Lipidogram: what is it, normal indicators, decoding. Lipidogram (lipid profile, lipid status, fat metabolism, total cholesterol, HDL, LDL, VLDL, atherogenic coefficient (ka), plasma atherogenic index (aip), triglycerides)

Lipid spectrum (lipidogram) - a set of biochemical blood tests that allow you to assess the full state of fat metabolism in the body. The study includes the definition of:

• total cholesterol (OH);
• triglycerides (TG);
• high density lipoproteins (HDL);
• (VLDL);
• low density lipoproteins (LDL);
• coefficient of atherogenicity (KA).

In an extended lipid spectrum analysis, the lipid carrier proteins circulating in the blood, apoprotein A and apoprotein B, are also detected.

Compound

Cholesterol is the general name for fatty molecules that circulate in the blood. Cholesterol has several biological functions in the body. It is a structural component of the cytoplasmic membrane of all body cells. It is a precursor of the adrenal hormones corticosteroids, estrogen and testosterone. It is part of bile and fat-soluble vitamin D, which is responsible for the growth of bone and cartilage tissue and the immune defense of the body.

Since fat, and accordingly cholesterol, is hydrophobic in nature and cannot move independently in the blood, special transport proteins apoproteins join it. The protein + fat complex is called lipoprotein. According to their chemical and molecular structure, several types of lipoproteins are distinguished that perform their functions in the body.

- fraction of the lipid spectrum, which has anti-atherogenic properties. For the ability to bind excess fat in the body, transport it to the liver, where it is utilized and excreted through the digestive tract, HDL is called "good" or "useful" cholesterol.

Low and very low density lipoproteins- the main factor in the formation of atherosclerosis. Their main task is to transport cholesterol to all cells of the human body. In elevated concentrations, LDL and VLDL are able to "linger" in the vascular bed, deposited on the walls of the arteries and form cholesterol plaques.

Triglycerides are neutral fats circulating in the blood plasma, which are also. These lipids are the main fat reserve of the body, providing the energy needs of cells.

Atherogenic coefficient- this is the ratio of "useful" and "harmful" fats in the patient's blood, which is calculated by the formula: CA \u003d (OH - HDL) / HDL.

Apoproteins (apolipoproteins)- Carrier proteins of cholesterol fractions in the bloodstream. Apoprotein A1 is a component of HDL, apoprotein B is HDL.

Deviations from the norm in the lipid spectrum indicate violations of metabolic processes in the body and can lead to serious complications. Regular analysis and monitoring of its results will help prevent the development of diseases.

Indications for a lipid spectrum analysis

The study of the lipid spectrum is carried out for:

• diagnosing and monitoring the dynamics of atherosclerosis in patients with risk factors: smoking, alcohol abuse, cardiovascular pathology, arterial hypertension, diabetes mellitus, aggravated heredity;
• studying the state of fat metabolism in patients with coronary heart disease, after myocardial infarction;
• evaluation of fat metabolism in terms of management of patients with cerebrovascular diseases.

Recently, the analysis of all patients older than 50 years in most polyclinics is included in the scope of guaranteed screening (preventive) examination. This means that regardless of the reason for visiting a doctor, it should be carried out in the target age categories once a year (or every 2 years). If a deviation from the norm is detected at this stage, the patient may be assigned an extended blood test for the lipid spectrum.

In addition, it is recommended that all healthy young people undergo a lipid spectrum analysis once every 5 years. This will allow you to notice violations of fat metabolism in time and begin treatment.

Control of the treatment of atherosclerosis should also be carried out with the study of the lipid spectrum. A blood test is prescribed 1 time in 3 months during the period of selection of the drug and dose, and 1 time in 6 months in case of positive dynamics. Reducing cholesterol, LDL, VLDL and atherogenic coefficient indicates the correct selection of funds for the treatment of atherosclerosis.

How to prepare for the analysis?

Like any other biochemical test, lipid spectrum analysis requires a little preliminary preparation and adherence to the rules listed below:

• The study of the lipid spectrum is carried out in the morning on an empty stomach (fasting time should be at least 8 hours, but not more than 14). Drinking table water without gas is allowed. If there is no opportunity to donate blood in the morning, it is allowed to do this in the daytime. The interval between the last meal and blood sampling should be 6-7 hours.
• You should have dinner the day before, as usual, without adhering to a special diet: this way the results of the analysis on the lipid spectrum will be more reliable. Moreover, it is not necessary to break the habitual diet for a person within 1-2 weeks before the examination;
• It is recommended to stop smoking half an hour before blood sampling and from drinking alcohol - a day before;
• The study of the lipid spectrum should be carried out when the patient is calm and does not experience psychological discomfort;
• Before taking blood, you need to sit quietly for 5-10 minutes.

