Low density lipids are normal in women. LDL cholesterol analysis: what is LDL in a biochemical blood test LDL cholesterol analysis: what is LDL in a biochemical blood test

Most people hold the dangerous misconception that cholesterol is a very unhealthy substance. Whereas, in fact, our body cannot exist without cholesterol, which it produces itself. Cholesterol is involved in almost all metabolic processes, including in the synthesis of human sex hormones. Without cholesterol, the normal activity of any organ and system is impossible. But since cholesterol is insoluble in water, it moves around the body as part of special formations - lipoproteins. They have different densities. Lipoproteins high density, this is good cholesterol, which is delivered to its destination without delay. But low-density lipoproteins are harmful compounds that cling to the walls of blood vessels and form on them atherosclerotic plaques. But there are also very low density lipoproteins, or VLDL. That's what we'll talk about today.

Very low density lipoproteins are also carriers of cholesterol. But besides it, they contain another type of fat - triglycerides. This is the most common type contained in human body fats and one of the main sources of energy. After very low density lipoproteins (VLDL) have transferred the triglycerides contained in them to the muscles and organs for their intended purpose, they turn into low density lipoproteins (LDL), the precursors of which they are in essence.

VLDL norm. Result interpretation (table)

A blood test for the content of VLDL, as a rule, is never performed separately, but always only as part of the overall lipid profile of the body. Blood lipidogram is assigned in the following cases:

when referring to a doctor for men over 45 years of age and women over 55 years of age,
when determining elevated levels of total cholesterol,
with increased blood pressure,
after myocardial infarction or a stroke
if the patient has been diagnosed with coronary heart disease,
if the patient is diabetic,
The patient is diagnosed with obesity
the patient abuses alcohol,
is a smoker
leads sedentary image life.

Cholesterol levels should also be regularly checked for those people in whose family cases of atherosclerosis or related diseases of the heart and blood vessels have already been noted. An increase in cholesterol may well be hereditary factor which leads to such diseases. If there were cases in the family similar diseases already in young age, then it is recommended to do a lipid profile for a child already, starting from 2 years.

Blood is taken from a vein, strictly on an empty stomach, in the morning. It is recommended not to eat for 12-14 hours before the test. The concentration of very low density lipoproteins in the blood can vary and is not always an objective indicator of the true level of total cholesterol. Therefore, it is recommended to re-test within three months.

In accordance with accepted international standards VLDL content in the blood ordinary people and pregnant women:

If VLDL is elevated - what does it mean

As a rule, the content of very low density lipoproteins in the human body is lower than the content of low density lipoproteins. The increase in their concentration occurs proportionally and for the same reasons, namely:

reduced function thyroid gland- hypothyroidism,
cholestasis is an inflammatory process in gallbladder caused by stagnation of bile, for example due to the presence of calculi or liver disease,
chronic kidney failure,
nephrotic syndrome and chronic inflammatory process in the kidneys,
malignant tumor pancreas,
malignant tumor of the prostate.

An increase in low-density lipoprotein levels can also be caused by obesity or excessive alcohol consumption. Violation of lipid metabolism in the body can also be hereditary.

An increase in very low density lipoprotein levels is dangerous factor talking about high risk development of atherosclerosis in a patient concomitant diseases.

If VLDL is lowered - what does it mean

Lowering the level of very low density lipoproteins in the blood, as a rule, is not of clinical interest and is not used for diagnosis. However, it can also indicate the presence of certain diseases, namely:

increased function thyroid gland - hypothyroidism,
oncological diseases hematopoietic systems,
liver disease,
extensive burns,
inflammatory diseases joints,
chronic obstructive pulmonary disease,
lack of vitamin B12 in the body,
deficit folic acid,
acute inflammatory process in organism.

A decrease in the concentration of low-density lipoprotein may be hereditary. Intensive physical exercise or the use of some medicines- statins, erythromycin, estrogens.

Unlike the level of low-density lipoprotein, the level of very-low-density lipoprotein during pregnancy does not increase, but decreases.

