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 produced by the liver. In large quantities, it is found in the brain, adrenal glands, adipose tissue, and is also part of the membranes of almost all cells. Cholesterol is a precursor of steroid hormones necessary for full development, growth and puberty, takes part in the synthesis of bile acids, which ensure the absorption (absorption) of nutrients from the intestine and their entry into the blood. An increase in cholesterol levels leads to atherosclerosis - the formation of atherosclerotic plaques, which are an outgrowth on the inner wall of the vessel, consisting of a fatty core and membrane. Growing, atherosclerotic plaques narrow the lumen inside the vessels and disrupt the blood flow in the organ. As a result, ischemia (oxygen starvation) of the organ that receives blood from the affected artery develops. If the arteries of the heart are affected, then chronic ischemic 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 (necrosis of part of the heart), acute ischemia of the brain - to a stroke.

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

When cholesterol is combined 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 the removal of free cholesterol. HDL carry it from the tissues (including from the vessels of the heart, arteries of the brain, etc.) to the liver and prevent it from accumulating on the walls of the arteries. In the liver, cholesterol is converted into bile acids and excreted from the body. Thus, HDL prevent the formation of atherosclerotic plaques and related diseases.

Pre-menopausal women have higher HDL-cholesterol concentrations than men, hence the risk of cardiovascular disease is lower. After menopause, there is a decrease in the amount of HDL-cholesterol and the risk of cardiovascular diseases increases.

LDL cholesterol is the "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 carry 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 a degenerative change 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 content of triglycerides in 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 determined in the blood only in infants after feeding.

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

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

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

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

Using this analysis, the concentration of cholesterol, LDL (low density lipoprotein), HDL (high density lipoprotein) and triglycerides in blood serum (mmol / liter), as well as the atherogenic coefficient (CA) are determined.

Method

Colorimetric photometric method. Reagents are sequentially 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 to be determined and is determined on a special device - a photometer.

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

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

Norm:

total cholesterol:

Cholesterol-HDL

Cholesterol-LDL:

Triglycerides:

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

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

KA<3,0 - низкая вероятность развития атеросклероза

CA 3.0 - 4.0 - moderate risk of atherosclerosis

CA >4.0 - high risk of atherosclerosis

Atherogenic Plasma Index (AIP):
<0,11

AIP<0,11 - низкий риск развития атеросклероза

AIP 0.11 - 0.21 moderate risk of atherosclerosis

AIP>0.21 - high risk of 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 (fat-poor) therapy and diet.

Increasing values ​​(positive result)

total cholesterol:

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

Lipoproteinemia (phenotype III);

2) secondary hyperlipoproteinemia:
- coronary artery disease;
- 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, which shows the norm and deviations, how to take

Cardiovascular diseases lead in the number of cases worldwide, and the main cause of them is considered to be a violation of fat metabolism with atherosclerosis that affects the vascular walls. Laboratory tests, including a lipid profile, help to objectively assess the degree of risk.

You can learn about the amount of total cholesterol from a biochemical blood test, but only this indicator 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 blood fractions. 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 analysis, venous blood is taken, and the patient must know some of the features of preparing for it and the conditions that may affect the result. The decoding of the lipidogram is carried out by a general practitioner, a cardiologist, an endocrinologist.

Lipidogram indicators

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

Timely detection of deviations from cholesterol and lipid fractions is necessary not only for the early diagnosis of the 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 concern. However, for correct conclusions, only this indicator is not enough, because cholesterol can also increase in absolutely healthy individuals without provoking atherosclerosis. To assess fat metabolism, it is important to establish the concentration of lipid fractions, the fluctuations of which characterize the pathology or the norm to a greater extent.

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 the bile necessary for proper digestion, it is the precursor of sex hormones, without which there is no development, puberty and functioning of an adult organism. In plasma, cholesterol is bound to lipoprotein proteins.

In addition to cholesterol (Cholesterol), lipidogram - a blood test for lipids includes indicators such as high, low and very low density - HDL, LDL, VLDL. It is they who make up the total cholesterol, but their role is different, therefore, the disease is not judged by total cholesterol. Based on the content of these components, plasma atherogenic coefficient, which serves as a prognostic factor for cardiovascular disease.

