDL levels are elevated, the culprits may include:

• eating food with animal fats;
• cholestasis;
• chronic kidney inflammation;
• hypothyroidism;
• diabetes;
• stones in the pancreas;
• long-term use of anabolic steroids, corticosteroids, androgens.

LDL cholesterol levels can change for no reason at all (biological variations). Therefore, this indicator may be falsely increased. In this case, the lipoprotein analysis must be repeated after 1–3 months.

Cholesterol treatment

If cholesterol is very high, use the traditional spectrum medicinal methods. Treatment of cholesterol is carried out with the following drugs:

• Statins (Mevacor, Zocor, Lipitor, Lipramar, Crestor, etc.). Treatment with statins increases production special enzymes, which regulate the level of cholesterol in the blood, helping to reduce it by 50–60%;
• Fibrates (fenofibrate, gemfibrozil, clofibrate). Treatment with fibrates at a low HDL limit accelerates the activity of fatty acid metabolism;
• Sequestrants (cholestipol, cholestane). This treatment helps reduce cholesterol synthesis. If it is lowered, it is easier for it to bind to bile acid, which further reduces LDL levels;
• A nicotinic acid. With a high level of nicotinic acid in the body, a kind of competition occurs between the chemical processes of the liver. Treatment with nicotinic acid helps normalize cholesterol (it is lowered).

Drug treatment begins only with very high cholesterol levels! Only in cases where traditional prevention does not bring desired result. The dosage is determined by the doctor individually for each patient. You cannot self-medicate!

Lipoproteins (lipoproteins) of high and low density in the blood: what is it, normal, increase

Lipoproteins are complex protein-lipid complexes that are part of all living organisms and are necessary integral part cellular structures. Lipoproteins perform a transport function. Their content in the blood is an important diagnostic test, signaling the degree of development of diseases of the body systems.

This is a class of complex molecules that can simultaneously contain free, fatty acid, neutral fats, phospholipids and in various quantitative ratios.

Lipoproteins deliver lipids to various fabrics and organs. They consist of non-polar fats located in the central part of the molecule - the core, which is surrounded by a shell formed from polar lipids and apoproteins. This structure of lipoproteins explains their amphiphilic properties: simultaneous hydrophilicity and hydrophobicity of the substance.

Functions and meaning

Lipids play important role in the human body. They are found in all cells and tissues and participate in many metabolic processes.

lipoprotein structure

• Lipoproteins are the main transport form of lipids in the body. Since lipids are insoluble compounds, they cannot independently fulfill their purpose. Lipids bind in the blood to proteins - apoproteins, become soluble and form a new substance called lipoprotein or lipoprotein. These two names are equivalent, abbreviated as LP.

Lipoproteins occupy a key position in the transport and metabolism of lipids. Chylomicrons transport fats that enter the body with food, VLDL deliver endogenous triglycerides to the site of disposal, cholesterol enters cells with the help of LDL, HDL has anti-atherogenic properties.

• Lipoproteins increase the permeability of cell membranes.
• LPs, the protein part of which is represented by globulins, stimulate the immune system, activate the blood coagulation system and deliver iron to the tissues.

Classification

Blood plasma lipids are classified by density(using the ultracentrifugation method). The more lipids a drug molecule contains, the lower their density. There are VLDL, LDL, HDL, and chylomicrons. This is the most accurate of all existing classifications A drug that was developed and proven using a precise and rather painstaking method - ultracentrifugation.

The size of the LP is also heterogeneous. The largest molecules are chylomicrons, and then in decreasing size - VLDL, LPSP, LDL, HDL.

Electrophoretic classification LP is very popular among clinicians. Using electrophoresis, the following classes of lipid were identified: chylomicrons, pre-beta lipoproteins, beta lipoproteins, alpha lipoproteins. This method based on introduction into a liquid medium active substance using galvanic current.