Lipoproteins (or their other name - lipoproteins) are called complex structures blood plasma - protein-lipid complexes, which are an integral part of blood components. Their main function is transport: they deliver lipids to the organs and tissues of the body.

Their variety is very low density lipoproteins, which are synthesized by liver cells. They are the second largest of all lipoproteins present in the body. Most of them consist of triglycerides, while these components also contain cholesterol.

It has been established that very low density lipoproteins are direct sources of "bad" cholesterol, so this indicator must be monitored with the help of timely delivery of appropriate tests.

Basic analysis for people with high cholesterol- lipidogram, which is recommended for every person over 20 years of age at least once every 5 years.

If the data laboratory diagnostics confirmed that VLDL is increased or decreased, which means that there is a violation in the body fat metabolism. First of all, this indicates a high risk of formation cholesterol plaques on the walls of blood vessels, which is fraught with thrombosis, atherosclerosis and other serious consequences.

Interpretation of the results of the analysis for VLDL

Since the density of lipids is much less than the density of water, which cannot be said about the proteins in the blood, when analyzing the content of lipids in the plasma, it is important to average density. For this reason, the method of interpreting the results of the analysis is based on the classification of lipoproteins into fractions: the amount of lipoprotein in each fraction is determined, as well as its total amount and the presence of triglycerides.

The difficulty of interpreting the analysis for VLDL lies in the fact that in the scientific medical environment there are no reasonable criteria for their safe concentration in the blood. Increased content in the blood, VLDL, as well as LDL, undoubtedly indicates dysmetabolic disorders present in the body. At the same time, there are norms for the content of LDL, when a certain amount of these lipids must be present in human blood.

It is known that very low density lipoproteins are a pathological form of lipoproteins, therefore, receptors for it in the human body have not yet been formed. Despite this, doctors are guided by the generally accepted norm for the content of VLDL in human blood: 0.26-1.04 mmol / l. Anything above or below this indicator indicates possible pathological processes in the body, so you should immediately consult a doctor for advice.

VLDL norm

The main purpose of the analysis for VLDL is to assess the risk of developing atherosclerosis or other cardiovascular diseases, as well as to identify their presence and, possibly, stage in a patient aimed at diagnosis. For the bulk of people, the following values \u200b\u200bare considered normal: 0.26-1.04 mmol / l. When the level of very low density lipoproteins in the lipid profile is in the indicated range, this means that the adjustment of fat metabolism in the body is not needed.

If the patient has other diagnostic methods confirmed the high risk of atherosclerosis and coronary disease heart, this means that the rate of very low density lipoproteins is in a narrower range - 0.03-0.45 mmol / l. If VLDL is higher than these values, urgent measures must be taken to normalize blood lipoprotein and lower its level with the help of a well-chosen diet and drug therapy.

It should be borne in mind that the level of very low density lipoproteins can change from time to time, such a process in the body is called the normal fluctuation of cholesterol metabolism - its biological variation.

A one-time analysis for VLDL does not always reflect the real state of fat metabolism in the body. If metabolic disorders are suspected, the patient may be advised to take such an analysis twice with an interval of 2-3 months.

The following factors can increase the level of very low density lipoproteins:

prolonged adherence to a mono-diet, fasting;
smoking;
taking certain medications: androgens, anabolic steroids, corticosteroids;
pregnancy and postpartum period(first 6 weeks);
donating blood in a standing position;
a diet rich in animal fats.

Wherein lipid metabolism in the body will be normal and its adjustment is not required.

Increased values

If VLDL in the blood is elevated, in most cases the main reason for this was heredity or adherence to food rich in animal fats. In many patients, these two problems lead to dysmetabolic problems at once.

An increase in very low density lipoproteins indicates an unfavorable state of the vessels, especially if the violation of the fat balance has occurred a long time ago. VLDL are sources of "bad" cholesterol, therefore, an increase in their concentration leads to the formation of cholesterol plaques on the vascular endothelium, their thickening and fragility, as well as other problems. That's why high rate VLDL means existing cardiovascular pathologies in the body or a high risk of their occurrence.

