How to take a lipid metabolism test. Deviations of LDL and LPP. What is included in the blood lipid spectrum

Cholesterol is a lipoprotein, and in the human body it is present in the blood and in cell membranes. Blood cholesterol is represented by cholesterol esters, and in membranes - free cholesterol. Cholesterol is vital necessary substance, as it participates in the formation of bile, sex hormones, and imparts hardness to the cell membrane. The idea that cholesterol = harm is wrong. A lack of cholesterol is more dangerous for the body than its excess. However, an excess amount of cholesterol in the blood is a prerequisite for the development of such diseases as atherosclerosis. Therefore, the determination of cholesterol is a marker of the development of atherosclerosis.

How to take a blood test for cholesterol?

To determine the lipid profile, blood from a vein taken in the morning on an empty stomach is used. Preparation for the test is usual - abstaining from food for 6-8 hours, avoiding physical activity and heavy drinking. fatty foods. Determination of total cholesterol is carried out using a standardized method international method Abel or Ilka. Determination of fractions is carried out by sedimentation and photometry methods, which are quite labor-intensive, but accurate, specific and quite sensitive.

The author warns that the normal values ​​are averaged and may differ in each laboratory. The material in the article should be used as a reference and no attempts should be made to make a diagnosis or begin treatment on your own.

Lipidogram - what is it?
Today the concentration of the following blood lipoproteins is determined:

1. Total cholesterol
2. High-density lipoproteins (HDL or α-cholesterol),
3. Low-density lipoprotein (LDL beta cholesterol).
4. Triglycerides (TG)

The combination of these indicators (cholesterol, LDL, HDL, TG) is called lipid profile. More important diagnostic criterion the risk of developing atherosclerosis is an increase in the LDL fraction, which is called atherogenic, that is, contributing to the development of atherosclerosis.

HDL, on the contrary, are antiatherogenic fraction, as they reduce the risk of developing atherosclerosis.

Triglycerides are a transport form of fats, so their high levels in the blood also lead to the risk of developing atherosclerosis. All these indicators, taken together or separately, are used to diagnose atherosclerosis, coronary artery disease, and also to determine the risk group for the development of these diseases. Also used as treatment control.

Read more about coronary heart disease in the article: Angina pectoris

“Bad” and “good” cholesterol – what is it?

Let us examine in more detail the mechanism of action of cholesterol fractions. LDL is called “bad” cholesterol because it is what leads to the formation of atherosclerotic plaques on the walls of blood vessels, which interfere with blood flow. As a result, due to these plaques, deformation of the vessel occurs, its lumen narrows, and blood cannot pass freely to all organs, resulting in cardiovascular failure.

HDL, on the contrary, is “good” cholesterol, which removes atherosclerotic plaques from the walls of blood vessels. Therefore, it is more informative and correct to determine cholesterol fractions, and not just total cholesterol. After all, total cholesterol consists of all fractions. For example, the cholesterol concentration in two people is 6 mmol/l, but in one of them 4 mmol/l is HDL, and in the other the same 4 mmol/l is LDL. Of course, a person whose HDL concentration is higher can be calm, but a person who has a higher LDL concentration should take care of his health. This is the possible difference, with seemingly the same level of total cholesterol.

Lipid profile norms - cholesterol, LDL, HDL, triglycerides, atherogenicity coefficient

Let's look at the lipid profile indicators - total cholesterol, LDL, HDL, TG.
An increase in blood cholesterol levels is called hypercholesterolemia.

Hypercholesterolemia occurs as a result of an unbalanced diet in healthy people (excessive consumption of fatty foods - fatty meat, coconut, palm oil) or as a hereditary pathology.

Normal blood lipids

The atherogenic coefficient (AC) is also calculated, which is normally less than 3.

Atherogenic coefficient (AC)

CA shows the ratio of atherogenic and antiatherogenic fractions in the blood.

How to calculate CA?

It’s easy to do this simply by having the results of a lipid profile. It is necessary to divide the difference between total cholesterol and HDL by the HDL value.

Decoding the values ​​of the atherogenic coefficient

• If the CA of atherosclerosis is minimal.
• If KA is 3-4, then the content of atherogenic fractions is higher, then there is high degree the likelihood of developing atherosclerosis and coronary heart disease (CHD),
• If KA > 5 - indicates that a person has a high probability of atherosclerosis, which significantly increases the likelihood of vascular diseases of the heart, brain, limbs, kidneys

For detailed information about atherosclerosis, read the article: Atherosclerosis

In order to normalize fat metabolism, it is necessary to strive for the following blood parameters:

What do abnormal lipid profile indicators indicate?

Triglycerides

TG is also considered a risk factor for the development of atherosclerosis and coronary artery disease ( ischemic disease hearts). When the concentration of TG in the blood is more than 2.29 mmol/l we're talking about that the person is already sick with atherosclerosis or ischemic heart disease. When the blood TG concentration is in the range of 1.9-2.2 mmol/l (borderline values), it is said that the process is underway development of atherosclerosis and ischemic heart disease, but these diseases themselves have not yet fully developed. An increase in TG concentration is also observed in diabetes mellitus.

LDL

An LDL concentration above 4.9 mmol/l indicates that a person has atherosclerosis and coronary artery disease. If the LDL concentration is in the range of borderline values ​​of 4.0-4.9 mmol/l, then atherosclerosis and ischemic heart disease develop.

HDL

HDL in men is less than 1.16 mmol/l, and in women less than 0.9 mmol/l - a sign of atherosclerosis or ischemic heart disease. When HDL decreases to the borderline range (in women 0.9-1.40 mmol/l, in men 1.16-1.68 mmol/l), we can talk about the development of atherosclerosis and ischemic heart disease. An increase in HDL cholesterol indicates that the risk of developing coronary artery disease is minimal.

Read about the complication of atherosclerosis - stroke:

Often, doctors, in addition to standard examination methods, prescribe blood pressure lipid profile - what is it? Study or lipid profile – laboratory method diagnostics, which allows not only to identify the degree of current violations fat metabolism in the body, but also suggest the risk of developing pathology of the heart muscle, blood vessels, as well as other complications of atherosclerosis.