Fractionation LPs are carried out to determine their concentration in the blood plasma. VLDL and LDL are precipitated with heparin, and HDL remains in the supernatant.

Kinds

Currently there are the following types lipoproteins:

HDL (high density lipoprotein)

HDL transports cholesterol from body tissues to the liver.

1. An increase in HDL in the blood is observed in obesity, fatty hepatosis and biliary cirrhosis of the liver, alcohol intoxication.
2. A decrease in HDL occurs when hereditary disease Tangier, caused by the accumulation of cholesterol in tissues. In most other cases, a decrease in the concentration of HDL in the blood is a sign.

The HDL level differs between men and women. In males, the LP value of this class ranges from 0.78 to 1.81 mmol/l, the norm in women for HDL is from 0.78 to 2.20, depending on age.

LDL (low density lipoprotein)

LDLs are carriers of endogenous cholesterol, triglycerides and phospholipids from the liver to tissues.

This class of drugs contains up to 45% cholesterol and is its transport form in blood. LDL is formed in the blood as a result of the action of the enzyme lipoprotein lipase on VLDL. When there is an excess of it, they appear on the walls of blood vessels.

Normally, the amount of LDL is 1.3-3.5 mmol/l.

• The level of LDL in the blood increases with hypofunction thyroid gland, nephrotic syndrome.
• A reduced level of LDL is observed with inflammation of the pancreas, hepatic-renal pathology, acute infectious processes, pregnancy.

infographics (click to enlarge) - cholesterol and LP, role in the body and norms

VLDL (very low density lipoprotein)

VLDL is formed in the liver. They transport endogenous lipids, synthesized in the liver from carbohydrates, to tissues.

These are the largest LPs, second in size only to chylomicrons. They are more than half triglycerides and contain small amounts of cholesterol. When there is an excess of VLDL, the blood becomes cloudy and takes on a milky tint.

VLDL is a source of “bad” cholesterol, from which plaques form on the vascular endothelium. Gradually, the plaques increase, accompanied by the risk of acute ischemia. VLDL is elevated in patients with kidney disease.

Chylomicrons

Chylomicrons are absent in the blood of healthy person And appear only when lipid metabolism is disturbed. Chylomicrons are synthesized in epithelial cells of the mucous membrane small intestine. They deliver exogenous fat from the intestines to peripheral tissues and liver. Most of the transported fats are triglycerides, as well as phospholipids and cholesterol. In the liver, under the influence of enzymes, triglycerides break down and fatty acids are formed, some of which are transported to the muscles and adipose tissue, and the other part binds to blood albumin.

what do major lipoproteins look like?

LDL and VLDL are highly atherogenic- containing a lot of cholesterol. They penetrate the artery wall and accumulate there. When metabolism is disrupted, LDL and cholesterol levels rise sharply.

HDL are the safest against atherosclerosis. Lipoproteins of this class remove cholesterol from cells and promote its entry into the liver. From there, it enters the intestines along with bile and leaves the body.

Representatives of all other classes of drugs deliver cholesterol into cells. Cholesterol is a lipoprotein that is part of the cell wall. It is involved in the formation of sex hormones, the process of bile formation, and the synthesis of vitamin D, necessary for the absorption of calcium. Endogenous cholesterol is synthesized in liver tissue, adrenal cells, intestinal walls and even in the skin. Exogenous cholesterol enters the body along with animal products.

Dyslipoproteinemia is a diagnosis for disorders of lipoprotein metabolism

Dyslipoproteinemia develops when two processes are disrupted in the human body: the formation of lipoproteins and the rate of their elimination from the blood. N An imbalance in the ratio of lipoproteins in the blood is not a pathology, but a development factor chronic disease, in which the arterial walls become denser, their lumen narrows and the blood supply is disrupted internal organs.

With an increase in blood cholesterol levels and a decrease in HDL levels, atherosclerosis develops, leading to development of deadly diseases.

Etiology

Primary dyslipoproteinemia is genetically determined.