It has been established that very low density lipoproteins are increased, as a result following issues in organism:

diabetes mellitus - systemic metabolic disorder, an indirect result of which is elevated VLDL in the blood;
decreased function of the thyroid gland or pituitary gland. As a result, it breaks hormonal background and, accordingly, many metabolic processes;
nephrotic syndrome resulting from chronic inflammation kidneys, affects the process of excretion of certain substances from the body, metabolism slows down;
alcoholism and obesity negatively affect the metabolic processes in the body;
pancreatitis is a disease of the pancreas that occurs in acute or chronic stage;
Very low density lipoproteins may be elevated in the blood of patients with malignant formations in the pancreas or prostate.

In some patients, VLDL is elevated due to hereditary or congenital pathologies. Doctors refer to the first group of diseases as glycogenesis, as a result of which the metabolism of the reserve form of glucose is disturbed in the body. congenital form imbalance of lipoproteins in the body - Niemann-Pick disease, in which VLDL and HDL accumulate in the liver, lungs, spleen, spinal cord and brain. These conditions require lifelong diet and medication support that can lower low- and very-low-density lipoprotein levels in the blood.

If the analysis for VLDL showed that lipoproteins are elevated, then the patient needs urgent medical advice. Such patients are diagnosed with type III, IV, or V primary hyperlipidemia. If the patient's very low density lipoproteins have become stably elevated as a result of another disease, they speak of secondary hyperlipidemia.

Reduced values

If the analysis showed that very low density lipoproteins in the blood are lowered, this means that there are no serious dysmetabolic disorders in the human body. This result of the analysis with a low level of VLDL does not have a special clinical significance and can sometimes be seen in people with the following diseases:

obstructive changes in the lungs;
acute infections in organism;
other diseases occurring in acute form;
cancerous lesion bone marrow;
increased secretion of thyroid hormones;
folic or B12 deficiency anemia;
severe liver pathology;
multiple burns;
joint inflammation.

If the diagnostic data indicates reduced level VLDL in the blood, fat balance in the body usually does not need to be adjusted, specific treatment such patients are not prescribed. But they may recommend to be examined by others. narrow specialists, which may help to identify other diseases that led to a change in the concentration of very low density lipoproteins in the blood in the direction of its decrease.

In some cases low level lipoproteins of very low density allows to diagnose hereditary disease- hypocholesterolemia. The nature of this pathology is not fully understood. It was found that patients hereditary form hypocholesterolemia usually suffer from coronary heart disease, their condition is often accompanied by xanthomatosis of the tendons and skin - lipoprotein deposits in the form of growths and plaques.

It is worth noting that the following factors can affect the result of the analysis, i.e., lower the level of very low density lipoproteins in the blood:

a diet low in lipoproteins in the diet;
taking some medicines: statins, antifungal drugs, estrogens, clofibrate, antifungal drugs, allopurinol, cholestyramine, colchicine, erythromycin;
long stay in a supine position;

What is the danger of increasing VLDL

An analysis for the content of lipoproteins of various densities in the blood is carried out in order to assess the risk of developing pathologies of cardio-vascular system. Of particular interest are LDL and VLDL, since they are the carriers of cholesterol to the heart. Considering VLDL in more detail, doctors associate their increase with an increased risk of developing cardiovascular diseases:

atherosclerosis;
acute disorders cerebral circulation;
myocardial infarction;
obliterating endateritis;
cardiac ischemia;
thrombosis;
strokes;
hypertonic disease hearts;
angina.

An increase in the level of very low density lipoproteins in the blood provokes thickening and fragility of blood vessels, microcracks appear on their inner layer. In the area of such damage, protective blood cells rapidly absorb VLDL, which leads to the accumulation of cholesterol in them. As a result of this process, protective blood cells accumulate in the area of vascular damage and form foamy formations, which eventually transform into atherosclerotic plaques. The latter, in turn, impede blood flow in any part of the body: coronary region, brain, lungs, etc., leading to serious consequences.

