Lipid spectrum of transaminases. Lipidogram. Decoding, norms for men and women. Deviations in the lipid profile. How to take the test correctly and what affects the result

Many patients in therapeutic and cardiology departments, and indeed older people in general, are prescribed an analysis called a “blood lipid profile”. But many doctors forget to explain what it is and what it includes. But this study clarifies how disturbed lipid metabolism is, and how it should be corrected: with diet, folk remedies, or the use of specific medications is already required.

Considering that the level of fat depends on individual characteristics, to decipher the analysis, a special table of norms for the entire lipid spectrum is used, both in women and men, taking into account their age.

Fats received from food or synthesized in the body perform their specific functions, and in some chemical reactions no substance can replace them. They are insoluble in the aqueous environment (which is blood, lymph, intracellular fluid), therefore they bind to proteins, forming lipoproteins.

These complex compounds contain the same lipid components, only each fat-protein complex contains them in its own percentage. These are triglycerides, phospholipids, cholesterol, its esters and fat-soluble vitamins (E and carotenoids). And the higher the concentration of fat, the less carrier protein, and the lower the density of the lipoprotein. It can be very low, intermediate, low and high.

A feature of the biochemistry of lipid metabolism is the gradual transition of one fraction to another after the cleavage or addition of the fatty component. It turns out that the result of a lipid profile shows at what stage the lipid balance was disturbed and how deep. Moreover, based on the study, doctors calculate the risk of development and dynamics of cardiovascular diseases, and monitor treatment.

In medicine there are several synonyms for analysis. In addition to the lipid profile, it is called “lipid profile” or “lipid status”, although its essence does not change. The hemotest includes determining the concentration of lipoproteins, the total cholesterol contained in them, triglycerides, and the extended test also includes the level of some carrier proteins.

Indications for analysis

Lipid metabolism disorders are just a condition of the body. It progresses slowly and imperceptibly. And the presence of an imbalance is often learned after the development of the independent pathology caused by it, primarily of the heart and blood vessels. And the first manifestations of dyslipidemia are nonspecific symptoms:

• drowsiness, lethargy, increased fatigue;
• nervous irritability;
• headaches (such as migraines);
• heaviness, discomfort, pain in the right hypochondrium.

In this situation, using a lipid profile, you can assess the level of risk of developing vascular atherosclerosis, cholelithiasis, hypertension, and type II diabetes.

More characteristic signs of lipid imbalance include deposits of cholesterol deposits under the skin epidermis, which occur with persistently elevated cholesterol levels. These are xanthomas, xanthelasmas, yellow rims around the cornea (lipoid arches). Their presence indicates an advanced disorder of lipid metabolism. With such changes in the skin, doctors usually prescribe a lipid profile.

The analysis of venous blood for a lipid profile also has clearly formulated absolute indications:

• hereditary dyslipidemia;
• hereditary predisposition to it;
• hypertension and secondary arterial hypertension;
• previous heart attack or stroke;
• diabetes;
• pathology of the thyroid gland with dysfunction;
• obesity;
• liver diseases with symptoms of blockage of the bile ducts;
• inflammation of the pancreas;
• renal pathology accompanied by failure;
• premenopausal and menopausal age;
• poor nutrition with uncontrolled consumption of animal fats, simple carbohydrates, fast food, physical inactivity, bad habits.

It is important to know that atherosclerosis, diabetes, hypertension, and obesity are not only the result of lipid balance disorders, but also contribute to its deterioration. Doctors call this process a vicious circle. Therefore, in case of the listed pathology, one study is not enough: regular monitoring of the state of fat metabolism is necessary. Periodically, blood is donated for lipid status even when therapy is started in order to know how adequate it is.

Lipid spectrum indicators: interpretation, norms and deviations

If the level of glucose, blood cells, and liver condition indicators are static and do not depend on gender, and in adults - on age, then lipid metabolism data change every 5 years. Moreover, not only the numbers change, but also the relationship between the factions. Which, in essence, plays a major role in assessing the patient’s condition.

