High density lipoprotein cholesterol. High-density cholesterol: reasons for the decrease and ways to normalize HDL levels. Reasons for increasing and decreasing HDL

Lipids are fats that do not dissolve in water, so in its purest form they are not present in the blood because they cannot move and be transported along with the bloodstream.

Therefore, nature provided a cohesive substance in which fats acquire solubility in the blood and greater mobility - these are lipoproteins (or lipoproteins). They are a complex consisting of fats and proteins, externally resembling a soft, waxy mass that is found in almost all parts of the body and is part of cellular structures. To many, this substance is better known as cholesterol.

It is not enough to know one concept; for diagnostic purposes, specialists analyze the state of the subclasses and fractions of this complex compound. One such subgroup is high-density lipoprotein (or HDL). Today we will tell you what HDL is in a biochemical blood test, what deviations indicate, and what norm is acceptable for healthy person.

Which cholesterol is good and which is bad?

No matter how surprising it may sound to some, cholesterol does not always cause harm to the body; in acceptable quantities, it is even necessary for the body to build cell membranes, to participate in metabolic processes, the production of sex hormones and much more.

Scientists have long been dividing cholesterol into “bad” and “good”. We usually get the bad one with food, along with fried sausages, sausages, canned food, smoked meats, fast food, mayonnaise and other very fatty and heavy foods. This does not mean that the body does not need it at all; it can well support and stimulate the immune system, but only when it is in an acceptable quantity.

Good, healthy cholesterol is produced human body to combat negative particles and normalize vital processes.

This is the high-density lipoprotein in question. It helps drive harmful substances back into the liver for processing, serves as a building material for cells, helps regulate the production of hormones by the adrenal glands, and is also responsible for the psycho-emotional state of a person and prevents the occurrence of depressive state And sharp changes moods. In layman's terms, HDL is the “good” cholesterol. And therefore if HDL is lowered, this is absolutely not good sign, in this case, the risk of atherosclerosis, heart attack, stroke and other blood vessel diseases increases significantly.

Thus, high- and low-density lipoproteins have almost opposite functions and types of effects on the body, and therefore the diagnostic value of these substances is different.

HDL norm

In order to evaluate possible risks development of cardiac ischemia, or myocardial infarction, atherosclerosis or the appearance of blood clots, as well as to select the correct treatment tactics, cardiologists, therapists and endocrinologists often prescribe to the patient biochemical research blood.
Lipoprotein levels may vary for different people age category and gender. The normal HDL level for a healthy person is:

for children:
up to 5 years - 0.98-1.94 mmol/l;
5-10 years - 0.93-1.94 mmol/l;
10-15 years - 0.96-1.91 mmol/l;
over 15 years - 0.91-1.63 mmol/l.
for adults:
from 20 years - 0.78-2.04 mmol/l;
from 30 years - 0.72-1.99 mmol/l;
from 40 years old - 0.7-2.28 mmol/l;
from 50 years old - 0.72-2.38 mmol/l;
after 60-65 years - 0.78-2.48 mmol/l.

It should be noted that the norm of the indicator may differ slightly, depending on the laboratory in which the research is carried out.

HDL norm in men, slightly lower than in women. A reading of less than 1.036 mmol/L for men and 1.30 mmol/L for women leads the doctor to believe that high-density cholesterol is lower permissible norm, which means the risk of cardiovascular diseases is much higher.

Often, doctors test high-density lipoprotein cholesterol levels to assess the potential risk of ischemia.
relative to the total amount of cholesterol in the blood. For this purpose, an atherogenic coefficient was created, showing the balance between “good” and total cholesterol.

KA= Total cold - HDL/HDL.

Normally, this coefficient should be in the range of 2-2.5 (for newborns - no more than 1, for men after 40 years - no more than 3.5).

Low HDL cholesterol, what does this mean?

The level of beneficial cholesterol substances in the blood may differ from standard values for a number of reasons: various reasons, for example not proper nutrition, bad habits, rhythm of life, etc.

But maybe HDL cholesterol is also lowered pathological reasons, these are:

vascular atherosclerosis;
endocrine diseases and violations;
cholelithiasis;
hepatic and kidney diseases: cirrhosis, nephrotic syndrome, and etc.;
hyperlipoproteinemia type IV;
and etc. infectious diseases in the acute stage.