Blood for analysis is taken from a vein. Usually 5-10 ml is sufficient. The laboratory assistant then properly prepares the biological fluid and transports it to the laboratory. Then the blood is sent for decoding: the results of the lipid spectrum test, as a rule, are ready within a day.

Normal and pathological values ​​of the lipid spectrum

The norms of a blood test for the lipid spectrum vary depending on the age of the subject and the equipment of a particular laboratory. Average indicators are presented in the table below

Lipid Spectrum Index	Norm in the blood
total cholesterol	3.20 - 5.26 mmol/l
high density lipoproteins
Female	> (greater than) 1.1 mmol/l
Male gender	> (greater than) 1 mmol/l
low density lipoproteins	< (меньше) 3,50 ммоль/л
Very low density lipoproteins	< (меньше) 0,50 ммоль/л
Triglycerides	less than 2 mmol/l
Atherogenic coefficient	2-3
Apo(lipo)protein A
Female	1.08 - 2.25 g/l
Male gender	1.04 - 2.02 g/l
Apo(lipo)protein (B)
Female	0.60 - 1.17 g/l
Male gender	0.66 - 1.33 g/l

As a rule, with violations of fat metabolism, all indicators deviate from the norm. This condition is called dyslipidemia.

What does dyslipidemia mean?

A decrease or increase in the lipid spectrum can lead to significant malfunctions in the body. When correcting fat metabolism, first of all, it is necessary to focus on the causes that caused the violations.

Cholesterol

Most often, the first in patients who applied to the clinic, an increase in cholesterol is diagnosed. This indicator in a newborn does not exceed 3 mmol / l, but begins to gradually increase with age. Despite the fact that the average cholesterol rate is in the range of 3.2-5.26 mmol/l, these values ​​in elderly patients can be extended to 7.1-7.2 mmol/l.

Up to 80% of the cholesterol circulating in the blood is formed in the liver (the so-called endogenous cholesterol). The remaining 20% ​​comes from food. Therefore, one of the main risk factors for the deviation of this analysis from the norm is nutritional errors: eating a large amount of food saturated with animal fats (, fatty meat, milk and dairy products).

Other risk factors for high cholesterol include:

• hereditary genetic diseases (familial hypercholesterolemia);
• ischemic heart disease, myocardial infarction;
• liver diseases (cholelithiasis, primary biliary cirrhosis);
• kidney disease (chronic pyelonephritis, chronic glomerulonephritis, chronic renal failure);
• diabetes;
• thyroid disease (hypothyroidism);
• obesity;
• taking medications (diuretics, beta-blockers, combined oral contraceptives, glucocorticoids);
• alcoholism;
• diseases with a violation of mineral metabolism, gout.

Since cholesterol is a collective concept that includes all fractions of fats circulating in the blood, it can most often be increased by increasing atherogenic lipids. An analysis of the lipid spectrum in this case may show an increase in the concentration of LDL and VLDL at normal or reduced values. The coefficient of atherogenicity and the risk of developing atherosclerosis in the subject, respectively, will be increased.

Cholesterol reduction is less common. The causes of these lipid disorders can be:

• starvation, up to complete exhaustion;
• malabsorption syndrome, other gastrointestinal problems that interfere with the absorption and assimilation of food;
• severe diseases, including infectious ones, sepsis;
• chronic pathology of the liver, kidneys, lungs in the terminal stage;
• taking certain medications (statins, fibrates, ketoconazole, thyroxine).

Cholesterol reduction usually occurs at the expense of all fractions of the lipid spectrum. When deciphering the analysis, a picture of hypolipoproteinemia will be observed: a decrease in the concentration of not only total cholesterol, but also HDL, LDL, VLDL, triglycerides and atherogenic coefficient. This condition is fraught with a violation of the construction of cell membranes in the body, which means pathology on the part of all organs and systems, loss of childbearing function by women of childbearing age, depression of the nervous system with the formation of depression and suicidal thoughts. The condition is corrected by eliminating the cause that caused it, by prescribing a diet rich in animal fats.

high density lipoproteins

Most often, when analyzing the lipid spectrum in patients with atherosclerosis and cardiovascular pathology, a decrease in this indicator is determined. HDL is the main anti-atherogenic factor, which should be maintained within the target values ​​(>1-1 mmol/l in women and >1 mmol/l in men). When decoding analyzes for the lipid spectrum, it was noted that a critical decrease in HDL is more often observed in men than in women. This is due to the "protective" effect on the vessels of estrogens - female sex hormones. That is why women aged 40-50 years (that is, before the onset of menopause, when the concentration of estrogen in the blood decreases) have a lower risk of coronary heart disease and myocardial infarction. In old age, the incidence of cardiovascular pathology becomes approximately the same in both sexes.