Cholesterol is formed by liver cells and enters the body from the outside with food, and its excess is excreted. VLDL are not saturated with cholesterol and are 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 incorporated into very low density lipoproteins, thus “neutralizing”.

High-density lipoproteins are classified as anti-atherogenic fractions, that is, these components prevent atherosclerosis, removing "bad" cholesterol from the circulation. With their 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 limits of the norm, 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 retains normal values.

Triglycerides are a normal component of the blood, they are considered natural metabolites that are part of VLDL, ingested and excreted by the liver. Their main volume is concentrated in adipose 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 when normal concentrations are exceeded.

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

So, the lipidogram consists of the definition:

• total cholesterol;
• triglycerides;
• HDL;
• LDL;
• VLDL.

The coefficient of atherogenicity, which makes it possible to quantify the risk of atherosclerotic lesions of the vascular endothelium, is calculated according to these indicators: the sum of VLDL and LDL values ​​is divided by the HDL level. (Normal - up to 3.5).

For the correct interpretation of the lipidogram, some other conditions must be taken into account:

1. Age;
2. Heredity in relation to cardiovascular pathology;
3. The presence of carbohydrate metabolism disorders;
4. The 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, gives the most accurate prognosis for atherosclerosis and diseases of the heart and blood vessels.

When should the lipid spectrum be examined?

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 with an already established diagnosis,. It is important for the dynamic monitoring of patients who are on and taking drugs to reduce cholesterol.

Indications for a lipid profile are:

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

How to pass the analysis correctly and what affects the result?

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

The lipid spectrum of the blood is very sensitive to external conditions. This doesn't just apply to eating. The result can be affected by excitement, excessive physical effort, medication, recent other studies, infections, etc., so all these factors must be borne in mind.

Blood sampling for lipid spectrum is recommended in the morning, on an empty stomach, at least 12 hours after the last meal. Half an hour before the study, physical activity and psycho-emotional experiences, as well as smoking, should be excluded. The analysis should not be carried out in patients with acute myocardial infarction and during the first 3 months from the moment of its occurrence.

The result can change:

Many medications can cause an increase or decrease in both total cholesterol and its fractions, so if you are taking any medication, be sure to notify your doctor about this.

Total cholesterol rises in the treatment of 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 the lipid profile. Hormones, some diuretics and tranquilizers also increase total cholesterol.

Decrease in total cholesterol noted in persons taking lipid-lowering drugs (,), as well as when prescribing estrogen, androgen, 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 lower HDL.

The ability of many drugs to influence lipid profile indicators 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 heart pathology may be increased.

Norm or pathology?

When deciphering the lipidogram in adults, the 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. The pathology is also evidenced by an atherogenic coefficient of more than three and a reduced content of high density lipoproteins.

The norm is considered the values ​​​​of lipid spectrum indicators:

• 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.

High-density lipoproteins have different normal values ​​for women and men. So, an increased likelihood of atherosclerotic lesions and cardiovascular pathology is indicated by HDL below 1 mmol per liter of blood in men and less than 1.3 in women. Low risk is defined for people of both sexes if HDL exceeds 1.55 mmol per liter.

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

A positive lipid profile result, i.e. an increase in its atherogenic indicators can be observed with 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;
• Starvation.

High-density lipoproteins usually decrease with 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, 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 noticed elevated cholesterol in a biochemical blood test, then he will send for a lipid spectrum study to exclude metabolic disorders. Patients with normal cholesterol levels still need such a 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 the study of 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 is usually no difficulty 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. Under this concept, a series of blood tests is hidden, with the help of which deviations in the balance of body fats are found. If abnormalities are found during the lipid metabolism check, then atherosclerosis is likely.

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

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

The analysis of the lipid composition of the blood is of the greatest importance in the diagnosis of atherosclerosis. The survey is aimed at an objective assessment of disorders that occur in lipid metabolism. Deviations from the lipid profile, which revealed 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 required 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 the 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 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 be synthesized and attached 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 while taking drugs 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 the 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. Represents 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 safely move in the blood of women and men, the body covers cholesterol cells with proteins. This is how elements called lipoproteins are formed. 85-90% of cholesterol molecules are produced in the liver. The rest comes into the body with food.