The level of “good” cholesterol may decrease due to long-term use of certain medicines, severe stress, or acute infectious exposure. In this case, the patient is prescribed a repeat study, after about 1.5-2 months.

High-density lipoproteins are elevated, what does this mean?

Having studied the information about HDL, you may think that an increased level is a favorable sign for the body, because this substance prevents the formation of excess cholesterol, and therefore reduces the risk of cholesterol plaques and the development of all kinds of ailments. This is true, but not always. HDL cholesterol is elevated, what does this mean?

Yes, of course, if high-density lipoproteins are elevated in the blood, doctors say that the likelihood of developing ischemia (CHD) is minimal, because There are more than enough “useful” components and they actively do their job. However, when HDL cholesterol is significantly elevated, there is reason to suspect some problems in the body. Such pathological conditions, we can highlight a few, these include:

hereditary increase in lipoproteins in the blood - hyperlipoproteinemia;
biliary (primary) cirrhosis of the liver;
Hepatitis B chronic form;
alcoholism or other kind chronic intoxication body.

Also, I would like to note that there are some factors that can affect the result and provoke an increase in the indicator, for example:

pregnancy period (therefore, it is recommended to take the test no earlier than 6-8 weeks after birth);
taking statins, estrogens, fibrates, cholistyramines, or insulin.

How to increase HDL cholesterol?

As we already said, unique feature cholesterol of the HDL fraction is that it is denser and is able to transfer “excess” cholesterol from organs and vessels back to the liver, from where it will subsequently be excreted from the body. Scientists have proven that increasing HDL by just 0.02 mmol/l reduces the risk of heart attack by more than 3%.

Therefore, the question often arises on the Internet about how to increase good cholesterol and lower bad cholesterol.

It should be understood that the terms “bad” and “good” cholesterol are used to explain the problem more easily to patients. Well, based on the properties of various subclasses of cholesterol.

So, in order to increase the level of good cholesterol, you must first of all follow the recommendations for reducing LDL, i.e. “bad” cholesterol. To do this, you need:

reduce the consumption of saturated trans fats, they are usually found in maximum quantities in products of animal origin (meat, lard, cream, butter...);
decrease daily consumption calories, the best option would be to include fiber-rich vegetables, berries and fruits in the menu;
increase physical activity, we're talking about about useful gymnastic and cardio exercises;
to refuse from bad habits;
make it a rule to drink green tea, it contains polyphenols that help reduce general level cholesterol, and at the same time increase HDL. Cranberry juice has similar properties.

So that in the future you are not overtaken by a whole “bouquet” of diseases and problems with blood vessels, think about your health and watch your diet now!

LDL (low-density lipoprotein) is called “bad cholesterol” for a reason. By clogging blood vessels with clots (up to complete blockage), they significantly increase the risk of atherosclerosis with the most serious complications: myocardial infarction, coronary artery disease, stroke and death.

LDL - what is it?

Low-density lipoproteins are the result of the metabolism of lipoproteins with very low and intermediate densities. The product contains an important component: apolipoprotein B100, which serves as a link for contact with cell receptors and the ability to penetrate inside it.

This type of lipoprotein is synthesized in the blood using the enzyme lipoprotein lipase and partially in the liver, with the participation of hepatic lipase. The LDL core is 80% fat (mainly cholesterol esters).

The main task of LDL is to deliver cholesterol to peripheral tissues. At normal operation they deliver cholesterol into the cell, where it is used to create a strong membrane. This leads to a decrease in its content in the blood.

Product contains:

21% protein;
4% triglycerols;
41% CS esters;
11% free cholesterol.

If LDL receptors do not function properly, lipoproteins stratify the vessels, accumulating in the bloodstream. This is how atherosclerosis develops, the main symptom of which is a narrowing of the lumen in the vessels and disruptions in the circulatory system.

The pathological process leads to serious consequences in the form of ischemic heart disease, heart attack, age-related dementia, and stroke. Atherosclerosis develops in any organ - heart, brain, eyes, gastrointestinal tract, kidneys, legs.

Of all types of lipoproteins, LDL is the most atherogenic, since it contributes more than others to the progression of atherosclerosis.

Who is prescribed an LDL test?

