It is believed that every person needs to take a blood test for cholesterol from time to time. Having received a referral, the patient of the clinic can see the unfamiliar word “lipidogram” in it. What kind of research is this, how is it being conducted? Why is this analysis done?
Deciphering the blood lipid profile gives the doctor important information to assess the condition of the patient, the course or risks of diseases of the liver, kidneys, cardiovascular system, autoimmune processes. Just a blood test for cholesterol or total cholesterol is not very informative and can only be used in screening studies or in assessing the dynamics of treatment.
What are blood lipids?
The fats already available or coming from food are needed by the body for energy metabolism, the construction of cell membranes, the synthesis of hormones and other substances.
Cholesterol (cholesterol) and triglycerides are determined in the blood.
In its pure form, lipids cannot be in the blood. If this happens, irreparable - fat embolism (or blockage) of the vessel with all the ensuing consequences can occur.
Therefore, fats are found and transported in the bloodstream as part of lipoproteins - formations in which the protein part is attached to the fat particle. The ratio of the components can vary, this has diagnostic value, it is precisely this that the decoding of the lipid profile will show.
How to take an analysis?
In order for the result to be reliable, before passing a blood test to a biochemical laboratory, you need to fulfill simple requirements. Blood is drawn from a vein on an empty stomach, no less than 12 hours after a meal, usually in the morning.
Why is this so important? The fact is that after eating, especially fatty, blood serum becomes cloudy (chylous). This makes analysis difficult. But this can happen with some serious diseases. Therefore, the researcher, for the accuracy of diagnosis, must know for sure that the patient has complied with the requirement to pass a fasting blood test.
Research methods
Currently, enzymatic methods for determining blood lipids are the main ones. Specially selected reagents cause staining of the sample, which fixes the device. Determination of high-density lipoprotein cholesterol is done in several stages, for which the precipitation and centrifugation of blood serum are preliminarily carried out.
Modern biochemical analyzers cost a minimum amount of blood serum and reagents. With their help, mass surveys are carried out, accurate results are obtained.
The previously used acidic method for determining cholesterol was harmless to the laboratory assistant and required a large number of dangerous reagents.
Indicators
Lipidogram - what is it? It presents several indicators obtained as a result of blood serum analyzes, and calculated values:
- total cholesterol (OXS);
- high density lipoprotein cholesterol (HDL cholesterol or HDL);
- low density lipoprotein cholesterol (LDL cholesterol or LDL);
- triglycerides (TG);
- atherogenic coefficient (KA or IA).
Cholesterol and triglycerides are measured in mmol / L.
The atherogenic coefficient is simply a calculated numerical value that shows how many times the number of LDL cholesterol exceeds the amount of HDL cholesterol.
Some laboratories detect very low density lipoprotein cholesterol (VLDL cholesterol).
Normal values
Has a blood test been performed (lipid profile)? The decoding is as follows:
- For total cholesterol, the optimal value is considered to be from 3.5 to 5.2 mmol / L, the level from 6.2 mmol / L is increased.
- HDL cholesterol should be more than 1.4 mmol / L. An indicator below 1.0 mMol / L is considered unfavorable.
If you subtract from the amount of total HDL cholesterol, you get the level of LDL cholesterol. It is considered "bad", its level should not exceed 4.0 mmol / L.
Lipidogram - what is it? Thanks to this study, the value of blood triglycerides is established. This derivative of glycerin and fatty acids is the main source of energy derived from food fats. It is stored by the body in fat cells.
The norm in the blood is considered a value below 1.5 mmol / L. It is believed that with age this indicator increases. But in any case, a result higher than 2.3 mmol / L cannot be called favorable. It also reflects a lipid profile.
The norm of the atherogenic index indicator is in the range from 2.6 to 3.5. If less is better. A value higher than 3.5 happens with significant lipid metabolism disorders.
Atherogenic index
Lipidogram - what is it? The index, or coefficient of atherogenicity, is very important, showing the ratio of "bad" and "good" cholesterol in the blood.
To calculate it, you need to divide the difference between total cholesterol and HDL cholesterol by the value of HDL cholesterol. The obtained result shows the content of LDL cholesterol, that is, dividing one into the other, we see how many times there are more “bad” cholesterol than “good”:
KA = OXC - HDL cholesterol / HDL cholesterol, or
CA = LDL cholesterol / HDL cholesterol
For example, if the total cholesterol is 6.0 mM / l, HDL cholesterol is 2.0 mM / l, CA = 2. This is a good indicator.
And if the total cholesterol is also 6.0 mM / l, and HDL cholesterol is 1.0 mM / l, then KA = 5. With this result, we can talk about pathology.
So, if HDL cholesterol is elevated, the atherogenic coefficient, respectively, is lower. This is why it is important to know the level of not only total cholesterol. With the same indicator, the body can be protected in different ways from the risk of atherosclerosis.
"Bad" or "good"?
In fact, cholesterol can be neither "bad" nor "good." This is an extremely important component of the body. Hormones, including genital, nerve and brain tissue, cell membranes, the production of bile acids - everywhere it is needed. Each cell of a living organism consists of a double layer of cholesterol molecules.