Reasons secondary dyslipoproteinemias are:

1. Physical inactivity,
2. Diabetes,
3. Alcoholism,
4. Kidney dysfunction
5. Hypothyroidism,
6. Hepatic-renal failure,
7. Long-term use of certain medications.

The concept of dislipoproteinemia includes 3 processes - hyperlipoproteinemia, hypolipoproteinemia, alipoproteinemia. Dyslipoproteinemia is quite common: every second inhabitant of the planet experiences similar changes in the blood.

Hyperlipoproteinemia - increased content LP in the blood due to exogenous and endogenous reasons. The secondary form of hyperlipoproteinemia develops against the background of the underlying pathology. At autoimmune diseases LPs are perceived by the body as antigens to which antibodies are produced. As a result, antigen-antibody complexes are formed, which are more atherogenic than the drugs themselves.

Alipoproteinemia is a genetically determined disease with an autosomal dominant type of inheritance. The disease is manifested by enlarged tonsils with an orange coating, hepatosplenomegaly, lymphadenitis, muscle weakness, decreased reflexes, hyposensitivity.

Hypolipoproteinemia — low levels of LP in the blood, often asymptomatic. The causes of the disease are:

1. Heredity,
2. Poor nutrition
3. Passive lifestyle,
4. Alcoholism,
5. Pathology of the digestive system,
6. Endocrinopathy.

Dyslipoproteinemias are: organ or regulatory , toxigenic, basal - study of the level of LP on an empty stomach, induced - study of the level of LP after eating, medications or physical activity.

Diagnostics

It is known that excess cholesterol is very harmful for the human body. But a lack of this substance can lead to dysfunction of organs and systems. The problem lies in hereditary predisposition, as well as in lifestyle and dietary habits.

Diagnosis of dyslipoproteinemia is based on medical history, patient complaints, clinical signs- presence of xanthoma, xanthelasma, lipoid arch of the cornea.

The main diagnostic method for dyslipoproteinemia is a blood lipid test. The atherogenicity coefficient and the main indicators of the lipid profile - triglycerides, total cholesterol, HDL, LDL - are determined.

Lipidogram - method laboratory diagnostics, which identifies lipid metabolism disorders leading to the development of heart and vascular diseases. A lipidogram allows the doctor to assess the patient’s condition, determine the risk of developing atherosclerosis of the coronary, cerebral, renal and hepatic vessels, as well as diseases of the internal organs. Blood is donated to the laboratory strictly on an empty stomach, at least 12 hours after the last meal. One day before the test, alcohol intake is excluded, and smoking is excluded an hour before the test. On the eve of the analysis, it is advisable to avoid stress and emotional overstrain.

Enzymatic research method venous blood is fundamental for the determination of lipids. The device fixes pre-painted special reagents samples. The diagnostic method allows you to conduct mass examinations and obtain accurate results.

Take tests to determine lipid spectrum With for preventive purposes, starting from adolescence, it is necessary once every 5 years. Persons over 40 years of age should do this annually. Blood tests are carried out in almost every district clinic. Patients suffering from hypertension, obesity, heart, liver and kidney diseases are also prescribed a lipid profile. Compounded heredity, existing risk factors, monitoring the effectiveness of treatment - indications for prescribing a lipid profile.

The results of the study may be unreliable after eating the day before, smoking, stress, acute infection, during pregnancy, taking certain medications.

Diagnosis and treatment of pathology is carried out by an endocrinologist, cardiologist, therapist, doctor general practice, family doctor.

Treatment

plays a huge role in the treatment of dyslipoproteinemia. Patients are advised to limit the consumption of animal fats or replace them with synthetic ones, and eat up to 5 times a day in small portions. The diet must be enriched with vitamins and dietary fiber. You should avoid fatty and fried foods and replace meat sea ​​fish, eat a lot of vegetables and fruits. General restorative therapy and sufficient physical activity improve general state sick.