The diagnostic value of this laboratory analysis is extremely high: every year in the world the number of patients suffering from coronary heart diseases and cerebral circulatory disorders is growing. The cause of these diseases in 70-80% of cases is atherosclerosis, a multifactorial disorder of fat metabolism that provokes:

• deposition of cholesterol plaques on the internal intima of blood vessels;
• obstruction of normal blood flow;
• oxygen starvation of internal organs.

A lipid profile allows you to diagnose atherosclerosis or assess the risks of its development: we will look at what it is and what the cost of the procedure is below.

Who is the test prescribed for?

A blood lipidogram is an advanced examination method that allows you to obtain a detailed picture of lipid metabolism. Although some indicators of this diagnostic test can be considered as part of a biochemical blood test (for example, total cholesterol), only a specialized study can obtain a complete laboratory picture.

A lipid profile is prescribed for:

• increasing the level of lipoproteins determined biochemically;
• comprehensive examination of patients suffering from heart pathology, cerebral vessels, arterial hypertension;
• endocrine disorders;
• preventive examination of patients with an increased risk of developing myocardial infarction, cerebral stroke(for example, people with a family history of heart disease, men and women over 55 who smoke);
• examination of patients who have suffered an acute vascular accident;
• when prescribing lipid-lowering drugs;
• to monitor efficiency therapeutic measures in all patients suffering from atherosclerosis.

What is included in the blood lipid spectrum?

This analysis includes 6 indicators; let’s look at them in more detail.

• Total cholesterol. Cholesterol is a monohydric fatty alcohol, mostly synthesized in human body liver cells. Twenty percent of the substance can come from food. Cholesterol performs many biological functions important functions: is part of the bioplasmic membrane of every cell of the human body, ensures its permeability to ions, active ingredients intercellular fluid; makes the cell membrane stronger and more stable; participates in the production of mineralocorticosteroids, glucocorticosteroids, sex hormones by adrenal cells; protects erythrocytes (red blood cells) from the action of hemolytic poisons; is one of the components of bile synthesis. Since cholesterol is practically insoluble in water, it is transported in the blood by special carrier proteins - apolipoproteins. Depending on the density and saturation of apolipoproteins with fat molecules, several fractions of cholesterol are distinguished.
• HDL. (useful, “good” cholesterol) – the smallest fat particles, the size of which is only 8-11 nm (normal). Their main function– interaction with other lipoproteins and cells, collection of cholesterol, transporting it to the liver for further utilization. Thus, HDL “cleans” the walls of blood vessels from fatty deposits and ensures the prevention of atherosclerosis.
• LDL. (harmful, “bad” cholesterol) - large fatty particles measuring 18-26 nm, which are saturated with fatty alcohols, but poor in protein. They are transported throughout the body through the bloodstream and easily donate lipids to neighboring cells. LDL is the most atherogenic fraction of lipoproteins. They promote the formation of fatty plaques on inner wall vessels.
• VLDL. - another atherogenic class of cholesterol that transports fatty molecules to peripheral organs, provoking the deposition of lipids on the surface of the vascular wall. VLDL are large in size - their diameter reaches 30-80 nm. In addition, this class of lipoproteins is predominantly composed of triglycerides.
• Triglycerides. Triglycerides are organic substances that make up the main energy reserve of the cell. When taken in excess from food, triglycerides form a large amount of VLDL, the main atherogenic fraction of cholesterol. Large amounts of these substances are found in foods rich in animal fat: lard and fatty meat, butter, hard cheeses, egg yolk. Therefore, all patients suffering from atherosclerosis are recommended to observe plant-based diet, limiting the above dishes.
• The atherogenicity coefficient is a relative indicator that allows you to assess the risk of cardiac, vascular, cerebral complications atherosclerosis in a patient with dyslipidemia. The value is calculated using the formula: KA = (TC – HDL) / HDL. This determines the ratio of “bad” and “good” cholesterol fractions, which must be in constant balance to maintain a constant internal environment.

Tables of normal values ​​and risks

The lipidogram of a healthy person reflects a balanced ratio of all cholesterol fractions. The rate of analysis is presented in the table below.

Index	Norm (reference values), mmol/l
	Men	Women
Total cholesterol	3,22 – 5,66	3,22 – 5,66
HDL	0,71 – 1,76	0,84 – 2,27
LDL	2,22 – 4,82	1,97 – 4,54
VLDL	0,26 — 1,07	0,26 – 1,07
TG	0,39 – 1,76	0,39 – 1,76
Atherogenic coefficient	2,2 – 3,5	2,2 – 3,5

Also, depending on the lipid profile, the risk of developing atherosclerosis and its cardiovascular complications can be determined, so the interpretation of the analysis should be carried out by a specialist.

Risk	Lipid profile indicators, mmol/l
	Total cholesterol	HDL	LDL	TG	Atherogenic coefficient
Short	less than 5.0	above 1.30 in men, 1.55 in women	1,92-2,59	less than 1.70	2-2,5
Average	5,10 – 6,18	1.10-1.30 for men, 1.20 -1.50 for women	3,37 – 4,12	1,70-2,20	2,5-4
High	6,19 – 6,22	less than 1.10 in men, less than 1.20 in women	4,12-4,90	2,35 – 5,65	4-7
Very tall	above 6.23		above 4.90	above 5.65	above 7

Note! Because of the difference medical equipment used in laboratories, lipid profile standards may vary.

What do deviations from the norm indicate?

Total cholesterol is the main indicator of the blood test. It reflects the level of all lipoprotein fractions and is the first stage in diagnosing lipid metabolism disorders.

An increase in total cholesterol almost always indicates a high risk of developing cardiovascular diseases. It can be caused by:

• poor nutrition, use large quantity animal fats;
• physical inactivity, sedentary lifestyle;
• overweight;
• hereditary predisposition, cardiovascular diseases in blood relatives;
• smoking and alcohol abuse;
• old age: starting from the age of 20, due to a slowdown in metabolism, cholesterol levels begin to rise, reaching their maximum by 70-75 years;
• concomitant diseases: diabetes mellitus, decreased function thyroid gland.

Note! Pregnancy, as well as any acute infectious or inflammatory disease may cause an increase in cholesterol in the blood. To obtain reliable results, repeat the examination 2-3 months after birth or recovery.

