Lipidogram is a comprehensive study that includes the determination of total cholesterol, high-density lipoprotein cholesterol (HDL-cholesterol), low-density lipoprotein cholesterol (LDL-cholesterol) and triglycerides (TG) in blood serum. This analysis allows diagnosing lipid metabolism disorders, as well as assessing the risk of developing atherosclerosis and coronary heart disease.

Cholesterol is an important organic substance that is produced by the liver. It is found in large quantities in the brain, adrenal glands, adipose tissue, and is also part of the membranes of almost all cells. Cholesterol is a precursor to steroid hormones necessary for full development, growth and puberty; it takes part in the synthesis of bile acids, which ensure the absorption (absorption) of nutrients from the intestines and their entry into the blood. An increase in cholesterol levels leads to atherosclerosis - the formation of atherosclerotic plaques, which are a growth on the inner wall of the vessel, consisting of a fatty core and membrane. As atherosclerotic plaques grow, they narrow the lumen inside the vessels and disrupt blood flow in the organ. As a result, ischemia (oxygen starvation) develops in the organ that receives blood from the affected artery. If the arteries of the heart are affected, then chronic coronary heart disease develops, but if the plaques are located in the vessels of the brain, then brain disorders appear - headaches, dizziness, memory loss, etc. Over time, blood clots form on cholesterol plaques, which can break off and enter the bloodstream, causing blockage of blood vessels in various organs and tissues, which leads to acute oxygen starvation. Acute ischemia of the heart muscle leads to myocardial infarction (death of part of the heart), acute ischemia of the brain leads to a stroke.

Cholesterol and triglycerides are insoluble in water, and only soluble substances can be transported in the blood. The soluble form of these lipids is lipoproteins - their compounds with proteins.

When cholesterol combines with plasma proteins, high-density lipoproteins (HDL) and low-density lipoproteins (LDL) are formed.

HDL cholesterol is called "good" cholesterol, the main role of which is to remove free cholesterol. HDL carries it from tissues (including from the vessels of the heart, arteries of the brain, etc.) to the liver and does not allow it to accumulate on the walls of the arteries. In the liver, cholesterol is converted into bile acids and excreted from the body. Thus, HDL prevents the formation of atherosclerotic plaques and related diseases.

Women before menopause have higher concentrations of HDL cholesterol than men, and therefore have a lower risk of cardiovascular disease. After menopause, the amount of HDL cholesterol decreases and the risk of cardiovascular disease increases.

LDL cholesterol is “bad” cholesterol and one of the most important indicators of the risk of atherosclerosis. LDL is the most numerous class of lipoproteins in blood plasma. Their main function is the transfer of cholesterol from the places of its synthesis in the liver and intestinal mucosa to the places of its use (storage) in peripheral tissues (vessels of the heart, brain, etc.). LDL carries about 70% of all cholesterol in the blood plasma.

An increase in the level of LDL and cholesterol in the blood plasma increases the risk of atherosclerosis, therefore these lipids are called atherogenic (causing degenerative changes in the walls of the arteries).

Triglycerides are fats that make up 60-85% of adipose tissue and only a small amount is detected in the blood. Triglycerides enter the body with food or are synthesized in the body itself (in the liver, adipose tissue, small intestinal mucosa, muscles). Triglycerides are the main source of fatty acids and energy in the body.

Triglycerides in the blood, like cholesterol, circulate in the form of soluble compounds - lipoproteins and also come in two types:

Very low density lipoproteins (VLDL), the triglyceride content of which is 50-80%, protein 20-50%. In blood plasma taken on an empty stomach, they are contained in low concentrations;

Chylomicrons, which contain 85-90% triglycerides and 0.5-2.5% protein. Normally, they are detected in the blood only in infants after feeding.

An increased level of triglycerides in the blood indicates the risk of developing atherosclerosis, coronary heart disease and cerebrovascular disease (damage to the blood vessels of the brain, leading to disruption of its functions).

In addition to the indicators described above, the lipid profile usually includes the atherogenic coefficient (AC), which is calculated using the formula:

KA = (total cholesterol - HDL) / HDL or KA = (LDL + VLDL) / HDL.

An atherogenic coefficient exceeding normal values ​​indicates an increased risk of cardiovascular diseases.