Figure: useful and harmful “diets” from the point of view of drug balance

Lipid-lowering therapy and antihyperlipoproteinemic drugs are intended to correct dyslipoproteinemia. They are aimed at reducing cholesterol and LDL levels in the blood, as well as increasing HDL levels.

Among the drugs for the treatment of hyperlipoproteinemia, patients are prescribed:

• – “Lovastatin”, “Fluvastatin”, “Mevacor”, “Zocor”, “Lipitor”. This group of drugs reduces the production of cholesterol by the liver, reduces the amount of intracellular cholesterol, destroys lipids and has an anti-inflammatory effect.
• Sequestrants reduce cholesterol synthesis and remove it from the body - Cholestyramine, Colestipol, Cholestipol, Cholestan.
• I reduce the level of triglycerides and increase the level of HDL - “Fenofibrate”, “Ciprofibrate”.
• B vitamins.

Hyperlipoproteinemia requires treatment with lipid-lowering drugs "Cholesteramine", " Nicotinic acid", "Miskleron", "Clofibrate".

Treatment of the secondary form of dyslipoproteinemia consists of eliminating the underlying disease. Patients with diabetes are advised to change their lifestyle, regularly take antihyperglycemic drugs, as well as statins and fibrates. IN severe cases insulin therapy is required. In case of hypothyroidism, it is necessary to normalize the function of the thyroid gland. For this purpose, patients undergo hormone replacement therapy.

Patients suffering from dyslipoproteinemia are recommended after the main treatment:

1. Normalize body weight,
2. Dose physical activity
3. Limit or eliminate alcohol consumption,
4. If possible, avoid stress and conflict situations,
5. Stop smoking.

Video: lipoproteins and cholesterol - myths and reality

Video: lipoproteins in blood tests - “Live Healthy!” program

There is an opinion that cholesterol in the human body is quite harmful substance. Many information sources advise constantly reducing this indicator in the human body. It is worth immediately noting that this opinion is erroneous, since it is cholesterol that is involved in many processes of the life of human cells.

LDL is considered atherogenic, and HDL is antiatherogenic

People around us believe that there are two types of cholesterol – “good” and “bad” and when there is a strong excess of it in the body, it is deposited on the vascular walls and leads to disastrous consequences. Let's take a closer look at what a lipid profile is and what level of cholesterol is not only safe, but also necessary for the healthy functioning of the body. And also what laboratory test is used to determine this indicator in the blood and its interpretation.

Cholesterol – what is it?

Cholesterol is a steroid or a substance of high biological activity. It is produced to a greater extent in human liver cells, up to approximately 50%, about 20% is synthesized by the intestines. All other cholesterol is synthesized by the adrenal glands, skin and gonads. And only up to 500 mg of cholesterol per day comes from food.

Cholesterol also has a number of functions. The most basic of them are the strengthening of the cell wall, the production of bile acid and the synthesis of steroid hormones.

LDL is the so-called “bad”, in fact, this concept does not exist in medical vocabulary, it is more of a common name for low-density lipoprotein. But it is bad because when it is in excess and oxidized, it actually settles on inner wall vessel, closing its lumen. Therefore, it is imperative to monitor this indicator, especially if total cholesterol in the blood is elevated.

HDL can be lowered for a number of reasons, e.g. poor nutrition or bad habits.

Lipoproteins vary in size, density and lipid content

HDL is considered “good” in everyday life. Differs from low-density lipoprotein in its structure and functional features. His main function is purification vascular wall from LDL. With a sufficiently high level of HDL or its normal level, people are less susceptible to atherosclerotic diseases. If the HDL blood test reveals a significant decrease in them, then atherosclerosis is presumably diagnosed and prescribed additional research to confirm the diagnosis.