IN mandatory LDL in a biochemical blood test must be determined:

For young people over 20 years old, once every 5 years: they should check the risk level of atherosclerosis;
If tests reveal elevated total cholesterol;
Persons at risk of heart disease (when facts of unexpected death, heart attack in young (under 45 years) relatives, coronary syndrome are recorded in the family);
With blood pressure exceeding the hypertensive threshold 140/90 mmHg;
Diabetics with diabetes of any type, patients with impaired glucose tolerance should be examined annually;
For obesity with a female waist circumference of 80 cm and 94 cm - male;
If symptoms of lipid metabolism disorders are identified;
Every six months - for ischemic heart disease, after a stroke and heart attack, aortic aneurysm, leg ischemia;
A month and a half after the start therapeutic diet or LDL-lowering medication therapy to monitor results.

Normal level of LDL in the blood

Two methods have been developed for measuring LDL levels: indirect and direct. For the first method, use the formula: LDL = total cholesterol – HDL – (TG/2.2). These calculations take into account that cholesterol can be in 3 fractions - low, very low and high density. To obtain the results, 3 studies are carried out: for total cholesterol, HDL and triglycerol. There is a risk of analytical bias with this approach.

Reliably determine the concentration LDL cholesterol in the blood of an adult it is not easy; in general, it is assumed that VLDL cholesterol contains approximately 45% of the total volume of triglycerides. The formula is suitable for calculations when the triglycerol content does not exceed 4.5 mmol/l and there are no chylomicrons (blood chylosis).

An alternative method involves directly measuring LDL in the blood. The norms of this indicator determine international standards, they are the same for all laboratories. In the analysis form they can be found in the “Reference values” section.

In adults, LDL is normally in the range of 1.2-3.0 mmol/L.

How to decipher your results

Age, chronic diseases, family history and other risk criteria adjust the parameters of the LDL norm. When choosing a diet or drug treatment, the doctor’s task is lowering LDL to the personal norm of a particular patient!

Features of the individual LDL norm:

Up to 2.5 mmol/l – for patients with heart failure, diabetics, hypertensive patients taking medications that lower blood pressure, as well as hereditary predisposition(there were relatives with CVD in the family - men under 55 years old, women under 65 years old).
Up to 2.0 mmol/l – for patients who have already had a stroke, heart attack, aortic aneurysm, transistor ischemic attack and others severe consequences atherosclerosis.

LDL cholesterol in the blood of women may differ slightly from the male norm in the direction of increase. Children have their own risk groups. The pediatrician deciphers these test results.

How to prepare for the examination

The analysis is carried out in a relatively good state of health. The day before you should not prescribe special diet, take biologically active additives or medications.

Blood is drawn from a vein on an empty stomach, 12 hours after the last meal. The patient should be at rest: a week before the examination, you cannot actively engage in sports, and heavy physical activity is not recommended.

During exacerbation chronic illnesses, after a heart attack, operations, injuries, after surgical diagnostics(laparoscoria, bronchosopia, etc.) you can take tests no earlier than six months later.

In pregnant women LDL level lowered, so it makes sense to conduct research no earlier than a month and a half after the birth of the child.

LDL analysis is carried out in parallel with other types of examination:

What you need to know about LDL

Some lipoproteins of this type, when moving through the bloodstream, lose the ability to bind to their receptors. The size of LDL particles is only 19-23 nm. Increasing the level contributes to their accumulation on inside arteries.

This factor changes the structure of blood vessels: the modified lipoprotein is absorbed by macrophages, turning it into a “foam cell”. This moment gives rise to atherosclerosis.

This group of lipoproteins has the highest atherogenicity: being small in size, they freely penetrate cells, quickly entering into chemical reactions.
Fact LDL determination– typical for high concentration triglycerol.

LDL is lowered - what does this mean? The following factors may influence the results:

Reduces indicators - thyroxine thyroid gland, estrogens and progesterone ( female hormones), essential phospholipids, vitamins C and B6, small doses of alcoholic beverages, dosed systematic physical activity, a balanced diet.
And if HDL is elevated, what does that mean? Increase cholesterol concentrations - beta-blockers, estrogens, loop diuretics, hormonal contraceptives, alcohol and tobacco abuse, overeating with fatty and high-calorie foods.