This test determines the concentration of cholesterol, LDL (low-density lipoprotein), HDL (high-density lipoprotein) and triglycerides in the blood serum (mmol/liter), as well as the atherogenic coefficient (AA).

Method

Colorimetric photometric method. Reagents are successively added to the blood serum, with which the test substances form colored compounds. The color intensity of these compounds is directly proportional to the amount of substances being determined and is determined using a special device - a photometer.

Reference values ​​- norm
(Lipidogram (lipid status), blood)

Information regarding the reference values ​​of indicators, as well as the composition of the indicators included in the analysis, may differ slightly depending on the laboratory!

Norm:

Total cholesterol:

Cholesterol-HDL

LDL cholesterol:

Triglycerides:

According to WHO, the optimal level of triglycerides in the blood serum is<1,7 ммоль/л. Концентрация триглицеридов 1,7 - 2,3 ммоль/л. расценивается как пограничная, а концентрация >2.3 mmol/l. - how tall.

Atherogenic coefficient (AC):
1,5 - 3,0

CA<3,0 - низкая вероятность развития атеросклероза

KA 3.0 - 4.0 - moderate risk of developing atherosclerosis

KA >4.0 - high risk of developing atherosclerosis

Atherogenic plasma index (AIP):
<0,11

AIP<0,11 - низкий риск развития атеросклероза

AIP 0.11 - 0.21 moderate risk of developing atherosclerosis

AIP >0.21 - high risk of developing atherosclerosis

Indications

Assessment of the risk of developing cardiovascular diseases;

Dynamic monitoring of patients with coronary heart disease (I20-I25), hypertension (I11-I13), atherosclerosis of the heart and blood vessels (I70.0), kidney pathology, diabetes mellitus (E10-E14);

Examination of patients with a family history of hypercholesterolemia;

Control of lipid-lowering (low-fat) therapy and diet.

Increasing values ​​(positive result)

Total cholesterol:

1) primary hyperlipoproteinemia:
-familial hypercholesterolemia (phenotype IIa, IIb);
-familial combined hyperlipoproteinemia (phenotype IIa, IIb);
- polygenic hypercholesterolemia (phenotype IIa);
-family dis-β

Lipoproteinemia (phenotype III);

2) secondary hyperlipoproteinemia:
-IHD;
- liver diseases (hepatitis, cirrhosis);

Kidney damage (nephrotic syndrome, chronic renal failure);
-hypothyroidism;

Diseases of the pancreas (chronic pancreatitis, malignant tumors);
-diabetes;

Obesity;
-pregnancy;
-alcoholism.

Lipidogram: the essence of the analysis, what it shows, the norm and deviations, how to take it

Cardiovascular diseases lead in the number of cases worldwide, and their main cause is considered to be disorders of fat metabolism with atherosclerosis affecting the vascular walls. Laboratory examinations, including a lipid profile, help to objectively assess the degree of risk.

You can find out about the amount of total cholesterol from a biochemical blood test, but this indicator alone does not make it possible to reliably judge the presence or absence of pathology. The study of the lipid spectrum involves determining the concentration of not only cholesterol, but also other fatty fractions of the blood. These indicators are very important in assessing the degree of risk of pathology of the heart and blood vessels, therefore they are indicated for people predisposed to atherosclerosis, myocardial ischemia, and diabetes.

For the analysis, venous blood is taken, and the patient must know some of the features of preparation for it and the conditions that may affect the result. The lipid profile is deciphered by a general practitioner, cardiologist, or endocrinologist.

Lipid profile indicators

The pathology of fat metabolism plays a key role in the genesis of a variety of diseases and, above all, vascular lesions. There is no longer any doubt about the influence of lipid metabolism disorders on the development of atherosclerosis, and this disease is the path to dangerous damage to the aorta, kidney vessels, and limbs.

Timely detection of abnormalities in cholesterol and lipid fractions is necessary not only for early diagnosis of pathology of the cardiovascular system, but also for the prevention of severe complications of atherosclerosis.

Many people know that the level is the most important indicator of fat metabolism, so its increase is always a cause for concern. However, this indicator alone is not enough for correct conclusions, because cholesterol can increase in absolutely healthy individuals without provoking atherosclerosis. To assess fat metabolism, it is important to establish the concentrations of lipid fractions, the fluctuations of which are more characteristic of pathology or normality.