A decrease in HDL occurs when:

• atherosclerosis;
• cardiovascular diseases;
• smoking and alcohol abuse;
• overweight;
• chronic liver diseases accompanied by cholestasis;
• diabetes.

An increase in the indicator in lipid spectrum analyzes is rare.

Low and very low density lipoproteins

This form of lipids is considered a key link in the pathogenesis of atherosclerosis. The lower the density of the protein + fat complex, the easier it settles on the inner surface of the vessels, forming at first a soft and loose lipid spot, and then, gradually strengthening with connective tissue, it turns into a mature cholesterol plaque. An increase in the concentration of LDL and VLDL occurs for the same reasons as an increase in cholesterol.

With a significant excess of the norm of LDL and VLDL, the atherogenic coefficient can reach values ​​of 7-8 or more (with a norm of 2-3). Such indicators of the lipid spectrum indicate already formed atherosclerosis and a high risk of complications from the cardiovascular, nervous system.

Triglycerides

Scientists consider triglycerides as an additional factor of atherogenicity. In atherosclerosis, in addition to an increase in total cholesterol and low-density lipoprotein fractions, triglycerides are also likely to be elevated.

Atherogenic coefficient

The atherogenic coefficient is an integral value that can be used to determine the risk of developing atherosclerosis and its complications in each individual patient. An increase in its value indicates the predominance of lipoproteins of "harmful" fractions over "useful", which means an increasing risk of deposition of cholesterol plaques on the inner surface of the arteries.

Apolipoproteins

Usually, when deciphering the analysis for the lipid spectrum, the concentration of carrier proteins, apolipoproteins, is not calculated. This study will be useful in investigating the causes of the hereditary form of hypercholesterolemia. For example, with a genetically determined increase in apolipoprotein A, the concentration of low density lipoproteins naturally increases. As a rule, such conditions require a lifelong prescription of a therapeutic diet and medications.

Lipidogram target values: what indicators should you strive for

The older the patient, the harder it is for him to keep his cholesterol and other indicators of the lipid spectrum normal. According to statistics, every third inhabitant of the planet over 60 suffers from atherosclerosis, and cardiovascular diseases are in the first place among the causes of death.

Correction of disturbed fat metabolism is a long process and requires maximum control both on the part of the general practitioner who prescribes the treatment, and on the part of the patient himself. The higher the initial level of cholesterol, the longer should be the therapy of atherosclerosis. The target values ​​of the lipid spectrum, which should be strived for by all patients with cardiovascular pathology and cerebrovascular accidents:

• total cholesterol - less than 5.26 mmol / l;
• KA - less than 3.00 mmol / l;
• low density lipoproteins - below 3.00 mmol / l;
• high density lipoproteins - above 1 mmol / l;
• triglycerides - less than 2 mmol / l.

Upon reaching these values ​​of the lipid spectrum in the blood, the risk of developing myocardial infarction and stroke is reduced by 3.5 times.

Thus, the lipid spectrum is a comprehensive analysis that allows you to give a complete assessment of fat metabolism in the body. The sooner lipid profile disorders are detected, the sooner they can be corrected by changing the diet, lifestyle and prescribing medications.

There is an opinion that cholesterol in the human body is a rather harmful substance. Many information sources advise to constantly reduce this indicator in the human body. It should be noted right away that this opinion is erroneous, since it is cholesterol that is involved in many life processes of human cells.

LDL is considered atherogenic while HDL is anti-atherogenic.

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

Cholesterol - what is it?

Cholesterol is a steroid or highly biologically active substance. It is produced to a greater extent in human liver cells, up to about 50%, about 20% is synthesized by the intestines. The rest of the cholesterol is synthesized by the adrenal glands, skin and gonads. And only up to 500 mg of cholesterol per day comes from food.

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

LDL - the so-called "bad", in fact, this concept does not exist in the medical vocabulary, it is more a common name for low-density lipoprotein. And it is bad because with its excess and oxidation, it really settles on the inner wall of the vessel, closing its lumen. Therefore, it is imperative to control this indicator, especially if total cholesterol in the blood is elevated.

HDL can be lowered for a number of reasons, such as poor diet or bad habits.

Lipoproteins vary in size, density and lipid content

HDL - in everyday life is considered "good". It differs from low-density lipoprotein in its structure and functional features. Its main function is to cleanse the vascular wall from LDL. With a sufficiently high level of HDL or its norm, people are less prone to atherosclerotic diseases. If the HDL blood test reveals a significant decrease in them, then atherosclerosis is presumably diagnosed and additional studies are prescribed to confirm the diagnosis.