Reasons for changes in LDL levels

Prerequisites that contribute to a decrease in LDL concentrations may be
congenital pathologies of lipid metabolism:

If LDL is low, secondary pathologies may be the cause:

Hyperthyroidism - overactivity of the thyroid gland;
Liver pathologies - hepatitis, cirrhosis, congestive CVD with excess blood in the liver;
Inflammation and infectious diseases- pneumonia, tonsillitis, sinusitis, peritonsillar abscess.

If LDL is elevated, the causes must be congenital hyperlipoproteinemia:

The cause of increased HDL can also be secondary hyperlipoproteinemia in the form of:

Preventing the consequences of HDL imbalance

How to treat increased level HDL?

The basis for stabilizing LDL levels is lifestyle changes:

Change eating behavior towards a low-calorie diet with minimum quantity fat
Weight control, measures to normalize it.
Systematic aerobic training.

Maintaining proper nutrition (calories from fatty foods– no more than 7%) and active image life can reduce LDL levels by 10%.

How to normalize LDL if, within two months of observing these conditions, LDL levels have not reached the desired level? In such cases, medications are prescribed - lovastatin, atorvastatin, simvastatin and other statins, which must be taken constantly under the supervision of a doctor.

How to reduce the likelihood of the aggressive effects of “bad” cholesterol, watch the video

"Very bad" cholesterol

Among the 5 main carriers of cholesterol are very low density lipoproteins (VLDL), which have maximum atherogenic capabilities. They are synthesized in the liver, the size of the protein-fat substance is from 30 to 80 nm.

Since blood contains up to 90% water, fats need “packaging” – protein – for transportation. The amount of protein and fat in lipoproteins indicates their density.

The larger the lipoproteins, the higher their fat content, and, therefore, the danger for blood vessels. For this reason, VLDL is the “badest” of all analogues. They provoke severe consequences of atherosclerosis (heart attack, ischemic heart disease, stroke).

Contains VLDL:

10% proteins;
54% triglycerides;
7% free cholesterol;
13% esterified cholesterol.

Their main purpose is to transport triglyceride and cholesterol produced in the liver into fat and muscle. By delivering fat, VLDL creates a powerful energy depot in the blood, since their processing produces the most calories.

In contact with HDL, they give up triglycerides and phospholipids and take up cholesterol esters. Thus, VLDL is transformed into a type of lipoprotein with an intermediate density, high rate which are threatened by atherosclerosis, CVD, and brain accidents.

Their concentration in the blood is measured using the same formulas; the norm for VLDL is up to 0.77 mmol/l. The reasons for deviations from the norm are similar to the reasons for fluctuations in LDL and triglycerides.

How to neutralize “bad” cholesterol - advice from Dr. Galina Grossman in this video

One of the reasons for the development of diabetes is elevated cholesterol levels in the blood. There is also an inverse relationship, when diabetes significantly increases cholesterol levels, which leads to the occurrence of cardiovascular pathologies.

Cholesterol is part of lipoproteins, which are a kind of vehicle, delivering fats to tissues. To monitor the health of a diabetic patient, the level of lipoproteins in the blood must be studied, in this way it is possible to notice and prevent pathological changes in organism.

Functions and meaning

Lipoproteins are complex compounds of lipids and apolipoproteins. Lipids are necessary for the functioning of the body, but they are insoluble, so they cannot perform their functions independently.

Apolipoproteins are proteins that bind to insoluble fats (lipids), transforming into soluble complexes. Lipoproteins transport various particles throughout the body - cholesterol, phospholipids, triglycerides. Lipoproteins play an important role in the body. Lipids are a source of energy, and also increase the permeability of cell membranes, activate a number of enzymes, participate in the formation of sex hormones, the work nervous system(transfer nerve impulses, muscle contractions). Apolipoproteins activate blood clotting processes, stimulate the immune system, and are a supplier of iron for body tissues.

Classification

Lipoproteins are classified according to density, composition of the protein part, flotation speed, particle size, and electrophoretic mobility. Density and particle size are related to each other - the higher the density of the fraction (compounds of protein and fat), the lower its size and lipid content.

Using the ultracentrifugation method, high molecular weight (high density), low molecular weight ( low density), low molecular weight lipoproteins (very low density) and chylomicrons.

Classification by electrophoretic mobility includes fractions of alpha lipoproteins (HDL), beta lipoproteins (LDL), trans-beta lipoproteins (VLDL), migrating to the globulin zones, and chylomicrons (CM), which remain at the start.