A lipidogram with the study of all fatty components of blood plasma makes it possible to more accurately assess the risk of atherosclerosis. The analysis may reveal abnormalities even when the total cholesterol concentration is within normal limits.

Cholesterol is an integral component of cell membranes; it is part of bile, necessary for proper digestion, and is a precursor of sex hormones, without which development, puberty and functioning of the adult body do not occur. In plasma, cholesterol is found bound to lipoprotein proteins.

In addition to cholesterol (CH), a lipid profile - a blood test for lipids includes indicators such as high, low and very low density - HDL, LDL, VLDL. They make up the total cholesterol, but their role is different, so the disease is not judged by total cholesterol. Based on the content of these components, it is determined plasma atherogenic coefficient, which serves as a prognostic factor for cardiovascular diseases.

Cholesterol is formed by liver cells and enters the body from the outside with food, and its excess is excreted. VLDL is not saturated with cholesterol and is able to bind it, becoming LDL. High-density lipoproteins capture excess cholesterol from the blood and deliver it to hepatocytes, where cholesterol is converted into fatty acids or included in very low-density lipoproteins, thus being “neutralized.”

High-density lipoproteins are classified as anti-atherogenic fractions, that is, these components prevent atherosclerosis, removing “bad” cholesterol from the circulation. When they decrease, the likelihood of atherosclerosis increases.

The bulk of blood fats are LDL, which are endowed with the ability to “stick” to the walls of blood vessels and participate in the formation of fat-protein plaque. They account for up to 70% of total cholesterol. If these substances do not go beyond the normal limits, then the risk of pathology is minimal, because the exchange occurs in the right way. In cases where LDL is elevated and settles on the vascular walls, we can talk about a high probability of atherosclerosis, even if total cholesterol remains at normal values.

Triglycerides are a normal component of the blood; they are considered natural metabolites that are part of VLDL, come with food and are excreted by the liver. Their main volume is concentrated in fatty tissue; they are the main energy substrate in the body. Being an integral part of metabolic processes, they, at the same time, can cause serious harm if normal concentrations are exceeded.

It has been established that TGs increase in atherosclerosis, diabetes mellitus, excess weight, hypertension and play an important role in the genesis of coronary heart disease and vascular changes in the brain.

So, a lipid profile consists of the definition:

• Total cholesterol;
• Triglycerides;
• HDL;
• LDL;
• VLDL.

The atherogenic coefficient, which makes it possible to quantify the risk of atherosclerotic damage to the vascular endothelium, is calculated using these indicators: the sum of the values ​​of VLDL and LDL is divided by the level of HDL. (Normally – up to 3.5).

To correctly decipher a lipid profile, it is necessary to take into account some other conditions:

1. Age;
2. Heredity in relation to cardiovascular pathology;
3. Presence of carbohydrate metabolism disorders;
4. Presence and degree of obesity;
5. Blood pressure level;
6. Bad habits (smoking, alcohol).

Only an objective assessment of the lipid spectrum, taking into account these factors, provides the most accurate prognosis for atherosclerosis and heart and vascular diseases.

When is it necessary to study the lipid spectrum?

The study of the lipid spectrum aims not only to determine the risk of heart and vascular diseases, but also to assess the effectiveness of treatment for an already established diagnosis. It is important for dynamic monitoring of patients on and taking medications to lower cholesterol.

Indications for a lipid profile are:

• Examination as part of preventive measures for people over 20 years of age - once for five years;
• Increased total cholesterol in a biochemical blood test;
• The presence of changes in cholesterol concentrations in the past;
• Unfavorable heredity, when among close relatives there are patients with severe atherosclerosis, hereditary forms of fat metabolism disorders;
• Presence of risk factors - smoking, diabetes, excess weight, arterial hypertension, age over 45 and 55 years for men and women, respectively;
• Treatment with lipid-lowering drugs, prescription of a special diet (monitoring the effect).

How to take the test correctly and what affects the result?

When going for any research or analysis, we all want to get the correct and most reliable result, and in the case of a lipid profile, as with other tests, you need to know and follow some rules so as not to distort the indicators.