Lipid profile

This is a special biochemical blood test. The study involves breaking down lipids (fats) into their individual components. Using this analysis, you can monitor indicators and promptly contact specialized medical care for any pathological abnormalities. This biochemical analysis includes:

1. Total cholesterol or cholesterol is one of the main indicators of the state of fat balance in the human body. Produced in liver cells.
2. HDL (high-density lipoprotein) - delivers cholesterol to the liver from the vascular wall when it is in excess.
3. LDL (low-density lipoprotein) is a carrier of cholesterol from the liver to the arteries; when in excess, it settles on the vascular wall.
4. TG (triglycerides) are neutral lipids.

Even when this study The atherogenic coefficient (AC) is calculated and determines the predisposition to atherosclerosis. This is called the ratio between HDL and LDL.

Indications for analysis

For some vascular diseases the level of LDL in the blood increases significantly, this may indicate atherosclerosis and concomitant diseases. Most likely, total cholesterol will also be increased. And the HDL indicator, which is responsible for the process of converting cholesterol into bile and removing cholesterol plaques from the walls of blood vessels, drops significantly in the blood.

A lipid profile is often prescribed when a risk of coronary heart disease is suspected.

A blood test for a lipid profile is prescribed to people who belong to the “risk group” and have some of the following diseases:

• ischemic disease hearts;
• liver and pancreas;
• chronic pancreatitis;
• obesity, foodborne;
• hyperthyroidism;
• alcoholism;
• myeloma;
• sepsis;
• gout.

The lipid profile is also prescribed for children, but also for certain diseases, for example, diabetes mellitus or with a hereditary predisposition to lipid metabolism disorders.

Interpretation of the analysis

Lipidogram allows you to detect lipid metabolism disorders

IN medical practice There are certain standards by which the lipid profile is assessed. It is also worth noting that blood biochemistry standards may vary slightly in different laboratories, this is due to the use of different kits and reagents for research. When deciphering the analysis, the weight and age of the patient are taken into account.

Index	Regulatory boundaries
Total cholesterol	3.2 – 5.5 mmol/l
HDL	> 0.9 mmol/l
LDL	1.7 – 3.5 mmol/l
TG	0.4 – 1.8 mmol/l

Decoding this laboratory research Only a doctor should deal with it; it is he who will be able to competently assess the situation and, if necessary, prescribe adequate and timely treatment. Also, the doctor must correlate the test result with individual characteristics the patient and his medical history. For example, a recent heart attack or taking medications.

What can cause an increase in LDL levels?

LDL can increase in some kidney and liver diseases due to an imbalance in HDL. Risk factors for increasing “bad” cholesterol include: smoking, alcohol abuse alcoholic drinks, overeating, insufficient physical activity or physical inactivity, bile stagnation. To reduce or maintain LDL, you need to resort to healthy image life and proper nutrition.

Preparing for analysis

Before donating blood for a lipid profile, you must abstain from eating for 12 hours

To obtain a correct and informative analysis result, a prerequisite on the part of the patient is preparation for it. Blood is drawn from a vein and must be taken on an empty stomach. You should stop eating 8 hours before the test, or better yet 12. Dinner should be very light and consist mainly of fiber; exclude fatty varieties meat, all types of sausages and smoked meats. Since this will lead to chyle in the blood serum and the analysis will be incorrect. You should also refrain from drinking coffee and alcohol the day before, and do not smoke at least two hours before donating blood. If applicable medications, then it is better not to take them before taking the test. And if this is undesirable, then be sure to warn your doctor about taking them.

What are the benefits of lipids?

Lipid metabolism is very important for the healthy functioning of the human body. The main function of metabolism is the breakdown, digestion and absorption of fats into intestinal tract. A very important fact is that lipids are actively involved in the synthesis of male and female hormones. Therefore, any imbalance in fat balance can lead to problems with reproductive system. At normal indicators lipid profile, the adrenal glands produce a sufficient amount of vitamin D. Also, if this indicator is impaired in the blood, a person’s immunity is significantly reduced.