A decrease in serum cholesterol concentration may indicate:

• hyperthyroidism;
• liver diseases accompanied by a violation of its synthetic activity, cirrhosis;
• fasting, strict vegetarian diet;
• malabsorption (malabsorption nutrients intestinal cells);
• malignant form of anemia;
• sepsis, generalized infection;
• rheumatoid arthritis;
• chronic obstructive pulmonary diseases.

Only a doctor can determine the cause and consequences of deviations in cholesterol levels from the norm during a comprehensive assessment of the patient’s condition.

HDL deviations

Decreased concentration good cholesterol Experts associate it with the risk of atherosclerotic problems. It has been proven that every 0.13 mmol/l deviation from the average increases the possibility of developing coronary heart problems and acute coronary insufficiency by 25%.

Reasons for decreased HDL:

• chronic pathology of the kidneys and liver;
• endocrine disorders, diabetes mellitus;
• acute infections caused by viruses and bacteria.

An increase in HDL levels is said to occur if it exceeds 2.2 mmol/l. Although high level“good” cholesterol protects blood vessels from the formation of atherosclerotic plaques; such changes in the lipid profile are not always assessed positively. Usually increase in HDL associated with hereditary genetic abnormalities of fat metabolism.

Deviations of LDL and VLDL

Doctors note a direct relationship between the increase in the concentration of LDL, VLDL and the risk of the formation of atherosclerotic plaques.

An increase in low molecular weight cholesterol fractions can be caused by:

1. hereditary predisposition: in the group of increased attention, persons whose blood relatives have suffered a heart attack, stroke or other acute vascular pathology under the age of 50;
2. diseases of the pancreas: pancreatitis, tumors, diabetes;
3. excessive consumption of animal fats in food;
4. obesity;
5. chronic renal failure;
6. metabolic disorders, gout;
7. hormonal changes, pregnancy.

Reducing the concentration of “bad” cholesterol is rare. With generally normal lipid profiles, this reduces the risk of developing atherosclerosis.

Triglyceride Abnormalities

A lack of HDL, the “good” cholesterol, leads to an increase in triglycerides. In addition, an increase in the concentration of the triglyceride fraction of fats occurs when:

• arterial hypertension, coronary heart disease, myocardial infarction;
• atherosclerosis;
• chronic kidney diseases;
• thrombosis of cerebral arteries;
• viral hepatitis B, C, liver cirrhosis;
• gout, other metabolic diseases;
• thalassemia, Down's disease;
• increased calcium levels in the blood;
• chronic pancreatitis, alcoholism.

Triglycerides have big influence on the process of formation of cholesterol plaques, the development of atherosclerosis.

A decrease in triglycerides is observed in: chronic obstructive pulmonary pathologies, cerebral infarction, hyperthyroidism, myasthenia gravis, burns, injuries, malnutrition.

Atherogenic coefficient

Since the atherogenicity coefficient is a relative value that evaluates the prognosis of the development of atherosclerosis and its complications, its determination is considered the most important. An increase in KA is observed with an imbalance of lipids in the body, associated with an increase in the concentration of “bad” cholesterol and a decrease in “good” cholesterol. The higher this indicator, the more likely the patient will have acute cardiovascular and cerebral problems.

Preparing for the examination

There is no special preparation for the examination. Experts advise following the following rules:

1. Since the analysis is lipid spectrum The test is taken strictly on an empty stomach, the last meal should be approximately 12 hours before blood sampling (minimum 8, maximum 14). Juices, tea, coffee are also considered food, so you will have to abstain from them too. If you are very thirsty, pure mineral water is allowed.
2. For reliable results, you should not go on a sudden diet: for two weeks before the examination, eat as usual. If you have a large feast on the eve of the test, reschedule your trip to the laboratory for 2-3 days.
3. Do not drink alcohol at least 24 hours before the test.
4. Since the level of fats in the blood is subject to fluctuations, it is advisable to donate blood for a lipid profile in the morning, from 8 to 10 o’clock.
5. Do not smoke an hour before blood collection.
6. If possible, exclude factors influencing the examination result: debilitating physical exercise, overwork, psycho-emotional experiences, stress.
7. Before taking blood, it is recommended to take a breath and sit quietly for 10-15 minutes.
8. You cannot donate blood after an R-examination, sigmoidoscopy, or physiotherapeutic procedures.
9. To control the treatment of atherosclerosis with the help of prescribed lipid-lowering drugs, there is no need to stop taking the pills.

For research, 2-5 ml is taken venous blood, which is centrifuged and sent to the laboratory for analysis. The result is usually ready within 24 hours. If atherosclerosis is diagnosed, experts advise patients to donate blood for a lipid profile. at least 1-2 times a year.

Thus, a lipid profile is a study that is advisable for all patients with atherosclerosis and other disorders of fat metabolism. Low invasiveness, painlessness, high efficiency and the ability to assess prognostic risks allow us to consider this laboratory analysis as the main method for diagnosing dyslipidemia in humans.

It comes in the form of insoluble organic compounds, which for successful transportation to organ tissues and further absorption must be combined with special proteins - lipoproteins. With normal fat metabolism in the body, the concentration and structure of fats and lipoproteins is at a level that prevents cholesterol from settling on the walls of blood vessels.

But some diseases and conditions of the body can significantly affect lipid metabolism, thereby creating a risk of developing cardiovascular diseases (CVD), in particular atherosclerosis, as well as its severe consequences: myocardial infarction, stroke, angina pectoris, coronary heart disease. To timely identify such pathologies and assess the risk of developing CVD, a blood test is performed for lipid profile.

What it is?

The lipid profile is called biochemical analysis blood, objectively reflecting the concentration of fats and lipoproteins in the test serum.

The main purpose of such biochemistry is to assess the state of fat metabolism in the patient’s body, identify the risk of developing CVD (atherosclerosis, heart attack), cerebrovascular disease (stroke), as well as to determine the risk of cardiac ischemia.