The blood lipid spectrum is very sensitive to external conditions. This doesn't just apply to food intake. The result can be influenced by anxiety, excessive physical effort, taking medications, recently performed other tests, infections, etc., so all these factors must be kept in mind.

It is recommended to take blood samples for lipid levels in the morning, on an empty stomach, at least 12 hours after the last meal. Half an hour before the test, you should exclude physical activity and psycho-emotional experiences, as well as smoking. The analysis should not be performed in patients with acute myocardial infarction and during the first 3 months from the moment of its occurrence.

The result may change:

Many medications can cause an increase or decrease in both total cholesterol and its fractions, so if you are taking any medications, you must notify your doctor.

Total cholesterol increases during treatment with beta-blockers, by the way, often prescribed for pathology of the heart and blood vessels, which at the same time serves as a reason for a lipid profile. Hormones and some diuretics and tranquilizers also increase total cholesterol.

Decrease in total cholesterol observed in persons taking lipid-lowering drugs (,), as well as when prescribing estrogen, androgens, allopurinol and others.

Corticosteroid and sex hormones cause an increase not only in total cholesterol, but also in HDL and LDL. Hormonal contraceptives increase cholesterol, LDL and reduce HDL.

The ability of many drugs to influence lipid profile parameters makes it necessary not only to take it into account when interpreting the results, but also to closely monitor patients taking such drugs, because their risk of developing vascular and cardiac pathology may be increased.

Norm or pathology?

When deciphering a lipid profile in adults, a specialist first assesses whether there are deviations in the numbers of specific indicators. It is believed that the risk of atherosclerosis is increased if total cholesterol, LDL, VLDL and TG exceed normal values. Pathology is also indicated by an atherogenic coefficient of more than three and a reduced content of high-density lipoproteins.

The following values ​​of lipid spectrum indicators are considered the norm:

• Atherogenic coefficient - 2.2-3.5;
• TG level up to 2.25 mmol/l;
• HDL – 1.03-1.55;
• LDL up to 3.3;
• VLDL - 0.13-1.63 mmol per liter;
• Total cholesterol - up to 5.2 mmol / l.

For high-density lipoproteins, different normal values ​​are provided for women and men. Thus, an increased likelihood of atherosclerotic lesions and cardiovascular pathology is indicated by HDL levels below 1 mmol per liter of blood in men and less than 1.3 in women. Low risk is defined for both sexes if HDL levels exceed 1.55 mmol per liter.

The atherogenicity coefficient can also serve as a prognostic indicator. If it is below three, then the risk of atherosclerosis and vascular lesions is minimized. A coefficient level of 3-4 may indicate an increased risk of atherosclerosis, and with a value of 5 or higher, patients usually already have certain manifestations of atherosclerosis - coronary heart disease, discirculatory encephalopathy, kidney pathology, impaired blood flow in the extremities. With such numbers, vascular complications are quite likely.

A positive lipid profile result, that is an increase in its atherogenic indicators can be observed in a variety of pathologies:

1. Family, hereditary forms;
2. with atherosclerotic changes;
3. Hepatitis, cirrhosis of the liver;
4. Pathology of the urinary organs;
5. Decreased production of thyroid hormones;
6. Diseases of the pancreas (pancreatitis, diabetes);
7. Overweight.

A physiological increase in cholesterol is possible during pregnancy.

Reducing total cholesterol and its fractions is possible with:

• malignant tumors;
• Pulmonary pathology;
• Thyrotoxicosis;
• Infectious diseases, sepsis;
• burn disease;
• Fasting.

High-density lipoproteins usually decrease in coronary heart disease, atherosclerosis, myocardial infarction, diabetes, and stomach ulcers.

The nature of the food consumed has a great influence on the indicators of fat metabolism. Even if there is no atherosclerosis yet, changes in the lipid spectrum already create a risk of heart and vascular diseases. Abuse of quickly digestible carbohydrates, animal fats, fatty and fried foods, and alcohol creates an excessive load of cholesterol, which the body is not able to metabolize. Over time, increasing concentrations of its derivatives are deposited in the vascular endothelium.

If the doctor notices increased cholesterol in a biochemical blood test, he will refer you for a lipid profile study to rule out metabolic disorders. Patients whose cholesterol is normal still need such detailed analysis if they are exposed to risk factors. Persons who have an unfavorable heredity for dyslipidemia are examined regularly, at least once a year, regardless of age.

