Lipid Profile PDF

Lipid Profile Low Density Lipoprotein Cholesterol (LDL-C) ✓ Often called “bad cholesterol” because it deposits A group of tests that are often ordered together to excess...

Lipid Profile Low Density Lipoprotein Cholesterol (LDL-C) ✓ Often called “bad cholesterol” because it deposits A group of tests that are often ordered together to excess cholesterol in walls of blood vessels, which determine the risk of coronary heart diseases, which is can contribute to atherosclerosis associated with lipid disorders. ✓ Usually, the amount of LDL cholesterol is calculated LP is a good indicator of whether someone is likely to using the results of TC, HDL-C, and Triglycerides. have a heart attack or stroke caused by blockage of blood ✓ Normal Ranges: vessels or hardening of arteries. LDL-C Below 70 mg/dL Ideal for people at very Plasma Lipids with their Normal Value Below 1000 mg/dL high risk of heart disease 100-129 mg/ dL Near ideal 130-159 mg/ dL Borderline high 160-189 mg/ dL High 190 mg/ dL and above Very high Triacylglycerol (TAG) Low levels of TAG can be present: o Patients who carry genes for familial hypobetalipoproteinemia Clinical Significance/ Diagnostic Importance High levels of TAG can be present: Diagnosis of dyslipidemia o Metabolic syndrome Assessment of prognosis of a known dyslipidemic o Risk factor to CAD patient Very high levels of TAG “500 mg/dL”: To assess the risk of atherosclerosis and coronary o Can be concerning for development of artery disease (CAD) pancreatitis Typically includes/ Components of Lipid Profile ✓ Triglyceride is body storage form of fat and energy. Total cholesterol (TC) ✓ Most TAG found in adipose tissue ✓ This test measures all of the cholesterol in all the ✓ Give energy in case of absence of carbohydrates lipoprotein particles ✓ Some triglycerides circulate in the blood to provide ✓ TC= LDL + HDL + (1/5 Triglyceride) fuel for muscles to work ✓ Normal Ranges: ✓ Extra triglycerides are found in the blood after TC After meal TAG “gut” >>> blood >>> adipose Below 200 mg/dL Desirable 200- 239 mg/ dL Borderline High ❖ Elevated in obese or diabetic patients. 240 mg/ dL and above High ❖ Level increases from eating simple sugars or drinking alcohol High Density Lipoprotein Cholesterol (HDL-C) ❖ Associated with heart and blood vessel disease ✓ Measures the cholesterol in HDL particles ✓ Often called “good cholesterol” because it removes ✓ Triglycerides level: excess cholesterol and carries it to the liver for o TAG test needs 12 hrs. fasting because its level removal. is affected by meal (fatty meal, high ✓ It removes excess cholesterol from tissues (cleans carbohydrates meal) blood) o Level should be: Less than 150mg/dL ✓ High levels linked to a reduced risk of heart and o High TAG leads to fatty liver blood vessel disease. The higher HDL level, the ✓ Normal Ranges: better TAG ✓ Normal Ranges: Less than 100 mg/dL Optimal HDL-C 101- 150 mg/ dL Normal Below 40 mg/dL (men) Poor 150- 199 mg/ dL Borderline high Below 50 mg/dL (women) 200- 499 mg/ dL High 40- 49 mg/dL (men) Better 500 mg/ dL and above Very high 50- 59 mg/dL (women) 60 mg/ dL and above Best VHDL-C) ✓ Calculated from “triglycerides/ 5” ✓ This formula is based on the typical composition of VLDL particles Lipid Profile and their Interpretation Atherosclerosis (Arteriosclerotic Vascular Disease) Component Desired Borderline High Very A condition in which an artery wall thickens as a result of level high High an accumulation of fatty materials such as cholesterol. TC < 200 200- 239 ≥ 240 > 290 In Greek, athere means gruel, and skleros means hard. LDL- C < 130 130-159 ≥ 160 ≥ 190 Triacylglycerol < 150 150- 200 > 200 > 500 Response- to- Injury Hypothesis HDL- C > 40 - > 60 - 1. Chronic endothelial injury ❖ HDL is the only known anti-atherogenic LP (lipoprotein) 2. Accumulation of ❖ LDL is the best known atherogenic LP and 70% of plasma lipoproteins total cholesterol is in fact carried by LDL. 3. Monocyte adhesion to ❖ Therefore, the ratios between TC to HDL and LDL to the endothelium HDL are more reliable marker for atherogenic risk and 4. SMC proliferations and risk for CAD. ECM production ❖ All these ratios are expected to be low for good health. 5. Factor release 6. Platelet adhesion Epidemiology: Ubiquitous among most developed nations. “lifestyle and diet disease” Major Risks Lesser or Uncertain Risks Nonmodifiable Obesity Increasing age Physical inactivity Male gender Stress (type A personality) Family history Postmenopausal estrogen Genetic abnormalities def. Risk of High LDL and Heart Disease High carbohydrate intake High blood LDL will deposit Potentially Controllable Lipoprotein (a) cholesterol in the inner walls of the Hyperlipidemia Hardened (trans) arteries that feed the heart and brain. Hypertension unsaturated fat intake It can form plaque (thick, hard Cigarette smoking Chlamydia pneumoniae deposit) that can narrow the arteries Diabetes infection and make them less flexible. C- reactive protein This condition is known as atherosclerosis. ❖ Multiplicative effect: If a clot forms and blocks a narrowed 2 risk factors increase risk four-fold artery, heart attack or stroke can 3 risk factors increase the rate of MI seven times result. Hypercholesterolemia related diseases/ conditions Dyslipoproteinemia Myocardial infarct (MI) A group of disorders characterized by abnormally high or Rupture, Ulceration, or Erosion low concentrations of plasma lipoproteins. = thrombus formation--- downstream ischemia Aneurysm Hypercholesterolemia = pressure or ischemic atrophy of the underlying It is a presence of elevated levels of cholesterol in the media, with loss of elastic tissue- weakness blood. Arrythmias It is a sub category of hyperlipoproteinemia, which is the = due to scar formation presence of elevated levels of lipoproteins (combined fat Mural thrombus and protein molecules) in the blood, which is itself a Atheroembolism subcategory of hyperlipidemia, or the presence of = microemboli elevated levels of lipids (fats) in blood. Cerebral infarct Renal infarct The risk factors for hypercholesterolemia Death Obesity and diet (environmental factor) Genetic factors Hypothyroidism Diabetes mellitus Obstructive jaundice Nephrotin syndrome Chronic renal failure