During the state analysis process of cardio-vascular system a person is required to undergo a biochemical blood test, the parameters of which are examined HDL cholesterol. Let's try to figure out what HDL is, why it is called good cholesterol, and how it affects the human body?

Factions

Often, when it comes to cholesterol, people believe that this substance adversely affects the functioning of the body. We try to avoid foods containing cholesterol and refuse fatty foods. Therefore, a doctor’s advice that you should raise the level of alpha cholesterol in the body often causes bewilderment. And the whole point is that cholesterol itself is a very important substance, moreover, vital for the proper functioning of the body. In addition, it is divided into various factions, some of which are called “good” and others called “bad”. Although, without “bad” fractions, new cells will not form and function in our body.

Cholesterol is a fat produced mainly in the liver (and partly in the intestines), which forms cell membranes and ensures their functionality, participates in the synthesis of certain hormones and the metabolism of substances, especially fat-soluble vitamins. This substance plays a very important role in the processes of fat metabolism.

A small portion of cholesterol ends up in human body along with food.

Because in my own way chemical structure Since it belongs to alcohols, this substance should be called cholesterol. However, in Russian both versions of the name are considered correct.

Molecules that transport fats between blood cells are called lipoid proteins. These are complexes that include proteins and fats (lipids).

There are three types of such complexes:

• High-density lipoproteins, which help remove cholesterol from the body and reduce the risk of developing cardiovascular pathologies. For this reason, high-density lipoprotein cholesterol is considered “good.” These lipoproteins are sometimes called in English letters HDL, which is an abbreviation for high-density lipoproteins.
• Low-density lipoproteins that transport fats from the liver to the cells of other organs. With an excess of lipids of this type, cholesterol penetrates the walls of blood vessels, forming plaques and reducing their lumen, which increases the risk of developing vascular pathologies.
• Triglycerides, which form blood fats together with cholesterol. The body converts all excess calories into triglycerides, which accumulate in fat deposits. With a lack of nutrition, fats are broken down and triglycerides become a source of energy.

The transcript of the cholesterol test should show not only the content of each lipid fraction, but also total cholesterol in the blood.

Let's take a closer look at how high-density lipoproteins affect the body, and what pathologies a deviation from the norm may indicate.

HDL

High-density cholesterol, or alpha cholesterol as it is also called, ensures the cleansing of blood vessels from clogging plaques. High-density lipids capture excess cholesterol from low-density lipids and transport them from body cells to the liver, after which cholesterol is excreted from the body.

Therefore, the balance of these fractions must be clearly maintained in the body.

If cholesterol levels rise, then the level of good cholesterol should also be raised, otherwise a disease such as atherosclerosis, as well as various ischemic pathologies. Because in this case, the rate of movement of cholesterol through the vessels towards the liver decreases sharply, which is why it begins to settle on their walls. When the patency of the vascular bed decreases, the risk of thromboembolism, heart attack, stroke and other serious diseases increases.

Explanation of the relevant indicators in biochemical analysis blood, subject to the rules for donating biomaterial, can tell the doctor about the presence of such pathologies:

• acute form of infection;
• liver or kidney disease;
• diabetes mellitus;
• metabolic disorders, obesity, vitamin C deficiency;
• developing atherosclerosis;
• IBS().

Biochemistry must be carried out before planned operations, as well as when adjusting the diet, monitoring the effectiveness of therapy.

If tests show that HDL is low while it is high, then the doctor should find out the reasons for this condition. To clarify the diagnosis, a number of additional examinations are prescribed.

Norms

The normal level of HDL fraction in a blood test depends on the age and gender of the patient. Typically its concentration is significantly lower than the content of low-density lipids. The norm for women by age differs from men’s indicators.

For alpha cholesterol, the norm in women is higher than in the blood of men of the same age. In addition, with age, both total cholesterol and the HDL fraction in the body increase.