The whole danger of atherosclerotic plaques is that they are able to grow in size, forming a blood clot. Such an intravascular formation can break off at any moment and migrate further along the vessels until the lumen of one of them is too narrow for further progress. Thus, vascular thrombosis is formed, which can be deadly for humans. The most common outcomes of thrombus migration through the vessels are cerebral stroke, cardiac stroke, and pulmonary embolism. In the vast majority of cases, when timely medical care was not provided, this leads to death.

There is evidence that an increased level of VLDL in the blood can provoke the appearance of calculi (sand and stones) in the gallbladder.

There is only one conclusion: an elevated level of VLDL indicates serious cardiovascular diseases or high risk of developing them. But if you hand over everything in a timely manner necessary tests and monitor the level of lipoproteins in the blood, you can manage to change your lifestyle in time, in particular, nutrition, in order to prevent fatal dangerous diseases. Sometimes, to keep VLDL levels within the acceptable range, patients are prescribed special preparations.

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The cholesterol level in healthy person should be within the normal range. With an increase or decrease in the level of lipoproteins in the blood, it is necessary to identify the disease and begin its treatment. That is why many doctors give Special attention analysis of LDL cholesterol.

Everyone knows that high blood cholesterol is bad. But what kind of cholesterol, and what types of it are there?

Cholesterol, which is distributed through the blood to the organs, is associated with proteins. After all, it is thanks to proteins that cholesterol is able to move in liquids. There are several types of such compounds:

HDL - high density lipoproteins;
LDL - low density lipoproteins;
VLDL - lipoproteins with a very low density, it is from them that the liver produces the so-called bad cholesterol;
LPPP - lipoproteins with intermediate density.

When the balance of bad and good cholesterol, with an upward shift in LDL, diseases of the heart and blood vessels develop or worsen.

When to check LDL levels

The level of ldl cholesterol (bad lipoprotein) should be checked for all people over the age of thirty at least once every 5 years. However, there are cases when an extraordinary study is indicated:

Taking medications to lower LDL levels.
Pathology of the liver.
Diseases of the heart muscle and blood vessels.
Use fatty foods a lot.
Men over 40 and women over 50.
Patients with a history of myocardial infarction or stroke.
Persistent hypertension with pressure values over 135/85 mm Hg. Art.
If hypercholesterolemia (increased LDL levels) has already been detected in a blood test earlier.
hereditary predisposition.
Drinking alcoholic beverages, smoking.
Availability excess weight body.
Sedentary lifestyle.
In the presence of diabetes.

Proper preparation for a blood test

To determine the level different types cholesterol, a biochemical blood test is performed. This kind laboratory research you can go to the clinic or in any paid laboratory, at the discretion of the patient. Blood is taken from a vein.

In order for the indicators to be correct, it is necessary to prepare for blood donation in accordance with all the rules:

Blood for analysis is taken in the morning on an empty stomach. You can eat 12 hours before the test.
For some time before the study, it is necessary to abandon fatty foods and fried food.
Alcohol and smoking should also be avoided for a few days. Do not smoke immediately before the test.
Within one or two weeks before blood sampling, exclude excessive physical activity (active and power types sports).

Lipidogram

What is a lipid profile? These are analytical data on the content of lipoproteins in the blood serum. It includes the following indicators:

total cholesterol estimated at without fail, its level depends on the gender and age of patients;
HDL - anti-atherogenic fraction (good cholesterol), it prevents the development of atherosclerotic plaques in the vessels;
LDL is an atherogenic fraction (bad cholesterol), an increase in its concentration is a sign of an existing or developing pathology;
the atherogenic coefficient is obtained as a result of the ratio of good and bad lipoprotein;
triglycerides are involved in the transport of lipids.

Indicator changes

If any indicator in the lipid profile deviated from the norm, this may indicate various pathologies or become a signal for preventive measures.