The level of total cholesterol in the blood does not mean anything, because it consists of two components - good and bad substances. The first is to understand 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 number of LDL is smaller.

To determine the risk of a heart attack, you will need to do 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 analyze lipid cells. One of the best solutions is to donate blood from a vein.

Triglycerides: the importance of studying in lipid profile analysis

What does high triglycerides mean? This indicates serious violations in the body. This lipid works as a thickener, due to which it contributes to the formation of blood clots, which impede blood flow. This indicates the risk of a heart attack. Speaking statistically, ¾ of patients with a heart attack (among women) had an elevated triglyceride content in the blood. If they had analyzed the lipid profile in time, they would have avoided such tragic consequences.

Note! As the concentration of triglyceride increases, the risk of breast cancer increases. Recent evidence has shown that lifestyle changes should be made when pre-meal triglyceride levels are 180 mg/dl.

This type of lipid adversely affects health in combination with low levels 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, one lipid profile and diet is unlikely to be limited. You will have to resort to medical treatment. But it works best when combined with a diet. If you take medication, 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 stick to it, then even difficult situations will not lead to sad consequences.

Preparation for lipid analysis and conduct

A lipid (fat) profile is an important blood test, and therefore it is worth preparing for it thoroughly. To do this, it is enough to follow three rules:

• we exclude the intake of alcoholic beverages 2 weeks before the analysis;
• the last cigarette before the examination an hour (preferably more);
• It is impossible to consume food in the morning - blood is taken on an empty stomach.

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

You can conduct an examination in any clinic where there is a laboratory. The analysis is carried out in a short time - the determination of the indicators included in the survey will take no more than an hour. And the very collection of blood from a vein will take a few minutes. The procedure is carried out by a chemical or enzymatic method. 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 that are contained in venous blood. The form you receive shows the current levels and an indicative value to aim for.

How to read the results

Do not panic if you have found high levels of total cholesterol. First of all, you should assess your age. The older the person, the higher the amount of this substance in the body - this is how nature intended. Along with this, the highest limit for this lipid is also growing. In addition, lipid metabolism is affected not by the total supply of cholesterol, but by quantitative. It is worth checking it, otherwise there is a risk of ringing the bells in vain, losing precious time and nerves. When evaluating a quantitative indicator, pay attention to LDL. If the content is less than the lower limit of the range, then there are failures 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, to assess their impact on health.

In the fat balance, LDL plays a much larger role if its content is above 3.37 mmol / l. The higher the final number, the greater the risk of “picking up” atherosclerosis. Exactly the same conclusion can be drawn with an LDL / HDL ratio of more than 3/1. If the number exceeds 4.14, then it is better not to postpone a visit to a cardiologist. In this case, the risk of ischemia is high. Therefore, there is a need to control the amount of fat 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 ailment as a gift as an inheritance, but you can get rid of this. The main thing is to conduct analyzes in time, to achieve a 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 carried out even when you are completely healthy. What is its need? .

Everyone is used to going to the doctor when something already hurts. Both women and men are afraid to visit therapists - that's the way it is. But when a certain time has already been treated, we periodically check ourselves: is there a relapse, is there an exacerbation. Exactly the same picture with interest in the lipid profile. The interest of many people in biochemical analyzes wakes up after a heart attack, the detection of atherosclerosis or coronary artery disease.

But it was necessary to go to the doctor 15-20 years ago, when it was possible to quickly correct the state of affairs, without waiting for the climax of life. The vessels that feed the heart do not clog in one second. The process takes years. Ultimately, the blood flow through them weakens so much that the "pump", experiencing a deficit, begins to act up. All this speaks of how necessary biochemical research is.

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

Important! Do not forget that you should not consider the content of each fat separately. It's worth seeing the big picture. All lipids individually can only tell about themselves. But a comprehensive decoding will allow you to assess health.

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