According to the hydrated density, intermediate density lipoproteins (IDL) are added to the above listed fractions. The physical properties of the particles depend on the composition of the protein and lipids, as well as on their ratio to each other.

Kinds

Lipoproteins are synthesized in the liver. Fats that enter the body from the outside enter the liver as part of chylomicrons.

The following types of protein-lipid complexes are distinguished:

HDL (high density compounds) are the smallest particles. This fraction is synthesized in the liver. It contains phospholipids, which prevent cholesterol from leaving the bloodstream. High-density lipoproteins carry out the reverse movement of cholesterol from peripheral tissues to the liver.
LDL (low density compounds) larger in size than the previous faction. In addition to phospholipids and cholesterol, it contains triglycerides. Low-density lipoproteins deliver lipids to tissues.
VLDL (very low density of compounds) are the largest particles, second in size only to chylomicrons. The fraction contains a lot of triglycerides and “bad” cholesterol. Lipids are delivered to peripheral tissues. If a large amount of per-beta lipoproteins circulates in the blood, then it becomes cloudy, with a milky tint.
XM (chylomicrons) are produced in the small intestine. These are the largest particles containing lipids. They deliver fats that enter the body with food to the liver, where triglycerides are subsequently broken down into fatty acids and added to the protein component of the fractions. Chylomicrons can enter the blood only when very significant violations fat metabolism.

LDL and VLDL belong to atherogenic lipoproteins. If these fractions predominate in the blood, this leads to the formation of cholesterol plaques on the vessels, which cause the development of atherosclerosis and concomitant cardiovascular pathologies.

VLDL is elevated: what does this mean for diabetes?

In the presence of diabetes mellitus there is increased risk development of atherosclerosis due to high content low molecular weight lipoproteins in the blood. At developing pathology changes chemical composition plasma and blood, and this leads to dysfunction of the kidneys and liver.

Malfunctions of these organs lead to an increase in the level of low- and very low-density lipoproteins circulating in the blood, while the level of high-molecular complexes decreases. If LDL and VLDL levels are elevated, what does this mean and how to prevent lipid metabolism disorders can be answered only after diagnosis and identification of all the factors that provoked an increase in protein-lipid complexes in the bloodstream.

The importance of lipoproteins for diabetics

Scientists have long established the relationship between glucose levels and cholesterol concentrations in the blood. In diabetics, the balance of fractions with “good” and “bad” cholesterol is significantly disturbed.

This interdependence of metabolism is especially clearly observed in people with type 2 diabetes. With good control of monosaccharide levels of type 1 diabetes, the risk of developing cardiovascular diseases decreases, and in the second type of pathology, regardless of such control, HDL still remains at a low level.

When VLDL is elevated in diabetes, what this means for a person’s health can be determined by the degree of neglect of the pathology itself.

The fact is that diabetes itself negatively affects work various organs, including hearts. If, in the presence of concomitant disorders, vascular atherosclerosis is added, this can lead to the development of a heart attack.

Dyslipoproteinemia

In diabetes mellitus, especially if left untreated, dyslipoproteinemia develops - a disease in which a qualitative and quantitative disturbance of protein-lipid compounds in the bloodstream occurs. This happens for two reasons - the formation in the liver of predominantly low or very low density lipoproteins and low speed their removal from the body.

Violation of the ratio of fractions is a development factor chronic pathology vessels, in which cholesterol deposits form on the walls of the arteries, as a result of which the vessels become denser and narrow in the lumen. In the presence of autoimmune diseases lipoproteins become foreign agents for immune cells, to which antibodies are produced. In this case, antibodies further increase the risk of developing vascular and heart diseases.

Lipoproteins: norm for diagnosis and treatment methods for deviations

In diabetes mellitus, it is important to control not only glucose levels, but also the concentration of lipoproteins in the blood. You can determine the atherogenicity coefficient, identify the amount of lipoproteins and their ratio by fraction, and also find out the level of triglycerides and cholesterol using a lipid profile.

Diagnostics

A lipoprotein test is performed by drawing blood from a vein. Before the procedure, the patient should not eat for twelve hours. One day before the test, you should not drink alcohol, and it is not recommended to smoke an hour before the test. After collecting the material, it is examined using the enzymatic method, in which the samples are stained with special reagents. This technique allows you to accurately determine the quantity and quality of lipoproteins, which allows the doctor to correctly assess the risk of developing vascular atherosclerosis.