The indicators that determine the lipid profile include the following elements:

• total cholesterol is the main fat in the blood that enters the body from food taken or is synthesized by liver cells and some other organs. The amount of total cholesterol is one of the most informative indicators of the lipid profile and most significantly affects the risk of developing atherosclerosis;
• densities are the only antiatherogenic lipid fractions, i.e. one of the tasks of these compounds is to prevent the deposition of cholesterol on the vascular endothelium. Based on this, HDL is called “useful” lipids, which bind cholesterol and deliver it to the liver, from where it is safely removed from the body after recycling processes;
• – these are atherogenic fractions that can precipitate and form atherosclerotic plaques. However, the proportion of these compounds among all blood lipids is low;
• low density lipoproteins are also atherogenic fractions transport form, which are capable of decomposition, as a result of which cholesterol is deposited in sediment on vascular walls. In other words, LDL is “bad” cholesterol, and when elevated, it increases the risk of developing CVD;
• Triglycerides are neutral lipids that are the main source of energy in the body, which is why it is so important to maintain them at normal levels.

All lipid fractions are interconnected and as the concentration of some increases, the concentration of others decreases or increases proportionally. Thus, some diseases are characterized by a significant increase in the level of LDL and VLDL. This factor is reflected in the level of total cholesterol, which in turn increases, and cholesterol begins to settle on the walls of blood vessels in the form of atherosclerotic plaques. At the same time, the concentration of HDL, the lipid fractions that are responsible for converting cholesterol into bile, decreases significantly.

The canonical structure of the lipid profile also implies, which, based on the ratio of all indicators of the lipid profile, shows a real predisposition to the development of atherosclerosis, linking together the described pattern. To determine it, the HDL value is subtracted from the total cholesterol value, and the result is divided by HDL.

When detecting myocardial infarction in blood biochemistry, the lipid profile can also be determined C-reactive protein– connection indicating inflammatory process in organism.

In some cases, an extended blood test for lipid profile is performed. In this case, control is also carried out in relation to additional parameters:

• Lipoprotein (a) is a subclass of blood lipoproteins; it consists of protein and a fatty part, therefore, like others, it performs a transport function. In terms of lipid composition, it is as close as possible to LDL, therefore, with an increase in this indicator, the risk of developing atherosclerosis and ischemia significantly increases.
• Apolipoprotein A1 is a protein that is the main component of HDL, the “good” cholesterol. At its normal level, they are created optimal conditions to prevent cholesterol from settling on vascular walls.
• Apolipoprotein B is the main protein of LDL and VLDL, which is involved in the metabolism of cholesterol and reflects the real risks of developing atherosclerosis. Apolipoprotein B is considered the best marker for determining the possibility of atherosclerotic lesions coronary vessels, nourishing the heart.

Indications for prescribing analysis

A biochemical blood test to determine the lipid profile is recommended for patients under 35 years of age every 5 years; for older people, such monitoring should be included in the annual list of mandatory studies.

Lipid profile measurements are carried out for the following purposes:

1. To identify the risk of developing CVD.
2. To determine the hereditary risk of coronary heart disease.
3. To monitor over time the condition of patients with pathologies of lipid metabolism.
4. To control the therapy being carried out.

Indications for analysis of lipid profile indicators are heart and vascular diseases:

• atherosclerotic vascular lesions;
• angina pectoris;
• ischemia;
• heart attack;
• hypertension.

It is mandatory to measure these values ​​for the following diseases of the liver and pancreas:

• chronic liver failure;
• cirrhosis of the liver;
• Hepatitis B;
• jaundice (extrahepatic);
• pancreatitis in acute and chronic stages;
• malignant lesion of the pancreas.

Indications for a lipid profile study include kidney disease:

• chronic renal failure;
• nephrotic syndrome;
• glomerulonephritis.

Patients with blood diseases should also be examined:

• sepsis;
• myeloma;
• anemia.

Such a study may have other indications:

• prolonged or uncontrolled use of oral contraceptives by women;
• alcohol intoxication (in chronic form);
• burns;
• anorexia nervosa;
• obesity;
• Reye's syndrome;
• gout;
• systemic lupus erythematosus;
• pathologies of thyroid hormone production and some other endocrine diseases;
• diabetes.

When identifying specified pathologies or if they are suspected, a lipid profile test must be taken as soon as possible, observing all the requirements for preparing for this diagnostic procedure.

Preparing for analysis

Considering that most dietary lipids are completely absorbed 12 hours after a meal, at least 12, but no more than 14 hours should pass after the last snack - only if you donate blood during this period, the likelihood of getting a reliable result is maximum. The lipid profile test itself is taken in the morning on an empty stomach; you can only drink still water.

If possible, you should go laboratory diagnostics before the start of the medication course or at least 2 weeks after its completion. If it is impossible to completely stop taking medications for this period, the doctor sending for the study must note in the referral all medications that the patient is taking. Especially it concerns the following drugs: Mildronate, Aspirin, Niacin, Phenobarbital, Phenytoin and any corticosteroids. The combined intake of vitamins E and C can also have an effect on blood lipid levels.

Preparing for the analysis also means avoiding fatty foods and alcohol for 1-2 days, and not smoking 12 hours before. Dinner on the eve of blood donation should be light - vegetable soup or salad, porridge with skim milk. Physical activity and psycho-emotional stress can lower or, conversely, increase some lipid profile indicators. Therefore, it is worth limiting yourself as much as possible from these factors at least a day before diagnosis.

You cannot donate blood for testing on the day of testing. following procedures and diagnostic measures:

• fluorography;
• radiography;
• rectal examination;
• physiotherapeutic procedures (radon baths, laser therapy, ultraviolet irradiation of blood and others).

Contraindications and side effects in relation to this diagnostic procedure no.

Explanation of lipid profile analysis

According to international standards according to SCORE scale normal indicators lipid profile and their deviations from the norm are within the following limits:

	Norm	Borderline level (moderate risk of atherosclerotic vascular changes)	High level (increased risk of atherosclerotic vascular changes)
Total cholesterol (mmol/l)	below 5.26	5,26-6,5	More than 6.5
HDL (mmol/l)	more than 1	0,9-1	Less than 0.9
LDL(mmol/l)	below 3.5	3,5-4,5	More than 4.5
Triglycerides (mmol/l)	below 2	2,0-2,5	More than 2.5
Atherogenic coefficient	2-3	3-3,5	More than 3.5

It is worth considering that the norms of these parameters may vary slightly depending on the patient’s gender, weight, the presence of certain diseases, as well as genetic or diagnostically identified predisposition.

The data obtained from the analysis of the lipid profile should be deciphered by the supervising physician, who will correlate the results obtained with the individual characteristics of the patient: the presence of certain diseases (for example, a previous myocardial infarction), taking medications. Yes, some medications are capable of artificially lowering the level of certain lipoproteins in the blood, so such points must be taken into account when deciphering the analysis data.