That is, nerve strength, beauty, intelligence, immunity, digestion, reproduction, and life in general depends on the presence and proper exchange of cholesterol. Its deficiency leads to severe disorders.
Cholesterol is 80% synthesized in the body, the rest comes from animal food. Normally, the feedback principle applies: the synthesis is reduced with sufficient intake of cholesterol from the outside, and vice versa. So nature foresaw, because people did not always have at their disposal a full refrigerator of food and a huge amount of products from sugar and white flour.
Interesting fact
Specialists conducted an extensive international study, during which, in addition to many other indicators, the lipid profile of the indigenous inhabitants of Western Siberia (Khanty, Mansi) was determined.
The measurement was performed blindly, only numbered blood serum samples were loaded into the analyzer.
Based on the results of the review of more than 400 samples, the results were clearly divided into three groups:
- in the first (largest) was normal (up to 5.0) total cholesterol, high (up to 3.0) HDL cholesterol, triglycerides below 1.0mol / L;
- in the second group, very low values ​​of total cholesterol and triglycerides were found;
- in the third (total about 30 people), the level of total cholesterol and triglycerides was significantly increased, and HDL cholesterol was reduced.
The atherogenic coefficient in the last group was 5, 8, and even 10!
The answer is:
- the first group consisted of adult representatives of nomadic peoples of the north of the Tyumen region;
- the second group - their children, as well as patients with tuberculosis;
- in the third, the “fattest” group was ... the administration of the villages in which the study was conducted!
Reindeer herders of the north of Siberia feed on fish, meat, wild plants. Of course, they also acquire sugar and flour, but a mobile lifestyle in harsh conditions does not allow the development of such diseases of civilization as diabetes, atherosclerosis, and obesity.
So what is the problem?
Why are they so frightened by high cholesterol and call it “bad”? It's not about cholesterol itself, but in relation to the size of the protein particle transporting it in the blood.
That is, if a relatively large part of blood cholesterol is in the composition of high density lipoproteins with a large protein part (HDL cholesterol is elevated), this is good. But with a protein deficiency in food, as well as with an excess of simple carbohydrates in it, insulin metabolism is disrupted. This leads to the fact that lighter and friable low density lipoproteins (LDL) are formed in the blood, which easily get stuck in the vessels and stick to their wall.
Atherosclerotic plaques form, blood vessels narrow and become inflamed, their reactivity changes. As a result, atherosclerosis, hypertension develops, there is a high risk of stroke, heart attack. Therefore, cholesterol in LDL is considered "bad." As you can see, this is not the case at all.
Cholesterol in HDL, on the contrary, is actively transported, cleanses blood vessels, so it is called "good."
Another variety
In addition, the so-called modified cholesterol is considered “bad”, that is, changed under the influence of harmful factors: radiation, insolation, chemical effects of domestic and industrial nature: smoking, inhalation of organic solvents, chlorine compounds, insecticides, etc.
Given the crucial biological role of cholesterol and fatty acids for the normal functioning of the body, it is easy to understand why changes in their chemical structure have a negative effect on health. This explains the high level of cardiovascular and oncological diseases, hormonal disorders, infertility in people living in adverse environmental conditions or having bad habits.
In this case, a direct relationship is triggered - the higher the level of cholesterol and the total amount of adipose tissue in the body, the higher the risk of getting sick.
Lipid metabolism problems
Lipid metabolism is most often impaired with the so-called diseases of the wrong lifestyle:
- obesity;
- atherosclerosis;
- type 2 diabetes mellitus;
- hypertension.
Low mobility, excessive consumption of fats, especially "wrong", and simple carbohydrates lead to this condition.
To correct the situation, you do not need to look for a magic pill. Such popular and widely advertised statins do not improve the quality of life. A list of contraindications and side effects is easy to explain. A tablet doesn’t care where to dissolve cholesterol - not only in the blood, but also in the membrane of the renal tubules or the nerve process, for example.
Proper nutrition will be much more effective, which consists in reducing the number of products containing sugar, starch, white flour, refined oils, animal fats.
Margarine and palm oil should generally be excluded. You can eat meat, eggs, butter, and even lard, but not abuse it. Vegetables, fruits, buckwheat and oatmeal, bran, seafood, nuts, fish, cold pressed vegetable oils are necessary for normal lipid metabolism.
Where to pass the analysis?
After reaching the age of twenty, at least once every five years it is necessary to take tests to determine the lipid spectrum. And after forty it’s better to do it every year, especially if there is a genetic predisposition. You can find out your lipid profile in almost any district clinic.
A person who visits a doctor with complaints of heart, liver, kidney disease, high blood pressure will be assigned a biochemical blood test, including a lipid profile.
The price of analysis may interest the patient if he goes to a paid clinic or wants to know the result without a doctor’s direction. Usually this study is free of charge, at the expense of compulsory health insurance.
Private medical centers set their prices, which start at 500 rubles. for the entire lipid spectrum and from 200 rubles. in one analysis.