The price for studying the lipid spectrum depends on the level of the clinic and the locality, varying between 500 and 1500 rubles. The analysis is quite common, so there are usually no difficulties in finding a clinic or laboratory where it can be performed.

If you are concerned about your health, then it is important to know what a lipid profile is. This concept hides a number of blood tests that help detect deviations in the balance of body fats. If abnormalities are found during lipid metabolism testing, then atherosclerosis is likely.

Patients with suspicions of a certain list of ailments need a biochemical blood test. Such diseases include:

• atherosclerosis;
• IHD - ischemic heart disease;
• myocardial infarction;
• vascular diseases of the brain.

The analysis of blood lipid composition is of greatest importance in the diagnosis of atherosclerosis. The examination is aimed at an objective assessment of disorders that occur in lipid metabolism. Deviations from the lipid profile, which were revealed by a biochemical test, indicate the likelihood of developing the disease. At the same time, they are directed to the vessels, heart and brain. The list of potentially diseased organs includes:

• gallbladder;
• liver;
• thyroid gland.

To ensure their functioning, it is necessary to donate blood and conduct a lipid profile analysis.

What indicator is included in the concept of lipid profile:

1. Cholesterol. It is considered one of the main fatty substances in the body. A certain percentage of cholesterol comes from food, but the lion's share is produced in the liver. Its amount is considered an important indicator in lipid metabolism. The content in the blood in large quantities indicates the likelihood of atherosclerosis. Normally, the amount is 3.2-5.6 mmol / l.
2. LDL. Low-density lipoproteins are one of the most harmful components of the fat balance. The danger is that LDL is highly likely to form atherosclerotic deposits in blood vessels. These deposits are called plaques. Normal values ​​for LDL are from 1.71 to 3.5 mmol / l.
3. HDL. The results of biochemical studies have confirmed that high-density lipoproteins are safe for lipid health. Therefore, it is believed that they play a positive role - they do not allow plaques to synthesize and attach to the walls of blood vessels. For the norm, it is necessary to maintain a value of more than 0.9 mmol / l.
4. VLDL are very low density lipoproteins. They are synthesized when taking medications aimed at reducing the amount of HDL in the body. They are considered dangerous lipids.
5. Triglycerides. Specific fatty compounds called neutral fats. They are among the sources of energy. If triglycerides enter the blood in excess, this will lead to the development of atherosclerosis. It is worth monitoring them so that test results do not exceed the norm of 0.41-1.8 mmol/l.

Do not forget about KA - the coefficient (index) of atherogenicity. The KA norm is below 3.5. This number indicates the ratio of atherogenic lipids to the harmless fat fraction.

Cholesterol

One of the lipids is cholesterol. It is a fat-like substance that is required for the synthesis of hormones. The substance is used as a building material for cell membranes and nerve fibers.

So that it can easily move in the blood of women and men, the body coats cholesterol cells with proteins. This is how elements called lipoproteins are formed. 85-90% of cholesterol molecules are produced in the liver. The remainder enters the body with food.

The level of total cholesterol in the blood does not mean anything, because it consists of two components - a good and a bad substance. The first refers to low-density lipoproteins. Good cholesterol is HDL, or high-density lipoprotein. Ideally, you should strive to ensure that the indicators of the second are as high as possible, and the amount of LDL is lower.

To determine the risk of a heart attack, you will need to make calculations. In this case, good cholesterol acts as a divider. The lower the number, the less cause for concern.

To find out the amount of bad and good substances in the blood, you will need to perform a lipid cell analysis. One of the best solutions would be to donate blood from a vein.

Triglycerides: importance of studying when analyzing lipid profile

What does high triglyceride levels mean? This indicates serious disorders in the body. This lipid works as a thickener, thereby promoting the formation of blood clots that impede blood flow. This indicates a risk of heart attack. Statistically speaking, ¾ of patients with a heart attack (among women) had elevated triglyceride levels in the blood. If they had analyzed the lipid profile in time, they would have avoided such tragic consequences.

Note! As triglyceride concentrations increase, the risk of breast cancer increases. Recent evidence suggests that lifestyle changes should be made when preprandial triglyceride levels are 180 mg/dL.