Let's consider what a deviation of the described indicators from the norm means and what diseases this may indicate.

Total cholesterol

Its excess normal values indicates existing pathologies of fat metabolism. Such a patient has a significantly increased risk of atherosclerosis and its consequences. In this case, a diagnosis of hypercholesterolemia is made and serious monitoring and adjustment of blood fats is required. With an increase in total cholesterol, a systemic diagnosis of dysbetalipoproteinemia can be made, but confirmation is needed additional research.

An increase in total cholesterol can also be observed with the following diseases:

• atherosclerosis;
• myocardial infarction;
• ischemia;
• diabetes mellitus types 1 and 2;
• obesity;
• gout;
• Gierke's disease;
• extrahepatic jaundice and all its varieties;
• primary cirrhosis of the liver;
• chronic liver failure;
• nephrotic syndrome;
• glomerulonephritis;
• chronic pancreatitis;
• malignant neoplasms in the pancreas;
• growth hormone deficiency;
• lack or excessive production of thyroid hormones;
• chronic alcohol intoxication.

Taking certain medications can also lead to an increase in total cholesterol levels: corticosteroids, hormonal contraceptives, aspirin-containing medications, beta blockers and many others. A healthy pregnant woman can get a similar test result. Total cholesterol can also be elevated in people who follow a protein-free diet.

Low cholesterol levels may occur in the following conditions:

• obstructive changes in the lungs;
• pulmonary tuberculosis;
• chronic heart disease;
• Tangier disease;
• sepsis;
• hepatocarcinoma;
• pathology of absorption in the gastrointestinal tract;
• prolonged fasting;
• burns of a large area of ​​the body;
• liver cirrhosis (its terminal stage).

Taking medications such as estrogens, statins, Thyroxine, Interferon, Clomiphene, Neomycin and some others can lead to a decrease in this indicator.

HDL

Previously it was believed that the higher the level of this indicator, the better. After all, HDL is directly involved in the processing and removal of “bad” cholesterol from the body. However, today it has been revealed that too high a concentration of high-density lipoproteins in the blood can also be a marker of certain pathological diseases:

• primary familial hypercholesterolemia;
• nephrotic syndrome;
• chronic renal failure;
• obstructive jaundice;
• obesity, diet rich in cholesterol-containing foods;
• Cushing's syndrome;
• anorexia;
• diabetes.

If the result of a lipid profile analysis showed that HDL is below normal, the risk of CVD increases, primarily atherosclerosis, since the ability of high-density lipoproteins to block and remove “bad” cholesterol is sharply reduced. There is a risk of developing the following diseases (or the patient already has them):

• atherosclerotic vascular damage;
• ischemia;
• chronic liver diseases;
• diabetes mellitus of both types;
• nephrotic syndrome;
• obesity.

It is worth remembering that some medications can also affect this indicator.

LDL

This fraction of lipoproteins determines the risk of developing atherosclerosis even more than total cholesterol in the blood. In addition, a high level of this indicator indicates the likelihood of heart disease. Elevated LDL cholesterol may indicate:

• atherosclerosis;
• ischemia;
• angina pectoris;
• hypertension;
• heart attack;
• liver and kidney diseases;
• obesity;
• anorexia.

If these lipoproteins are in the blood in very small quantities (below normal), there is a possibility of metabolic disorders, blood diseases, and thyroid gland.

VLDL

There is still debate in medical circles regarding this indicator and its permissible values, but one thing is clear - it increased level leads to CVD. VLDL may be higher than normal in the following pathologies:

• suppression of the functions of the thyroid gland and pituitary gland;
• diabetes mellitus types 1 and 2;
• systemic lupus erythematosus;
• pancreatic or prostate cancer;
• pancreatitis;
• obesity;
• kidney diseases.

A decrease in its level may indicate the presence of diseases of the lungs, blood, endocrine glands, liver, joints.

Triglycerides

This is one of the most important indicators that determine the risk of CVD. Therefore, first of all, when their concentration in the patient’s blood increases, it is worthwhile to additionally examine for the presence of the following diseases:

• atherosclerosis;
• myocardial infarction;
• cardiac ischemia;
• hypertension;
• severe kidney disease;
• pancreatitis;
• viral hepatitis;
• diabetes;
• thrombosis of cerebral vessels.

May talk about:

• cerebral infarction;
• chronic lung diseases;
• endocrine disorders;
• myasthenia gravis;
• kidney diseases.

Atherogenic coefficient

This indicator reflects the general ratio of “bad” and “good” cholesterol in the blood, therefore, if it slightly exceeds the norm (3-4), the patient is warned about high probability development of vascular and heart diseases. However, this risk can be minimized if you change your lifestyle and, in particular, your diet in a timely manner.

When this coefficient is in the range of 4-5, the risk of developing CVD is very high, and if it is above 5, then a patient with high probability There are already atherosclerotic changes in blood vessels.

Decoding the lipid spectrum of blood allows you to determine the quantitative and qualitative composition fatty acids.
These show the risk of developing cardiovascular diseases.

Determination of blood lipid spectrum

Due to poor nutrition, hereditary predisposition, sedentary lifestyle life, there is an increase in the content of “bad” cholesterol, a derivative of lipids.

An increased level of this compound leads to the progression of atherosclerosis, which in turn can cause a heart attack or stroke. If atherosclerosis or other pathologies are suspected, the patient is prescribed a blood test for lipids.

What does a blood lipid test show? It contains several meanings:

• total cholesterol;
• high-density lipoprotein cholesterol, in other words, HDL cholesterol;
• low-density lipoprotein cholesterol or on the tongue medical terms LDL cholesterol;
• triglycerides (chylomicrons).

It is considered normal if the total cholesterol level ranges from 5 to 5.1 mmol/l. A person is healthy if the HDL cholesterol level is more than 1 mmol/l. The target LDL cholesterol value is 3.36-4.14 mmol/l. Normal triglycide levels should be less than 2 mmol/L.

Based on these analyzes of the blood lipid spectrum, the doctor calculates an atherogenicity indicator, that is, identifies the degree of susceptibility of the patient to the development of atherosclerosis. To calculate it, the result of the HDL cholesterol test is subtracted from the total cholesterol level and the result obtained is divided by the HDL cholesterol value.