Separately, it is worth mentioning the physiological change in reference lipid values ​​that occurs after eating, physical and psychological stress, during pregnancy and in the first months of lactation. It is transient, lipid metabolism is restored on its own and does not require correction.

And now a little about each indicator.

Total cholesterol

This is the total value of all cholesterol contained in the blood. It is part of lipoproteins of different densities and does not circulate in free form. A simplified lipid profile only provides for the determination of total cholesterol. But a deviation from the norm informs doctors little about anything, because they need to know which fractions accounted for the change in lipid metabolism. But without it it is impossible to calculate the atherogenicity coefficient - the main indicator of the degree of risk of atherosclerotic vascular damage.

Depending on age, the range between the lower and upper limits of normal is 2–3 mmol/L. The growth chart for total cholesterol differs between men and women:

• in males, the maximum concentration is observed during puberty, which is associated with an increased level of sex hormones, and with a decrease in hormonal levels it begins to fall;
• In females, total cholesterol levels increase gradually, and the older the woman, the higher they are.

The norms for total cholesterol depending on age and gender are presented below.

High density lipoproteins (HDL, HDL)

The density of lipoproteins depends on the amount of protein they contain: the more protein they contain, the denser they are. And since we are talking about high density, then these fat-protein complexes contain a lot of protein and little fat. They are formed as a result of the cleavage of lipids used for the needs of cells. Consequently, high-density lipoproteins are “waste” substances, which only have to return to the liver and transport the remaining lipids to it.

These residues, as a result of complex chemical processes, are converted into bile acids and excreted into the gallbladder. Later, during meals, the gallbladder contracts, squeezing bile into the intestinal lumen. Here, bile acids break down the food bolus into absorbable elements, and themselves are destroyed.

It turns out that high-density lipoproteins help remove excess fat and cholesterol from the body. That is why they are called “good”. Consequently, the higher their level, the lower the risk of developing diseases caused by lipid metabolism disorders, and vice versa.

For analysis, the amount of cholesterol in the lipoprotein, and not the entire fat-protein complex, is of primary importance. Its normal HDL levels are summarized in the table.

Low-density lipoproteins (LDL, LDL)

But they are called “bad”. This is due to the fact that low-density lipoproteins make up the bulk of fat-protein complexes circulating in the blood. They transport cholesterol and small amounts of other fats from liver cells, where they are synthesized, to peripheral tissues. And unused LDL is deposited in the vascular walls in the form of atherosclerotic plaques.

A large concentration of “bad” lipoproteins sharply increases the risk of atherosclerosis. What it is? This is a narrowing of the lumen of the arteries, thrombosis, decreased elasticity of the walls, their increased fragility, stratification. The result is a disruption of tissue nutrition up to necrosis. Low concentration is also unfavorable. It threatens to disrupt the formation of steroid hormones, selective hypovitaminosis (A and D), slowdown of regeneration processes, and decreased mental abilities.

The optimal levels of LDL cholesterol can be found in the table.

Very low density lipoproteins (VLDL)

These are elementary primary particles synthesized by liver cells, which are the basis for the formation of LDL. They also partially enter the blood, but the percentage of cholesterol in them is low. VLDL are transporters of triglycerides, although they also play an important role in cholesterol metabolism. The ability of lipoproteins with very low density to penetrate the thickness of vascular walls is enhanced in diabetes and kidney pathology with insufficiency.

Average cholesterol values ​​in VLDL range from 0.26 mmol/L to 1.04 mmol/L. Their consistently increased synthesis automatically leads to an increase in the concentration of LDL, which leads to the development of atherosclerosis.

Triglycerides

They are named so because their molecules contain 3 fatty acids. The lipid composition of different triglycerides varies, and they can include both saturated and unsaturated fats. Depending on the composition, TGs perform different functions: either they are used to build cell membranes, or they are deposited in tissues in the form of fat depots, the ultimate goal of which is to supply energy to chemical processes in the body.