HDL cholesterol is normal in the blood of women by age:

If it is above normal, then the doctor must also determine the cause of this condition and take measures to lower the level of lipid proteins to the desired level.

The quantitative indicators of the lipid profile can be affected by various physiological factors. Thus, in women, low-density fats are increased during pregnancy and after menopause, this is explained by changes in female hormonal levels.

Deviations from the norm

The level of good protein can deviate from the norm either up or down. In each case there are some hidden reasons for this.

If HDL cholesterol is low, this condition can be caused by the following reasons:

• violation of fat metabolism;
• food allergies;
• liver diseases.

Low HDL cholesterol - what does this mean? A decrease in the level of VP lipoproteins below normal significantly increases the risk of developing vascular and cardiac pathologies. With this deviation, it is important to consume enough vitamin C.

Therefore, it is important to prescribe therapy in a timely manner that will increase this indicator.

Despite the fact that doctors most often try to increase good cholesterol in the blood, too high levels of HDL can also be a cause for concern, especially if the reasons for this increase in concentration are not established.

How to improve your lipid profile

To assess the patient's condition, the doctor prescribes a lipid profile. Research shows general indicator and quantitative values ​​of various lipids. What to do if the indicators deviate from the norm and how to increase good cholesterol to normal levels?

For those who do not know how to increase alpha cholesterol levels, doctors give the following recommendations:

• limit alcohol consumption as much as possible;
• give up nicotine addiction;
• correctly dose physical activity;
• review your diet, instead of fats and carbohydrates, switch to pectin, which reduces the amount bad cholesterol.

To prevent atherosclerosis, eat foods rich in vitamin C.

Balance of bad and good cholesterol

When assessing the analysis, the doctor must evaluate not only cholesterol indicators, but also their balance, expressed by the atherogenicity coefficient.

This indicator reflects the ratio of the amount of NP lipoproteins to VP lipoproteins. The higher the coefficient, the more the likelihood of developing hypertension, strokes and heart attacks, vascular damage.

Atherogenicity increases with intense physical activity, stressful situations and states of emotional uplift, since all this causes an increase in the amount of NP lipoproteins.

When analyzing the amount of good cholesterol, the doctor must conduct a comprehensive examination and analyze all related factors. This will allow timely identification of the risk of developing severe cardiovascular pathologies and prescribing effective treatment. A cholesterol test should be taken at least once a year. This will allow doctors to better monitor all changes occurring in the body and begin treatment in a timely manner if necessary.

In contact with

High-density lipoproteins are compounds consisting of lipids (fats) and proteins. They ensure the processing and removal of fats from the body, which is why they are called “good cholesterol”.

Synonyms Russian

HDL, high density lipoprotein, HDL, HDL cholesterol, alpha cholesterol.

SynonymsEnglish

HDL, HDL-C, HDL Cholesterol, High-density lipoprotein cholesterol, High-density lipoprotein, Alpha-Lipoprotein Cholesterol.

Research method

Colorimetric photometric method.

Units

mmol/l (millimoles per liter).

What biomaterial can be used for research?

Venous blood.

How to properly prepare for research?

• Do not eat for 12 hours before the test.
• Avoid physical and emotional stress and do not smoke for 30 minutes before the test.

General information about the study

Cholesterol (CH, cholesterol) – fat-like substance, vital necessary for the body. The correct scientific name for this substance is “cholesterol” (the ending -ol indicates that it belongs to alcohols), however, the name “cholesterol” has become widespread in the popular literature, which we will use later in this article. Cholesterol is formed in the liver and also enters the body with food, mainly meat and dairy products. Cholesterol is involved in the formation of cell membranes of all organs and tissues of the body. Hormones are created on the basis of cholesterol, which are involved in the growth, development of the body and the implementation of the reproduction function. Bile acids are formed from it, thanks to which fats are absorbed in the intestines.