If the atherogenicity coefficient is from 3 to 4, then the patient has a high probability of developing atherosclerosis, which means he should reconsider his lifestyle and diet.

In healthy people, this coefficient is below 3. The fact that this patient has atherosclerosis will become known if the level of the atherogenic coefficient rises above 5.

If on the eve of blood sampling the patient ate fatty foods, smoked an hour before the test, has a cold, has kidney disease, or is under stress, then the test result may be unreliable.

Preparation before taking the test

Before testing blood for lipid spectrum, appropriate preparation is required. At least two weeks before the test, you should not suddenly change your diet.

If you need to donate blood for analysis in the morning, then in the evening before this day you should not drink alcoholic drinks. The fact is that alcohol drunk the day before increases triglyceride levels.

You need to have dinner no later than 12-14 hours before taking tests to determine the lipid spectrum.

If this rule is not followed, the study may show elevated lipid levels. This is due to the fact that within 8-12 hours after eating, fats received from food actively circulate in the blood.

You only need to donate blood at the clinic on an empty stomach in the morning. If the patient takes certain groups of drugs - sulfonamides, steroids, adrenaline and some others, then the test results will most likely show increased cholesterol levels.

Taking heparin and erythromycin leads to insufficient secretion of cholesterol.

Main types of cholesterol

The existing types of cholesterol circulating in the blood can be divided into two groups: an atherogenic substance, that is, one that provokes the development of atherosclerosis, and an antiatherogenic compound, which has the exact opposite effect.

The group of atherogenic lipoproteins includes triglycerides and low-density lipoproteins. LDL is “bad cholesterol”, which leads to the progression of blockage of blood vessels with plaques.

This group of lipids is most actively involved in the formation of blood clots and leads to a narrowing of the lumens of blood vessels. Triglycerides are the leading source of energy for cell activity, but an increase in their level also leads to atherosclerosis.

Some time ago, it was believed on the contrary that it was HDL that led to the formation of atherosclerosis, but scientific research has refuted this fact.

Anti-atherogenic or “good” cholesterol is high-density lipoprotein; on the contrary, it reduces the risk of developing atherosclerotic deposits on blood vessels. HDL reduces the likelihood of cardiovascular disease by transporting free lipid compounds back to the liver, where they are processed.

There is another group of compounds - very low density lipoproteins (VLDL). These are chemical molecules that convert cholesterol into low-density proteins. In fact, it is also an atherogenic compound.

Harm to the body on video

Indications for the purpose of analysis

All people donate blood lipid spectrum during routine medical examinations. Doctors recommend that any healthy person donate blood at least once every five years to determine the value of total cholesterol.

If a blood test reveals an increased level of total cholesterol, the patient is sent for additional studies, namely, a blood test to determine the lipid spectrum.

If the patient or his relatives have cardiovascular diseases, obesity, diabetes mellitus The attending physician will definitely refer him to determine the level of lipoproteins in the blood.

Causes of lipid profile disorders

High cholesterol levels are common among people over 50 years of age. Before menopause, women have a low level of this compound in their blood compared to men.

This explains the fact that premenopausal women are less susceptible to developing hypertension and heart attacks than the stronger sex.

An increase in blood cholesterol levels is associated with consumption of fatty foods, physical inactivity, hereditary factor, smoking, overweight, stress.

Diabetes mellitus, decreased secretion of thyroid hormones, polycystic ovary syndrome, kidney disease - all these diseases cause increased lipid levels. Pregnancy also leads to an increase in “bad” lipoprotein and a decrease in the amount of “good” cholesterol in the blood.

A decrease in the amount of this substance in the blood can be associated with liver disease, poor diet, hyperthyroidism, constant stress, certain types of anemia, sepsis, and tuberculosis.

Consequences of lipid disorders

Active secretion of cholesterol can provoke the development of hypertension, atherosclerosis, cardiovascular diseases, thrombophlebitis, cause memory impairment, heart attack or even stroke.

The liver is primarily affected, as elevated lipid levels lead to fatty hepatosis, cholesterosis.

Low cholesterol levels are also not normal and can cause L

• depression;
• osteoporosis;
• infertility;
• problems with the gastrointestinal tract;
• hemorrhagic stroke;
• diabetes;
• lack of vitamins A, D, E, K.

Such people have an increased risk of developing liver cancer, alcoholism, and depression. Scientists have proven that the risk of suicide is 6 times higher in those patients who have low cholesterol. An excess of chylomicrons can be the starting point for the development of pancreatitis.

Cholesterol is an important component of human blood. Both excess and deficiency of this substance are equally dangerous for the body. The doctor determines the cause of deviation of cholesterol levels from the norm. He also prescribes treatment and gives recommendations that must be followed in order to bring cholesterol levels back to normal.

We treat lipid metabolism disorders with traditional medicine

Lipid metabolism disorders are treated with medication. And to make the effect better, the use of folk remedies is additionally indicated.

Sometimes doctors themselves prescribe them. Among traditional methods of treatment, they are often used herbal infusions and infusions.

They are easy to prepare at home. In any case, before being treated with one or another remedy, you must consult your doctor at a clinic or private medical center.

Self-medication does not contribute to achieving a therapeutic effect, and often the opposite is true.

1. Honey is a tasty and nutritious means of treating (and also preventing) diseases associated with lipid metabolism disorders. But it is important that it is natural. He is powerful antioxidant. For achievement better effect added to honey Apple juice(preferably squeezed at home using a juicer). Drink one glass of this mixture once a day on an empty stomach.
2. Excellent for treatment and vegetable juices. For example, it could be Fresh Juice, squeezed from potatoes (drink it three times a day, ½ cup). You can also make beet juice. Drink it 1/3 glass also 3 times during the day. Juices are diluted with boiled water before use.
3. An excellent remedy for diseases of fat metabolism is milk thistle. The pharmacy sells various herbal remedies based on it. Any of them is suitable for treatment.
4. Sometimes drinking more often is enough green tea, and the condition can already improve significantly.
5. The inflorescences of rose, immortelle and calendula contribute to the breakdown and removal of fats from the body. They also reduce the deposition of fat in blood vessels.
6. If cholesterol metabolism is impaired, the use of products containing elecampane roots, as well as dandelion and burdock is indicated. The same effect can be achieved by taking products based on the stems and leaves of oats and nettles. With them regular use The level of “bad” cholesterol in the blood will decrease.
7. It’s great if you can find in the pharmacy infusions from rose hips, rowan, and hawthorn. You can make a decoction yourself by taking equal quantities of dandelion roots, rose hips, rose and immortelle inflorescences. Leaves and stems of oats, yarrow, and nettle are also added here. The decoction is prepared as follows: take a tablespoon (tablespoon) of herbs prepared in advance (they are pre-dried), pour hot water in an amount of 400 ml. Everything is heated for about 10 minutes in a water bath and infused for about an hour under a tightly closed lid. The decoction should be taken little by little (about 100 ml) after meals 3 times a day.