This type of lipid adversely affects health in combination with a reduced level of “good” cholesterol in the blood. Many years of experience in Germany made it possible to find out that 4% of people can acquire such a combination, but the proportion of heart attacks in such patients was 25% of all cases.

What to do when the tests say that there are problems with the blood flow? In advanced situations, it is unlikely that it will be possible to limit oneself to one lipid profile and diet. You will have to resort to medical treatment. But it works best when combined with a diet. If you take medications but do not adhere to proper nutrition, therapy may not bring the desired results.

But do not panic in advance. In any case, the doctor will prescribe a diet. If you adhere to it, then even difficult situations will not lead to dire consequences.

Preparation for lipid analysis and carrying out

Lipid (fat) profile is an important blood test, so you should prepare thoroughly for it. To do this, just follow three rules:

• exclude the intake of alcoholic beverages 2 weeks before the analysis;
• last cigarette before the examination an hour (preferably more);
• You cannot eat food in the morning - blood is taken on an empty stomach.

Otherwise, behave as usual. Some doctors, to be on the safe side, exclude intense emotional and physical stress, coffee and tea. It is recommended to undergo blood lipid testing every 5 years, starting at age 20. If you neglect the rules, then there is a risk of losing time and money - the result of the biochemical analysis will be far from the truth.

The examination can be carried out in any clinic where there is a laboratory. The analysis is carried out in a short time - determining the indicators included in the survey will take no more than an hour. And the actual collection of blood from a vein will only take a few minutes. The procedure is carried out chemically or enzymatically. The latter is less accurate, but differs in speed. As a result of the test, you can find out the quantitative indicators of all lipids contained in venous blood. The resulting form indicates the current levels and the approximate value to which you should strive.

How to read the results

Don't panic if you have high total cholesterol levels. First of all, you should evaluate your age. The older a person is, the higher the amount of this substance in the body - this is how nature intended. At the same time, the highest limit for this lipid also increases. In addition, lipid metabolism is affected not by the total supply of cholesterol, but by the quantitative one. It is worth checking, otherwise there is a risk of ringing the bells in vain and losing valuable time and nerves. When assessing a quantitative indicator, pay attention to LDL. If the content is less than the lower limit of the range, then there are disruptions in the circulatory system that transports fats.

Note! Only a blood test for a lipid profile will provide an opportunity to examine in detail all these substances in the body and assess their impact on health.

LDL plays a much larger role in fat balance if its content is above 3.37 mmol/l. The higher the final number, the greater the risk of contracting atherosclerosis. Exactly the same conclusion can be drawn when the LDL/HDL ratio is more than 3/1. If the number exceeds 4.14, then it is better not to delay a visit to the cardiologist. In this case, the risk of developing ischemia is high. Therefore, there is a need to control the amount of fats in the blood.

The norm is achieved either by optimizing nutrition or with the help of medications. There is always a risk of receiving an illness as a gift as an inheritance, but you can get rid of this too. The main thing is to carry out tests on time and achieve competent decoding. Then you can find out which indicators to correct with the help of diet or therapy.

Why is a personal lipid profile so important?

A blood test called a lipid profile must be performed even if you are completely healthy. What is its need? .

Everyone is used to seeing a doctor when something hurts. Both women and men are afraid to visit therapists - that’s how it is. But when we have already been treated for a certain time, we periodically check ourselves: whether a relapse has occurred, whether there is an exacerbation. The picture is exactly the same with interest in the lipid profile. Many people become interested in biochemical tests after a heart attack, detection of atherosclerosis or coronary artery disease.

But you should have consulted a doctor 15-20 years ago, when you could quickly correct the situation without waiting for the climax of life. The vessels that feed the heart become clogged in more than one second. The process lasts for years. Ultimately, the blood flow through them weakens so much that the “pump”, experiencing a deficiency, begins to malfunction. All this shows how necessary biochemical research is.

To prevent such a turn of events, it is recommended to conduct a detailed examination, a blood test for lipids. Only then will the doctor draw conclusions, make a diagnosis or confirm good health.

Important! Don't forget that you shouldn't look at each fat content individually. It's worth seeing the big picture. All lipids individually can only tell about themselves. But a comprehensive decoding will allow you to assess your health.

Blood flow screening will exclude diseases in the adult and in the fetus if a pregnant woman was examined.