Lipid profile

This is a special biochemical blood test. The study includes the layout of lipids (fats) into individual components. With the help of this analysis, you can control the indicators and promptly turn to specialized medical care for any pathological abnormalities. This biochemical analysis includes:

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

Even with this study, the atherogenic coefficient (KA) is calculated, which determines the predisposition to atherosclerosis. The so-called ratio between HDL and LDL.

Indications for analysis

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

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

A blood lipid profile test is prescribed for people who are in the "risk group" and have some of the following diseases:

• cardiac ischemia;
• liver and pancreas;
• chronic pancreatitis;
• obesity, foodborne;
• hyperthyroidism;
• alcoholism;
• myeloma;
• sepsis;
• gout.

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

Analysis interpretation

Lipidogram allows you to detect lipid metabolism disorders

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

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

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

What can cause an increase in LDL levels?

LDL can rise in some diseases of the kidneys and liver, due to an imbalance of HDL. And also the risk factors for increasing "bad" cholesterol include: smoking, alcohol abuse, overeating, lack of physical activity or physical inactivity, bile stasis. To reduce or maintain LDL, you need to resort to a healthy lifestyle and proper nutrition.

Preparation for analysis

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

To obtain a correct and informative result of the analysis, a prerequisite on the part of the patient is preparation for it. Blood is taken from a vein and always on an empty stomach. Food must be abandoned 8 hours before delivery, and preferably for all 12. Dinner should be very light and consist mainly of fiber, exclude fatty meats, all types of sausages and smoked meats. Since this will lead to chileza in the blood serum and the analysis will be incorrect. You should also refrain from drinking coffee and alcohol the day before, do not smoke at least two hours before donating blood. If drugs are used, then it is better not to take them before taking the test. And if this is undesirable, then be sure to warn the doctor about their intake.

Why are lipids useful?

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

Often, doctors, in addition to standard examination methods, prescribe a lipid profile to patients with complaints of heart pain, shortness of breath, and blood pressure instability - what is it? A study or lipidogram is a laboratory diagnostic method that allows not only to identify the degree of current disorders of fat metabolism in the body, but also to 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 the number of patients suffering from ischemic heart disease and cerebral circulatory disorders is growing in the world. The cause of these diseases in 70-80% of cases is atherosclerosis - a multifactorial disorder of fat metabolism, provoking:

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

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

Who is assigned the analysis?

Blood lipidogram is an advanced examination method that allows you to get 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 provide a complete laboratory picture.

Conducting a lipid profile is prescribed for:

• an increase in the level of lipoproteins, determined biochemically;
• complex examination of patients suffering from pathology of the heart, 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, smoking men and women over 55 years of age);
• examination of patients who have undergone an acute vascular accident;
• when prescribing lipid-lowering drugs;
• to monitor the effectiveness of therapeutic measures in all patients suffering from atherosclerosis.

What is included in the lipid spectrum of the blood?

This analysis includes 6 indicators, we will dwell on them in more detail.

• total cholesterol. Cholesterol is a monohydric fatty alcohol, mostly synthesized in the human body by liver cells. Twenty percent of the substance can come with food. Cholesterol performs many biologically important functions: it is part of the bioplasmic membrane of every cell of the human body, ensures its permeability for ions, active components of the intercellular fluid; makes the cell membrane stronger, 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 fatty molecules, several fractions of cholesterol are isolated.
• HDL. (useful, "good" cholesterol) - the smallest fat particles, the size of which is only 8-11 nm (normal). Their main function is interaction with other lipoproteins and cells, collecting cholesterol, transporting it to the liver for further utilization. Thus, HDL "cleanses" the walls of blood vessels from fatty deposits, provides prevention of atherosclerosis.
• LDL. (bad, "bad" cholesterol) - large fatty particles 18-26 nm in size, which are saturated with fatty alcohols, but poor in protein. With the blood flow, they are transported throughout the body and easily give lipids to neighboring cells. LDL is the most atherogenic fraction of lipoproteins. They contribute to the formation of fatty plaques on the inner wall of blood 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 predominantly consists of triglycerides.
• Triglycerides. Triglycerides are organic substances that make up the main energy reserve of the cell. With excessive intake of them with food, triglycerides form a large amount of VLDL - the main atherogenic fraction of cholesterol. A large amount of these substances is found in foods rich in animal fat: lard and fatty meat, butter, hard cheeses, egg yolk. Therefore, all patients suffering from atherosclerosis are advised to follow a plant-based diet, limiting the above meals.
• The atherogenic coefficient is a relative indicator that allows assessing the risk of cardiac, vascular, cerebral complications of atherosclerosis in a patient with dyslipidemia. The value is calculated by the formula: KA = (OH - HDL) / HDL. Thus, the ratio of "bad" and "good" cholesterol fractions is determined, which must be in constant balance to maintain the constancy of the internal environment.