You can reduce blood cholesterol levels by consuming various medicinal herbs(sage, plantain, Chernobyl, birch leaves, alder catkins). It should be taken in a course (one month) three times a day. The decoction is made with a small amount of boiling water and left for an hour.

It’s easy to speed up your metabolism with the help of a herbal mixture with mint, shepherd's purse, sage, hay, blackberries, goldenrod, corn silk and other components in the composition. This herbal mixture is taken for 3 months in a row, also 3 times a day after eating.

You can always look for other types at the pharmacy. herbal infusions, helping to improve fat metabolism.

A lipidogram represents the lipid spectrum of blood in the form of a table with level values ​​for each indicator. Naturally, the indicators for adults and children differ. Lipids are most often associated in memory with cholesterol (lipoprotein). But this is out of habit of fighting it.

In fact, fats are very important for the body, although indeed deviations in fat metabolism can lead to the development of heart or vascular diseases. That is, it is necessary to maintain normal lipid levels. Levels are monitored using a lipid profile.

• Total cholesterol (cholesterol).
• Lipoprotein fractions.
• Triglycerides.
• Molecular complexes containing fats and fat-like substances.
• KA – atherogenic coefficient.

The lipid spectrum and its condition is one of the indicators of health, since fats and fatty compounds are an integral component of human cells and tissues.

In order not to lose energy while eating or being active muscular system, as well as to ensure the completeness of the vital processes of the whole organism during rest, sleep and other states of rest, lipids and their participation in all stages of the body’s vital activity are necessary.

Fat metabolism consists of several interrelated processes:

• Absorption of fats from food into gastrointestinal tract after preliminary splitting and digestion.
• Transfer of lipids into the intestine with the assistance of chylomicrons.
• Launching the metabolic processes of triglycerides, phospholipids, cholesterol.
• Interaction of fatty acids and ketone bodies.
• Lipogenesis.
• Breakdown of fats.
• Breakdown of fatty acids.

Thanks to the preservation of such processes, all the functions of lipids are performed.

Functions of lipids

Like all structural units of cells and tissues, fats have clearly defined functions:

• Structural is an essential part of cell membranes, especially neurons, since brain cells are not able to fully perform their functions without fats.
• Regulatory - includes the composition of vitamins, hormones, and takes an active part in the passage of nerve transmission.
• Transport – thanks to lipoproteins, transportation is carried out active substances throughout the body.
• Protective - every human organ is surrounded by adipose tissue, which protects them from external negative influences.
• Supportive - because adipose tissue surrounds the bases of the plexuses of blood vessels and nerves, the spaces between the nerves and vessels are filled with adipose tissue.
• Energy – the accumulated energy of adipose tissue during oxidative reactions is at least twice as high as that released by carbohydrates and proteins.
• Thermoregulatory – preserves the body when exposed to low temperatures from hypothermia.
• Trophic - a large number of active substances, for example, vitamins, are not able to be absorbed without the presence of lipids.
• Reproductive - stable activity of the human reproductive system cannot be carried out without lipids, since without their participation the absorption of minerals and other substances from the intestines into the blood is disrupted.

Violation of fat metabolism is fraught with many pathologies. To do this, you need to know what exactly each lipid test indicator means.

Lipid profile composition

Cholesterol

It is an organic compound. By its nature it is a lipophilic alcohol. It is a component of all cell membranes.

In the human body it is the starting material for the synthesis of sex hormones, corticosteroids, vitamin D, and bile acids.

The formation of total cholesterol mainly occurs in the liver. Absorbed in the intestines, it then enters the blood. For its transfer, the participation of protein-lipid compounds - lipoproteins, which consist of:

• Apoproteins.
• Cholesterol.
• Triglycerides.

The number of such complexes and the level of cholesterol present in them is reflected in its density. The more it is in such compounds, the lower its density becomes.

It is according to this characteristic that all lipoproteins are divided into the following types:

• LDL – low density lipoproteins.
• VLDL – very low density lipoproteins.
• HDL is high density lipoprotein.

LDL

The most atherogenic type of lipoprotein. Contains approximately 70% cholesterol. Synthesized in the liver from VLDL.

The main function is the transfer of cholesterol to various fabrics and organs. The concentration of total cholesterol is influenced by the cholesterol contained in LDL. When it increases, such complexes accumulate on the walls of blood vessels.

One of the “worst” abilities of LDL is that, being small in size, they freely pass through the endothelial barrier of blood vessels and penetrate the walls of vessels of any caliber.

In addition, only the cholesterol contained in LDL is deposited in the blood vessels and is practically not excreted due to the presence of a large number of receptors with which it is firmly attached to the vascular wall.

VLDL

Also refers to atherogenic types of lipids and is synthesized in the liver. VLDL contains 10% cholesterol.

Almost the entire composition of very low density lipoproteins is occupied by triglycerides, and to a lesser extent by cholesterol, which is distinguished by its aggressiveness towards the walls of blood vessels.

It is VLDL that are the precursors of the most dangerous low-density lipoprotein.

HDL

The most “useful” type of lipoprotein, which is also formed in the liver and contains up to 20% cholesterol.

The main function of such compounds is antiatherogenic.

The value of such complexes lies in the fact that they remove cholesterol from:

• Vessels
• Organs
• Fabrics.

Thanks to the reverse transport of cholesterol to the liver, its further utilization from the body with bile occurs.

Normal levels of high-density lipoproteins prevent vascular damage, and also destroy accumulations of cholesterol and other lipids on the walls of blood vessels and effectively reduce the risk of blockage of blood vessels.