Cholesterol is insoluble in water, so to move around the body it is “packed” into a protein shell consisting of special proteins - apolipoproteins. The resulting complex (cholesterol + apolipoprotein) is called lipoprotein. Several types of lipoproteins circulate in the blood, differing in the proportions of their components:

• very low density lipoproteins (VLDL),
• low density lipoproteins (LDL),
• high density lipoproteins (HDL).

High-density lipoproteins consist mainly of protein and contain some cholesterol. Their main function is to transport excess cholesterol back to the liver, from where it is excreted as bile acids. Therefore, HDL cholesterol (HDL-C) is also called “good cholesterol.” HDL makes up about 30% of the total cholesterol (cholesterol) in the blood.

If a person has hereditary predisposition to high cholesterol or he eats too many fatty foods, the level of cholesterol in the blood may increase so that the excess is not completely eliminated by high-density lipoproteins. It begins to be deposited in the walls of blood vessels in the form of plaques, which can limit the movement of blood through the vessel and also make the vessels more rigid (atherosclerosis), which significantly increases the risk of heart disease (coronary artery disease, heart attack) and stroke.

High levels of HDL cholesterol reduce the risk of developing plaques in blood vessels, as they help remove excess cholesterol from the body. Decrease in HDL cholesterol even with normal level total cholesterol and its fractions leads to the progression of atherosclerosis.

What is the research used for?

• To assess the risk of developing atherosclerosis and heart problems.
• To monitor the effectiveness of a low-fat diet.

When is the study scheduled?

• An HDL test is performed during routine preventive examinations or when total cholesterol is elevated as part of a lipid profile. It is recommended that all adults over 20 years old have a lipid profile at least once every 5 years. It may be prescribed more frequently (several times a year) if the patient is prescribed a diet limited in animal fats and/or is taking cholesterol-lowering medications. In these cases, it is checked whether the patient achieves the target level of HDL cholesterol and total cholesterol and, accordingly, whether his risk is reduced cardiovascular diseases.
• With existing risk factors for developing cardiovascular diseases:
  • smoking,
  • age (men over 45 years old, women over 55 years old),
  • promotion blood pressure(140/90 mmHg and above),
  • cases high cholesterol or cardiovascular diseases in other family members (heart attack or stroke in a close male relative under 55 years of age, a female relative under 65 years of age),
  • existing coronary heart disease, previous myocardial infarction or stroke,
  • diabetes,
  • excess body weight,
  • alcohol abuse,
  • reception large quantity foods containing animal fats,
  • low physical activity.
• If a child has a history of high cholesterol or heart disease in the family at a young age, then it is recommended that he take a cholesterol test for the first time between the ages of 2 and 10 years.

What do the results mean?

Reference values: 1.03 - 1.55 mmol/l.

The concept of “normal” is not entirely applicable to the level of HDL cholesterol. For different people With different numbers of risk factors, the HDL level will be different. To determine the risk of developing cardiovascular disease more accurately for a specific person, it is necessary to evaluate all predisposing factors.
In general, we can say that a reduced level of HDL predisposes to the development of atherosclerosis, and a sufficient or high level prevents this process.

In adults, HDL cholesterol, depending on the level, can be assessed as follows:

• less than 1.0 mmol/l in men and 1.3 mmol/l in women - a high risk of developing atherosclerosis and cardiovascular diseases, regardless of other risk factors,
• 1.0-1.3 mmol/l in men and 1.3-1.5 mmol/l in women - average risk development of atherosclerosis and cardiovascular diseases,
• 1.55 mmol/l and above – low risk of developing atherosclerosis and cardiovascular diseases; at the same time, the vessels are protected from negative influence excess cholesterol.

Causes reduced level HDL:

• heredity (Tangier disease),
• cholestasis - stagnation of bile, which can be caused by liver disease (hepatitis, cirrhosis) or gallstones,
• severe liver disease,
• untreated diabetes mellitus,
• chronic inflammation of the kidneys leading to nephrotic syndrome,
• chronic renal failure.