Tables of normal values ​​and risks

The lipid profile of a healthy person reflects a balanced ratio of all cholesterol fractions. The analysis rate 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, it is possible to determine the risk of developing atherosclerosis and its cardiovascular complications, so the analysis should be deciphered by a specialist.

Risk	Lipidogram parameters, 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! Due to the difference in medical equipment used in laboratories, lipid profile norms may vary.

What are deviations from the norm?

Total cholesterol is the main indicator of analysis for. It reflects the level of all fractions of lipoproteins and is the first step in diagnosing disorders of fat metabolism.

An increase in total cholesterol almost always indicates a high risk of developing cardiovascular disease. It can be provoked:

• malnutrition, the use of large amounts of animal fats;
• hypodynamia, 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, the level of cholesterol begins to rise, it reaches its maximum by the age of 70-75;
• concomitant diseases: diabetes mellitus, decreased thyroid function.

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

A decrease in the concentration of cholesterol in the blood serum may indicate:

• hyperthyroidism;
• liver diseases, accompanied by a violation of its synthetic activity, cirrhosis;
• fasting, strict vegetarian diet;
• malabsorption (impaired absorption of nutrients by 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 abnormal cholesterol levels during a comprehensive assessment of the patient's condition.

HDL deviations

Experts associate a decrease in the concentration of useful cholesterol 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 a decrease in 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 if it exceeds 2.2 mmol / l. Despite the fact that a high level of "good" cholesterol protects blood vessels from the formation of atherosclerotic plaques, such changes in the lipid profile are not always evaluated positively. Usually, an increase in HDL is associated with hereditary genetic abnormalities of fat metabolism.

Deviations of LDL and VLDL

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

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

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

Reducing the concentration of "bad" cholesterol is rare. With a generally normal lipid profile, this reduces the risk of developing atherosclerosis.

Triglyceride Abnormalities

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 disease;
• thrombosis of the arteries of the brain;
• viral hepatitis B, C, cirrhosis of the liver;
• gout, other metabolic diseases;
• thalassemia, Down's disease;
• increased levels of calcium in the blood;
• chronic pancreatitis, alcoholism.

Triglycerides have a great influence on the 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 coefficient of atherogenicity is a relative value that assesses the prognosis for the development of atherosclerosis and its complications, its determination is considered the most important. An increase in CA is observed with an imbalance of lipids in the body associated with an increase in the concentration of "bad" and a decrease in "good" cholesterol. The higher this indicator, the more likely acute cardiovascular and cerebral problems in the patient.

Preparation for the survey

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

1. Since the lipid spectrum analysis 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 refrain from them. With strong thirst, pure mineral water is allowed.
2. For a reliable result, you should not drastically go on a diet: eat as usual for two weeks before the examination. If on the eve of the test you have a big feast, move the trip to the laboratory for 2-3 days.
3. Do not drink alcohol at least a day before the study.
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 hours.
5. Do not smoke one hour before blood sampling.
6. If possible, exclude factors that affect the result of the examination: exhausting physical activity, 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 can not donate blood after R-examination, sigmoidoscopy, physiotherapy procedures.
9. To control the treatment of atherosclerosis with the help of prescribed lipid-lowering agents, it is not necessary to stop taking the tablets.

For the study, 2-5 ml of venous blood is taken, which is centrifuged and sent to the laboratory for analysis. The result is usually prepared within a day. With diagnosed atherosclerosis, experts advise patients to donate blood for a lipid profile at least 1-2 times a year.

Thus, the lipid profile is a study that is desirable 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.

In terms of mortality in the world, cardiovascular diseases rank first. One of the causes of this terrible disease is atherosclerosis, in which there is a narrowing and blockage of blood vessels.

For timely diagnosis of this disease and evaluation of the effectiveness of its treatment, a laboratory study of the blood composition for the content of fats and fat-like substances is carried out - lipidogram.

When diagnosing diseases, a biochemical blood test is usually performed. One of the indicators of such an analysis is total amount of cholesterol. However, when examining a patient for the presence of cardiovascular diseases, this indicator is not enough.

This is due to the fact that cholesterol and other fat-like substances in the blood are in the form of lipoproteins, which are compounds of lipids (fats) and proteins. With the help of these lipoproteins, the blood performs the necessary movement of insoluble fat-like substances throughout the body. Lipoproteins themselves are complex compounds that can have low density (LDL) or high density (HDL). The density of these compounds depends on the ratio of fat and protein in them. LDL contains more fat than HDL. It turns out that these two different substances differently affect the formation of plaques in the blood vessels, and, consequently, the disease atherosclerosis.