Cholesterol, triglycerides and lipoproteins: normal in men and women

In men and women normal indicators lipoproteins vary. This is due to the fact that the atherogenic coefficient in women is reduced due to increased elasticity blood vessels, which is provided by estrogen - the female sex hormone. After the age of fifty, lipoprotein levels become the same in both men and women.

HDL (mmol/l):

0.78 - 1.81 - for men;
0.78 - 2.20 - for women.

LDL (mmol/l):

1.9 - 4.5 - for men;
2.2 - 4.8 - for women.

Total cholesterol (mmol/l):

2.5 - 5.2 - for men;
3.6 - 6.0 - for women.

Triglycerides, unlike lipoproteins, have increased normal levels in men:

0.62 - 2.9 - for men;
0.4 - 2.7 - for women.

How to correctly decipher test results

The atherogenic coefficient (AC) is calculated using the formula: (Cholesterol - HDL)/HDL. For example, (4.8 - 1.5)/1.5 = 2.2 mmol/l. - this coefficient is low, that is, the likelihood of developing vascular diseases is low. If the value exceeds 3 units, we can talk about the patient having atherosclerosis, and if the coefficient is equal to or exceeds 5 units, then the person may have pathologies of the heart, brain or kidneys.

Treatment

If there is a violation of lipoprotein metabolism, the patient should first of all adhere to a strict diet. It is necessary to exclude or significantly limit the consumption of animal fats, enrich the diet with vegetables and fruits. Products should be steamed or boiled. It is necessary to eat in small portions, but often - up to five times a day.

Constant physical activity is equally important. Hiking, exercise, sports, that is, any active physical activity that will help reduce the level of fat in the body, are useful.

For the sick diabetes mellitus it is necessary to control the amount of glucose in the blood by taking antihyperglycemic medications, fibrates and satins. In some cases, insulin therapy may be required. In addition to medications, you need to stop drinking alcohol, smoking and avoid stressful situations.

Cholesterol is one of the most important substances for any living creature belonging to the animal kingdom. This fatty monohydric alcohol is one of the natural intermediate products of metabolic processes.

At the same time, cholesterol is considered one of the “culprits” of atherosclerosis and some other diseases. After the discovery of the role of this substance in pathophysiological processes, cardiologists, nutritionists, and doctors of some other specialties took up arms against it. In fact, everything is not so simple and unambiguous; the problem is not in cholesterol, as such, but in its quantity and the body’s ability to absorb this substance properly.

The body provides about 80% of the need for this substance on our own, cholesterol is synthesized in the liver. The body gets the rest from food of animal origin. It enters the blood in the form of complex compounds and is involved in a number of processes, in particular:

Growth and reproduction of cells, as one of the components of cell membranes and intracellular structures;
Hormone synthesis;
Transportation of substances with antioxidant activity and fat-soluble vitamins;
Synthesis of bile acids.

What is “bad” and “good” cholesterol

Cholesterol is insoluble in water, so it forms complex lipoprotein complexes for transport to target organs. The complex has spherical shape and consists of cholesterol esters and triglycerides coated with a shell of protein molecules.

There are several types of lipoprotein complexes in the blood, differing in composition and other physical and chemical properties. One of key characteristics lipoprotein complex - density. On this basis, the complexes are divided into “bad” and “good” cholesterol.

Low-density lipoprotein complexes are abbreviated as LDL and are conventionally called “bad” cholesterol. High-density lipoprotein, or HDL, is called “good.”

In fact, LDL and HDL cholesterol are vital to keeping the body functioning.

"Bad" cholesterol

As part of LDL, this compound travels from the liver to target organs, where it is included in the synthesis processes. LDL is the precursor of many hormones, including sex hormones. The body's need for readily available cholesterol is higher, so LDL accounts for over 60% of all cholesterol present in the blood. The content of cholesterol derivatives in them reaches 50%. When moving in the bloodstream, loose complexes can be damaged and cholesterol esters that are outside the protein membrane are deposited on the walls of blood vessels.

When LDL enters the blood in excess, the cells do not have time to absorb it completely and the process of deposit formation on the walls of blood vessels accelerates. Atherosclerotic plaques form. Narrowing of the lumen of blood vessels appears over time vascular insufficiency, ischemia in the affected area. When the plaque is destroyed, complete closure of the lumen of the vessel is possible - thrombosis or thromboembolism.