What do abnormal triglycerides indicate?

With an increase in the level of this substance to 2.3 or more mmol / l, they indicate the presence of diseases such as coronary heart disease and atherosclerosis various vessels. Another reason is the presence of diabetes in the patient.
The borderline value, from 2.0 to 2.3 mmol / l, is a consequence of a deterioration in health. Although atherosclerosis and coronary heart disease are not yet expressed characteristic symptoms, but their development has already begun. The period of asymptomatic course of pathology.
The norm of triglycerides is 1.9 mmol / l and less.

HDL can also be either low or high:

decline this indicator(in men up to 1.15 mmol/l or less, in women 0.8 mmol/l and below) is clear sign the presence of pathology of the heart (ischemic disease) and blood vessels (atherosclerosis).
Borderline indicators: for men - from 1.15 to 1.67 mmol / l; for women - from 0.8 to 1.35 mmol / l. These values are indicators of the development of the above pathologies of the cardiovascular system.
The high content of good lipoprotein reduces the likelihood of coronary disease and myocardial infarction.

What do LDL levels indicate?

The presence of diseases such as coronary artery disease and atherosclerosis is detected at rates of 4.8 mmol / l or more.
If LDL level from 4 to 4.8 mmol / l, then, most likely, the pathology of the cardiovascular system develops in the body.
The norm is considered to be below 3 mmol / l.

total cholesterol:

Normal values are considered to be from 3.1 to 5.1 mmol / l.
If the total cholesterol is above 6.2 mmol / l, then the pathology of the heart and blood vessels already exists.
If the values are in the range from 5.2 to 6.2, then the risk of pathology increases.

Signs of an increase in bad lipoprotein in the blood

On initial stage hypercholesterolemia, a person may not notice any changes in their health. However, the heart and blood vessels are already beginning to suffer:

The vascular wall loses its elasticity and firmness. The longer cholesterol does not decrease, the more the vessels suffer. Eventually, they become brittle.
Cholesterol plaques form, which impede blood flow. Due to this internal organs start to starve. As a result, atherosclerosis develops.
Blood clots are formed, which at any time can come off and clog the vessel.
The risk of myocardial necrosis, that is, myocardial infarction, increases.

If treatment is not carried out, then the person begins to feel various kinds of ailments:

headache;
dyspnea;
dizziness;
heartbeat.

A complication of this condition can be an embolism of the vessels of vital organs:

Blockage of cerebral vessels (ONMK).
Thromboembolism pulmonary artery(TELA).
When blocked coronary arteries myocardial infarction occurs.

All these pathological conditions require emergency medical attention and are common cause lethal outcome in patients with increased level cholesterol.

What can affect performance

It may happen that the results of the analysis for cholesterol were incorrect. For example, indicators are inflated, but there are no other signs of pathological changes in the heart and blood vessels of a person is not. When it's possible?

If on the eve of the study a person broke the diet and ate foods rich in lipids of animal origin.
Cholelithiasis.
Hypothyroidism.
Cholestasis (stagnation of bile for various reasons).
Long-term use of hormonal and antibacterial drugs.
pathology of the kidneys chronic course inflammatory process.
Disease of the pancreas (diabetes).
hereditary factor.
A woman has an increase in LDL levels during pregnancy.
Postponed severe stress or psycho-emotional stress.
In the postoperative period.
Recent cardiac stenting can also cause increased rates.

In some cases, rates may increase due to physiological characteristics patient. Therefore, when in doubt, re-holding laboratory research.

A second blood test is performed after 14 to 28 days.

Normalization of indicators

Lipidogram indicators can signal the development of pathology. In this case, it is quite realistic to normalize the indicators and cope with initial stage diseases (coronary heart disease, atherosclerotic plaques) and prevent the development of such a serious pathology as myocardial infarction.

Preventive actions:

Proper nutrition. Avoid fatty and sugary foods.
Moderate physical activity Helps increase good cholesterol and lower LDL levels.
Get rid of bad habits because they negatively affect the entire body.
Avoid stressful situations.
Carry out all doctor's orders.