LDL cholesterol is the main carrier of fats in tissues and organs. At the same time, it is the main source of cholesterol deposition on the walls of blood vessels and the most dangerous in terms of atherogenicity, that is, the ability to form plaques in blood vessels, their narrowing and blockage. At the same time, the amount of such cholesterol is up to 65% of the total amount of cholesterol in the blood.

HDL cholesterol prevents the formation of plaques, as it transports free fat-like substances from the cells to the liver, through which they are removed from the body.

There are also lipoproteins in the blood extra low density(VLDL). Currently, there is no reliable evidence of their negative effect on blood vessels, but often their number is also of interest in the diagnosis of cardiovascular diseases. Some scientists believe that VLDL, under certain conditions, is converted into LDL and thus increase the likelihood of atherosclerosis.

In addition to cholesterol in the blood contains fats - triglycerides(TG). These fats are the source of energy for cells. In the blood, triglycerides are part of VLDL. Their excess can also adversely affect the appearance of plaques in the vessels.

The presence of a very complex structure of fats in the blood requires a thorough analysis of the lipid spectrum for a correct diagnosis.

Usually lipidogram includes determining the amount of the following lipids in the blood:

• total cholesterol (Koch);
• HDL (α-cholesterol);
• LDL (β-cholesterol);
• VLDL;
• triglycerides.

According to the results of laboratory studies, atherogenic coefficient(Ka).
This coefficient is determined by the following formula:

Ka \u003d (Koh - HDL) / HDL.

What preparation is needed for the analysis?

A blood test to obtain a lipid profile is performed by conventional blood sampling from a vein. At the same time, it is necessary do this fence on an empty stomach. In addition, during the day before donating blood, it is necessary to abandon heavy physical exertion, smoking, and taking alcoholic beverages. It is advisable to exclude emotional stress before donating blood.

Norm of indicators

The results of the lipidogram are compared with the permissible values ​​of the corresponding indicators. The meanings of these boundary indicators are shown in table 1.

Table 1

An example of a lipidogram obtained for patient N. (age -74 years, preliminary diagnosis - coronary artery disease and angina pectoris 2 FC) are shown in table 2.

table 2

Based on the results of this lipidogram, Ka was calculated:
Ka \u003d (4.94-1.04) / 1.04 \u003d 3.94.

Interpretation of results in adults

The results obtained are interpreted as follows:
At Ka< 3 риск development of atherosclerosis is small. The value of this coefficient from 3 to 4 indicates the presence of atherosclerosis and coronary artery disease in the patient. With Ka\u003e 5, there is a high probability of diseases of the heart, brain and kidneys. If LDL\u003e 4.9, then this indicates the presence of atherosclerosis and coronary artery disease. With values ​​of this indicator from 4 to 5, we can talk about the presence of the initial stage of these diseases.

Meaning HDL indicator for men< 1,16 ммоль/л (для женщин – < 0,9) свидетельствует о наличии у пациента атеросклероза или ИБС. При расположении показателя в граничной области (мужчины – от 1,16 до 1,7 и женщины — от 0,9 до 1,4) можно диагностировать процесс появления этих болезней. При высоких значениях показателя ЛПВП риск появления атеросклероза очень мал.

Exceeding the TG level 2.29 mmol / l indicates the presence of atherosclerosis and coronary artery disease in the patient. With borderline values ​​of this indicator (1.9-2.2), we can assume the initial stage of development of these diseases. A high TG value is also possible if the patient has diabetes mellitus.

The results of the lipidogram of a real patient given in the example (Table 2) are quite match the code above. Indeed, despite the fact that the indicators of total cholesterol and triglycerides are normal, the HDL is quite low and is at the border of the acceptable range, and the LDL is out of range. Therefore, the patient is diagnosed the presence of atherosclerosis and coronary artery disease, which is confirmed by the low HDL value (1.04 mmol/l) and the high Ka value (3.94).

Desired indicators

In order for fat metabolism in the body was normal should aim for the following:

• total cholesterol - no more than 5 mmol / l;
• LDL - no more than 3 mmol / l;
• HDL — not less than 1 mmol/l;
• triglycerides - no more than 2 mmol / l;
• Ka - no more than 3.

Lipidogram in the treatment of diseases of the heart and blood vessels

As a rule, the appointment of a patient for a lipid profile is made by a cardiologist. Thanks to the results of LH, diseases such as myocardial infarction, stroke, kidney disease and other diseases can be diagnosed.