"Good" cholesterol

“Good” is popularly called high-density cholesterol complexes, HDL. These compounds transport cholesterol to the liver, where it is used to synthesize bile acids and excreted from the body. The cholesterol content in the complexes is up to 30%. In people with normal content This fraction of blood lipids reduces the risk of myocardial infarction to almost zero. When moving through the bloodstream, HDL captures excess cholesterol from the walls, according to some data, even from formed plaques. If HDL cholesterol is low, the body cannot cope with cleansing the walls of blood vessels, cholesterol continues to accumulate and atherosclerosis develops.

At the same time, it should be understood that the names “bad” and “good” cholesterol are more than arbitrary. What is HDL cholesterol? In fact, it is one of the final stages of lipid metabolism, “construction waste”, which must serve the body well before disposal. Replacing all “bad” cholesterol with good cholesterol is neither possible nor safe. The main thing is not so much absolute indicators LDL and HDL cholesterol levels, and their balance.

Blood cholesterol level

“Bad” and “good” cholesterol are not interchangeable compounds; they must always be present in the body, simultaneously and in a certain ratio. Deviation from the norm in the direction of increasing or decreasing the content of any of the cholesterol fractions or any of its fractions indicates the presence of serious problems in the body or potential threat their occurrence in the foreseeable future.

Estimated cholesterol levels:

General – less than 5.2 mmol/l
Triglycerides – no more than 2 mmol/l;
LDL – up to 3.5 mmol/l
HDL – more than 1.0 mmol/l

The concept of a norm is quite arbitrary. Cholesterol levels depend on gender, age, the presence of endocrine and other chronic diseases, and hereditary characteristics of lipid metabolism. This indicator is affected by stress, physiological changes seasonal. The individual norm may differ slightly from the average values; in the presence of certain diseases and other risk factors, cholesterol levels need to be more strictly controlled.

The attending physician will tell you about the individual norm and acceptable limits for each patient. He will give recommendations for effective reduction cholesterol level and, if necessary, prescribe treatment.

How to normalize cholesterol

First of all, doctors recommend adhering to special diet. Products containing trans fats are excluded from the diet, and the consumption of animal fats and sweets is limited. It is better to replace fatty meat with fatty meat sea fish, which contains omega-3 and omega-6 polyunsaturated fatty acids.

If necessary, the doctor will prescribe drug treatment. The course of treatment includes:

Statins;
Bile acid binders;
Fibric acids;
B vitamins, vitamin E, omega-3 fatty acids, folic acid.

High-density lipoprotein (HDL) is a substance that transports unused cholesterol (fats) in the blood from peripheral tissues to the liver for disposal of excess. HDL levels are reduced in cases of exacerbation of chronic diseases or acute infections.

Indicator standards:

in men – 30-70 mg/dl (0.78-1.1 mmol/l);
in women – 30-85 mg/dl (0.78-2.2 mmol/l).

From which it can be seen that the lower limit of indicators for adults is the same.

Cholesterol, the main substance transported to the liver by HDL, plays an important role in the body: it is responsible for maintaining hardness cell walls, the production of steroid hormones by the gonads and adrenal glands and, according to recent data, is also involved in the processes of tissue respiration in the brain. Contains a lot of cholesterol.

Lipoprotein structure

High-density lipoprotein (lipoprotein means the same) is conventionally called “good” because of its function, ultimately aimed at recycling excess cholesterol by the liver. Prevents various cardiovascular accidents, essentially controls a person’s body weight and even takes part in immune processes.

It is impossible to feel a decrease in high-density lipoproteins. To understand what low HDL means, you need to pay attention to indirect signs health problems:

weight gain without changes in eating style and previous physical activity;
the appearance of a feeling of shortness of breath during previously habitual walks at a moderate walking speed;
identified changes hormonal levels: menopause, diseases of the thyroid gland with insufficiency of its function, long-term use of oral hormonal contraceptives without monitoring of related indicators, diabetes mellitus;
long-term use of the following groups of medications: beta blockers (for increased blood pressure), diuretics.

Who needs an HDL blood test?