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Very low density lipoproteins or "the worst cholesterol" is responsible for the development severe complications atherosclerosis - ischemia and stroke.

Synonyms: very low density lipoproteins, pre-beta lipoproteins, pre-β-lipoproteins, VLDL

According to modern biochemical nomenclature, the following terms should be used:

"cholesterol", not ""

"lipoprotein" instead of ""

"triglycerol" or "triacylglycerol" instead of "triglycerol" or " "

This article will use both old and new definitions.

Very low density lipoproteins are

one of the five main protein-fat carriers of cholesterol and triglycerides with maximum atherogenic properties. Synthesizes their liver, size 30-80 nm.

Blood is 90% water, and fats repel water. To deliver them to the brain, heart and other organs, a water-soluble “package” is needed - protein. The complex of fat (cholesterol and triglyceride) with protein is called lipoprotein. The ratio of the main components of lipoproteins determines their density (thickness) and role in fat metabolism. How larger size lipoprotein, the lower its density and at the same time the higher the "fat content" - a danger to vascular wall. That is why very low density lipoproteins are the “worst” and “traumatic” vessels.

Components

proteins - 10%
triglycerides - 54%
free cholesterol - 7%
esterified cholesterol - 13%

The main function of VLDL is the transport of triglycerides and cholesterol synthesized in the liver itself (and not received with food) to peripheral tissues- in fat and muscle. Delivering fat from the liver to the tissues, very low density lipoproteins form an active energy depot in the blood (lipid processing provides the maximum number of calories).

An increase in very low density lipoproteins is a direct risk factor and its consequences in the form of brain catastrophes.

Research features

There is no universal method for measuring cholesterol in very low density lipoproteins. Since VLDL contain predominantly triacylglycerol in a stable concentration, the following formula is used to determine VLDL:

VLDL = TG/5 - if triglycerol was measured in mg/dL

VLDL = TG / 2.2 - if triglycerol was measured in mmol / l

VLDL = - (HDL + LDL) - universal formula

The formulas cannot be applied if the triglyceride level exceeds 4.5 mmol/L (400 mg/dL) because other lipoproteins will also be elevated at the same time.

Direct determination of very low density lipoprotein concentrations by ultrafiltration and electrophoresis is performed for scientific or research purposes only. IN daily practice VLDLP doctor is evaluated precisely according to the formulas described above.

Indications

in persons over 20 years of age, prophylactically every 5 years to assess the risk of atherosclerosis and its complications in the form of heart and vascular diseases
in case of high total cholesterol
if there are risk factors for heart disease (for example, if among direct relatives there were cases of sudden cardiac death, acute coronary syndrome or heart attacks before the age of 45)
at (more than 130/85 mm Hg)
at diabetes 1 and 2 types - regularly 1 time per year, with impaired tolerance to
at overweight and obesity (waist circumference more than 80 cm in women and 94 cm in men)
in the presence of symptoms of impaired lipid metabolism
with coronary heart disease, 6 weeks after myocardial infarction or stroke, with coronary artery disease of the lower extremities,

Norm, mmol/l

less than 0.77 mmol/l
less than 30 mg/dl

The norms of very low density lipoproteins in the blood are determined by international standards, therefore they are the same for all laboratories. In the laboratory test form, they go in the column - reference values \u200b\u200band the norm.

Analysis rules

in a state of relative well-being
without prior diet or the use of any dietary supplements or drugs
blood sampling for analysis is necessarily carried out on a empty heart - after 8-12 hours without food
physical rest - immediately before donating blood, a week before visiting the laboratory, you can not perform heavy physical work participate in sports activities
not earlier than 6 weeks after the exacerbation of any chronic disease, acute pathology, myocardial infarction, after operations or injuries, diagnostic interventions (, laparoscopy)
in women, the level of low-density lipoprotein decreases with, so they should be analyzed no earlier than 6 weeks after