If an increased content of LDL, which has a bad effect on blood vessels, is detected, the doctor may prescribe statin treatment(lovastatin, rosuvastatin, simvastatin). The presence of a large amount of TG also requires treatment with drugs. But if the patient's blood contains a large amount of HDL, then such treatment may be premature. In this case, sometimes take the usual measures, including diet, increased consumption of seafood and fish, maintaining a healthy lifestyle without smoking and drinking alcohol.

Therefore, when diagnosing diseases of the heart and blood vessels, the correct interpretation of the patient's lipid profile.

In the treatment of already established cardiovascular diseases, LH is used as a marker with which the doctor checks the safety and effectiveness of the prescribed treatment.

In the case of the appointment of statins, after some time it is prescribed repeated lipid profile. According to its results, the doctor determines the effectiveness of the treatment and, if necessary, makes its adjustment.

Prices in the company "Invitro"

When a lipidogram is prescribed by the attending cardiologist of the polyclinic, the analysis is free of charge. In other cases, such an analysis can be done at various medical centers.

The cost of such an analysis lies in within the range of 1000 to 1500 rubles.

For example, in the Invitro company in Moscow, such an analysis costs 1,080 rubles plus 199 rubles for blood sampling, and in St. Petersburg, the same analysis can be done at the NML company for 1,300 rubles.

It is believed that cardiovascular diseases are one of the most common types of diseases, which are also the most dangerous. It is the leading cause of death worldwide. Currently, the most common pathologies of the heart, which are associated with changes in the walls of blood vessels - the deposition of fatty plaques. They are formed due to increased levels of lipid-like substances in the blood. Therefore, during the examination of the heart, a lipid profile analysis is prescribed.

What is a lipid profile?

This is a study that allows you to determine the level of fats in the blood, as well as a number of other important criteria. Despite the fact that in some blood tests, for example, in biochemical, there are a number of indicators that are included in the lipid profile, the importance of the latter should not be underestimated. This detailed study is highly specialized and allows you to evaluate the factors that are necessary for making such a diagnosis as atherosclerosis.

This study is necessary for the diagnosis of heart disease, diabetes, vascular problems. Also at risk are those patients who have had cases of heart attacks or strokes in the family.

Lipidogram is recommended to be carried out regularly after twenty years, as well as:

• with high blood cholesterol;
• after suffering heart attacks, strokes, diabetes mellitus;
• if the patient is at risk: more than fifty-five years, maintaining the wrong image, metabolic disorders.

Study preparation

Cholesterol and fats (lipids) are not always harmful, they exist in the blood of a healthy person. It is these substances that form the cell walls, membranes, in the body. Moreover, lipids are one of the most important sources of energy, in this regard, during the diagnosis, not the presence of fats is detected, but their amount.

The results of the analysis can be influenced by various factors, so you need to follow certain rules on the eve of the study:

Venous blood is used for analysis. Doctors advise taking the test in the morning. Ten to fifteen minutes before blood sampling, it is recommended to relax and calm down. Eat a light dinner the night before.

The main components of lipid metabolism are cholesterol and triglycerides. Due to the fact that fats need to be transported, and proteins are used for this, both of these substances combine and form lipoproteins. During a blood test, each of the fractions is examined.

Additionally, LDLP can be determined - intermediate density lipoproteins, but this indicator is not of high significance. During the decoding of the lipid profile, risk factors are also taken into account: age, bad habits (obesity, smoking, alcoholism), predisposition to any diseases, diabetes mellitus, high blood pressure, kidney disease.

There are some factors that can affect the result and its correctness:

• increased physical or emotional stress;
• drinking alcohol or smoking before taking the test;
• eating fatty foods before the study, prolonged fasting;
• pregnancy;
• diseases of the internal organs of the excretory system;
• infectious diseases, injuries, exacerbation of chronic diseases.

total cholesterol

It is considered one of the most important indicators. Cholesterol is a very important component that is necessary for cell growth, it is involved in the production of important acids in the body.

High cholesterol levels in the blood can lead to thickening of the walls of the arteries, which can lead to circulation problems. Such vascular damage can lead to serious consequences, in the worst case, to a heart attack or stroke. There are two types of cholesterol: one that enters the body with fatty foods, and the other is due to the production of cholesterol in the body itself.

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It has been proven that the development of atherosclerosis occurs more often in connection with internal cholesterol than with the consumption of fatty foods.

In the body, cholesterol is produced by the liver. An increased rate may be associated with certain diseases, for example, diabetes, kidney disease.

A special scale was created to determine cholesterol levels.

Cholesterol levels can change with age. For example, at birth, the level is less than three mmol / l. Further, the indicator increases, there may be differences between the indicators of men and women. Such differences are associated with the hormonal background: male hormones increase its level, and female hormones decrease it. During pregnancy, cholesterol levels increase. Cholesterol levels rise with age - this is normal.