To timely detect a decrease in HDL, screening tests should be periodically performed, that is, those that are done routinely for everyone classified as at risk, namely:

Pregnant and menopausal women – a decrease in HDL is associated with hormonal changes and estrogen levels. Estrogen, being synthesized from cholesterol steroid hormone, through feedback regulates the liver's production of HDL. With a lack of “good” cholesterol, the concentration of “carriers” of these molecules back to the liver decreases and the amount of newly produced HDL decreases.

It has been observed that blood cholesterol levels increase sharply in women after menopause.

Suffering from obesity. Body mass index (BMI) is greater than 30.
Those who have suffered myocardial infarction and other vascular accidents.
Patients with vascular atherosclerosis, especially in the brain.
Having food allergies, in particular – celiac disease (intolerance to gluten contained in large quantities in grain products), because this group of patients has a limited opportunity to consume foods richest in fiber, which plays a role in key role in any therapeutic diet.
Often, an HDL test is prescribed before surgical interventions or invasive (penetrating inside the body) diagnostic procedures to assess the risk of possible complications.

Diagnostics

In a laboratory setting, blood is drawn, the serum is separated, and the HDL value is determined.

The sample is taken on an empty stomach, 12-14 hours after the last meal. Measure either one HDL or all indicators of the blood lipid profile in comprehensive analysis. Results are usually ready within 1 day or 1 business day.

In some situations, to answer diagnostic questions calculate the ratio of HDL to total cholesterol.

Blood tests for lipid profiles can reveal abnormalities in fat metabolism body

You should not do the testing yourself. Often the laboratory is interested in larger volumes diagnostic procedures, so the list necessary examinations must be prescribed by the attending physician.

Treatment

Low target values in HDL or lipid profile tests do not need to be treated. The patient must be treated individually, paying attention to clinical picture disorders, complaints and symptoms. This is what therapists do. Or those doctors with whom the patient is registered and attends consultations in a timely manner: endocrinologist, cardiologist and others.

Treatment begins with determining the cause that caused the decrease in HDL, and then therapy is directed to eliminating the identified cause or relieving an exacerbation. Most often this is:

Diabetes. For treatment, blood glucose levels are monitored (lipid-lowering drugs, diet) and complications are corrected.
Cirrhosis of the liver. Liver tests are monitored, diet is corrected, physical activity is prescribed that is adequate to the condition, and drug therapy is avoided by avoiding the use of alcohol and other toxic substances.
Obesity. Body mass index is determined using the formula: weight (kg) divided by height (cm) squared. The ideal range is 18-21. Increased rate More than 30 is considered obese, in which body weight is reduced.

Obesity is one of the risk factors for dyslipidemia

A diet with plenty of “fast” carbohydrates, big amount polyunsaturated fatty acids can also lead to decrease in HDL. The higher the concentration of low and very low density lipoproteins (LDL and VLDL) in the blood, the lower the HDL levels. Therefore, the diet is adjusted for treatment.

Universal tips for normalizing your daily routine, increasing physical activity and giving up bad habits, which will help not only increase HDL levels, but also avoid many other painful conditions.

Stop smoking. This action alone will increase HDL levels by 10%.
Monitor your weight, avoid increasing it to levels of obesity (BMI ›30), and if present, pay attention to measures to reduce it.
Sufficient physical activity. Exercise in the morning, during the warm season. A good remedy For cardio training there will be bike rides away from highways.
Pay attention to the amount of liquid consumed per day (should not be lower than 2-2.5 liters per day). Coffee is not included in this amount because it has the opposite effect to the desired goal, promoting dehydration and increasing blood pressure.
Avoid alcohol. As alcoholic drinks It is acceptable to drink red wine occasionally.

If you have lipid metabolism disorders, you should avoid alcohol

Some foods help raise HDL levels. This:

sea fish;
low-fat cottage cheese;
hard cheese;
milk and yogurt;
white meats ( Domestic bird, rabbit);
nuts and dried fruits;
legumes (soybeans, peas, chickpeas).

With all the variety of advice on normalizing low levels of HDL cholesterol, the key to prevention remains the normalization of lifestyle with normalization of body weight and sufficient physical activity, namely - physical therapy. This one is simple, but so important advice will help bring indicators back to normal faster and, moreover, is an excellent prevention of cardiovascular diseases and the musculoskeletal system than all possible diets at the same time, because the role of food in blood cholesterol levels is only no more than 20%.