Triglycerides

One of the most important sources of energy for the body. Formed in the liver and intestines.

Which enter the blood, are in complex with lipoproteins and are thus distributed to organs and tissues. Very low density lipoproteins take the greatest part in the transport of triglycerides.

Excessive amounts of TG are subject to accumulation in adipose tissue, which subsequently leads to the development primarily of vascular diseases.

Atherogenic coefficient

This indicator is calculated based on the levels of cholesterol and lipid fractions obtained and is calculated using the following formula:
KA (atherogenic coefficient) = (total cholesterol-HDL)/HDL

This coefficient reflects the risk of developing atherosclerotic damage to blood vessels and the heart.

In order to understand the dynamics of changes in such indicators, it is necessary to know the normal indicators of all elements of the lipid profile.

Lipidogram. Decoding

Normal lipid spectrum indicators for adults and children are different for each indicator:

1. Cholesterol:
   • Children under 14 years of age – 1.3 – 5.2 mmol/l
   • Adults – 3.4 – 5.4 mmol/l
2. HDL:
   • Children under 14 years of age – 0.9 – 1.9 mmol/l
   • Adults – 1.03 – 1.55 mmol/l
3. LDL:
   • Children under 14 years of age – 1.6 – 3.6 mmol/l
   • Adults – 1.71 – 3.6 mmol/l
4. VLDL:
   • Children under 14 years of age – 0.13 – 1.63 mmol/l
   • Adults – 0.13 – 1.63 mmol/l
5. Triglycerides:
   • Children under 14 years of age – 0.3 – 1.4 mmol/l
   • Adults – 0 – 2.25 mmol/l
6. Atherogenic coefficient. Normally it should not exceed 3. The higher the indicator, the more pronounced the progression vascular disease and the risk of complications.

Lipid analysis is not done just like that. For this, there are certain markers for which a blood lipid profile is necessary.

Indications for the purpose of analysis

Under ideal conditions after reaching healthy person 20 years in the absence of any indications or reasons for examination It is recommended to conduct a blood lipid test once every 3-5 years.

Direct indications for manipulation are:

• Hypertension, coronary heart disease and other pathologies of cardio-vascular system.
• Assessment of the risk of developing vascular accidents.
• Activity violations endocrine system, especially diabetes.
• Obesity.
• Smoking.
• Excessive alcohol intake.
• Age.
• Physical inactivity.
• Family history of heart attack, stroke, cardiovascular pathology, diabetes mellitus.
• Autoimmune processes.
• Monitoring the results of diet and treatment for atherosclerosis.

For reference. The components included in the lipid profile can either increase or decrease. The most common increase in such indicators, the reasons for which can be varied.

Reasons for changes in the lipid spectrum

A decrease in total cholesterol in the blood occurs in the following cases:

• Diseases of the lung tissue.
• Burn disease.
• Malignant neoplasms.
• Thyrotoxicosis.
• Fasting, exhausting diets.
• Severe infectious diseases.
• Generalized sepsis.

A separate line highlights a decrease in HDL, which indicates the rapid development of atherosclerotic damage to the body and the risk of acute coronary syndrome.

An increase in cholesterol and lipoprotein fractions indicates:

• Cardiac ischemia.
• Risk of developing a heart attack.
• Hereditary (familial) hyperlipidemia.
• Vascular diseases.
• Risk of stroke.
• Hepatitis, liver cirrhosis.
• Diseases of the urinary system.
• Hypothyroidism.
• Pathology of the pancreas.
• Obesity.
• Pregnancy - in this case the process is physiological.

Attention. The most important lipid profile data are for the cardiovascular system.

Importance in determining heart and vascular diseases

Atherosclerosis is a formidable, “silent” disease in the initial stages that inevitably leads to death without proper treatment and observation. It is for the purpose of excluding, determining, and monitoring such a condition that a lipid profile is used.

Despite the wide use of such blood tests, there are many cases where they are limited to just cholesterol testing. This is far from correct.

A competent doctor knows that normal total cholesterol levels do not mean that everything is in order in the body.

LDL, for example, changes its values ​​upward even when cholesterol levels are normal. It is at this time that the mechanism of formation of atherosclerotic plaques begins to gradually begin.

Determining the spectrum of lipids in atherosclerosis allows not only to identify the risk of developing a heart attack, stroke, but also allows you to assess the patient’s condition and determine further tactics for patient management.

Attention. An increase in cholesterol, low- and very low-density lipoproteins, triglycerides, and the atherogenic coefficient indicate the presence of atherosclerosis, and the degree of increase in these indicators indicates the severity of the pathological process.

On the contrary, high-density lipoproteins decrease with the development of atherosclerosis.

A dangerous diagnostic sign is rapid decline HDL, since this indicates that accumulated cholesterol and lipid fractions are not removed from the body, but increase the rate of deposition on the walls of blood vessels and heart valves, which inevitably leads to the death of the patient.

Important. In case of atherosclerosis, a diet is first prescribed, after which an intermediate interpretation of the lipid profile is carried out.

If lipid levels do not change, the issue of prescribing statins is decided. In this case, intermediate monitoring of blood parameters is also mandatory.

For the most accurate analysis, it must be carried out in accordance with all standards.

How the research is carried out

Only proper preparation to the study will allow you to obtain the most accurate data. For this purpose, before taking the analysis, it is necessary
comply with the following requirements:

• Blood is donated only on an empty stomach.
• In the evening, before the morning blood draw, all fatty foods from the diet. Dinner should be early and light.
• Avoid physical activity.
• No smoking.
• Don't drink alcohol.
• If you are taking any medications, notify your doctor.

Only if the above factors are excluded, laboratory analysis data will be most accurate.

Important. A blood lipidogram not only reflects the degree of damage to the cardiovascular system, but also other pathologies in the human body.

But, nevertheless, its importance in assessing the severity of atherosclerosis is undeniable. Only the lipid profile is the main marker of the condition of the heart and blood vessels in atherosclerotic lesions.

For reference. So, what is a lipid profile? This is not just another blood test. This is a complete assessment of fat metabolism in the body, an assessment general condition person, and most importantly - an indicator that before the doctor and the patient himself will be able to identify the initial stages of atherosclerosis and the risks of developing serious complications. In such cases, only with the help of a lipid profile can one begin timely treatment and prevention of complications.