The level of the indicator is directly related to the functioning of the liver. For example, with liver diseases, a decrease in blood levels is observed. Thanks to the diet, you can significantly reduce the amount of cholesterol. It is recommended to maintain the level no more than 5 mmol / l for prevention.

Triglycerides

The increase in cholesterol and triglycerides most often occurs simultaneously, so both of these indicators should be considered together. In the case of a significant increase in only one of these indicators, the analysis is considered incorrect. Most often, this means that a person has eaten a lot of fatty foods the day before.

Triglycerides are a complex of substances that are "energy" for the whole body. For the most part, triglycerides are found in adipose tissue, they enter the body with food, and are processed in the liver.

The criteria are the following numbers.

The lowest rates are observed in the first ten years of life. The level rises with age. An increase in triglyceride levels can lead to diseases of the cardiovascular system and atherosclerosis. Part of the increased rate can be combined with obesity, diabetes.

A decrease in triglyceride levels may be associated with such diseases: hyperthyroidism, malnutrition, lung disease. The level of this indicator in the blood can change with age.

In addition to the indicators described above, the results of lipoproteins are also important. They are divided into several categories depending on their association with proteins: low density, high density, very low density.

LDL

LDL is considered one of the main indicators of the possible development of atherosclerosis. Due to their low density, with improper nutrition, they accumulate in the blood, as they do not have time to be processed. The more LDL accumulate, the more likely it is that an atherosclerotic plaque can form in their place.

You need to follow these rules.

	Norm (mmol / l)
Men up to 1 year	0,52-2,86
Men 1 to 4 years	0,71-2,86
Men 5 to 9 years old	1,64-2,86
Men 10 years	1,75-2,86
Men 11 to 17 years old	1,67-2,86
Men over 18 years old	1,72-3,51
Women up to 1 year	0,51-2,86
Women from 1 year to 4 years	0,71-2,86
Women 5 to 9 years old	1,64-2,86
Women 10 to 18 years old	1,77-2,86
Women over 18 years old	1,77-3,6
	1,77-3,6

VLDL and HDL

Many believe that VLDL as well as LDL have an impact on the development of atherosclerotic plaques. Some believe that VLDL is pathological by default, but this has not yet been proven. In any case, elevated rates indicate a violation in lipid metabolism.

High density lipoproteins are a very important component. HDL not only does not provoke the ingress of fats into the walls of blood vessels, but also prevents this process. Lipoproteins allow you to get rid of excess cholesterol that accumulates in cells.

These substances deliver cholesterol to the liver, they also help turn very low density lipoproteins into low density substances - move to a higher level. Therefore, during the lipidogram, a decrease in the indicator is considered a negative sign.

The analysis norms should be determined according to the following parameters:

• the risk of developing vascular diseases is high if the results are as follows: in men - less than 1.01 mmol / l, in women - less than 1.32 mmol / l;
• the average level of development of cardiovascular diseases: in men - 1-1.35 mmol / l - men, in women - 1.31-1.52 mmol / l;
• the risk of formation of atherosclerotic plaques is not high, good indicators: 1.61 mmol/l and more.

Atherogenicity is the tendency of the body to develop fatty formations on the walls of blood vessels. This indicator allows you to summarize and draw a conclusion based on the results of the study. To calculate this coefficient, the following results are required: the level of cholesterol and high-density lipoproteins. It is believed that this indicator determines which cholesterol in the body is more: “bad” or “good”.

The normal level is between 2.2 and 3.5. With an increase in the value of the coefficient, we can talk about the possibility of developing atherosclerosis. The relationship of this indicator for predicting various disorders has been scientifically proven. For the prevention of cardiovascular diseases, it is recommended to conduct a blood lipid profile at least once a year.

When the first signs of atherosclerosis begin to appear, it is sometimes too late, and therapy is ineffective. Therefore, annual studies can avoid this disease. In addition to research, you need to lead a healthy and active lifestyle, eat right.

DO YOU STILL THINK IT'S IMPOSSIBLE TO FULLY HEAL?

Have you been suffering for a long time from constant headaches, migraines, severe shortness of breath at the slightest load and, in addition to all this, pronounced HYPERTENSION? Did you know that all these symptoms indicate an INCREASED level of CHOLESTEROL in your body? And all that is needed is to bring cholesterol back to normal.

Judging by the fact that you are now reading these lines, the fight against pathology is not on your side. Now answer the question: does it suit you? Can all these symptoms be tolerated? And how much money and time have you already "leaked" for ineffective treatment of SYMPTOMS, and not the disease itself? After all, it is more correct to treat not the symptoms of the disease, but the disease itself! Do you agree?