Triglycerides come from food and are formed in tissues, transported as part of lipoproteins of different densities, therefore, their concentration also depends on age and gender. An increased level of triglycerides in the blood occurs immediately after eating, during pregnancy, and hyperlipidemia of any etiology. Reduced - indicates accelerated metabolic processes (thyrotoxicosis), impaired absorption (malabsorption syndrome, starvation) and synthesis (liver pathology).

Atherogenic coefficient (AC)

This is the indicator for which, in essence, a blood test for the lipid spectrum is carried out. It is calculated using the formula:

Normal values ​​of the atherogenic coefficient are considered to be:

• up to 30 years – no higher than 2.5 for men and 2.2 for women;
• after 40 years of age - less than 3.5 for men and 3.2 for women.

The higher the coefficient, the more likely and faster atherosclerotic plaques form.

Additional indicators

To understand the biochemical reasons for the high atherogenicity coefficient, additional information about lipid metabolism is needed. These include determining the level of the main transport proteins. Therefore, the extended lipid profile includes indicators of apolipoprotein A1, B and (a).

1) Apo A1– a carrier protein in HDL, synthesized by the liver and intestinal epithelium. It activates the enzyme lipase, which catalyzes the breakdown of cholesterol, and thereby promotes its elimination. A decrease in the level of Apo A1 threatens intensive deposition of lipids and proteins in the vascular walls with the formation of atherosclerotic plaques. Conversely, the higher its concentration, the lower the risk of developing atherosclerosis. Reference values ​​for apolipoprotein A1 are presented below.

2) Apolipoprotein B found in all fat-protein complexes, except high-density ones. Apo B-100 consists of hundreds of amino acids and is synthesized by liver cells. Its half version, Apo B-48, is produced by the intestinal epithelium. In addition to transport, apolipoproteins B perform the function of recognizing LDL by receptors in peripheral cells, and therefore contribute to their fixation on cytoplasmic membranes.

Clinical and laboratory studies have proven that the level of apolipoprotein B is even more reliable than the concentration of LDL in determining the degree of risk of developing atherosclerosis. Therefore, in advanced lipid profile analyses, an additional “atherogenic coefficient” is calculated - the ratio of the amount of Apo B to Apo A1. Normally, it should not exceed 0.9 for men and 0.8 for women.

What to do if test results are bad

It is unlikely that the patient will independently understand the causes and consequences of disorders of his own fat metabolism. Only a doctor can restore the altered lipid spectrum. Moreover, in deciphering a detailed lipid profile, not only the local therapist is involved, but also many specialized specialists: a cardiologist, an endocrinologist, a gastroenterologist. Methods of correction and treatment are selected in consultation with the involvement of a nutritionist and a physical therapy doctor.

1. In the case of minor and moderate disorders without genetic damage, changes in diet and lifestyle, folk and homeopathic remedies may be sufficient to restore lipid balance.
2. Severe dyslipidemia is treated comprehensively and over a long period of time, possibly for a lifetime. In addition to diet, moderate exercise, and giving up bad habits, specific therapy is prescribed with statins, fibrates, cholesterol absorption inhibitors, vitamins, and bile acid sequestrants.

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

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

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

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

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

There are also lipoprteins in the blood especially low density(VLDL). Currently, there is no reliable evidence of their negative effect on blood vessels, but often their quantity is also of interest in the diagnosis of cardiovascular diseases. Some scientists believe that VLDL, under some conditions, converts to LDL and thus increases the likelihood of atherosclerosis.

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

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

Usually lipid profile includes Determination of the following lipids in the blood:

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

Based on the results of laboratory tests, it is calculated atherogenic coefficient(Ka).
This coefficient is determined by the following formula:

Ka=(Koh –HDL)/HDL.

What preparation is needed for the analysis?

A blood test to obtain a lipid profile is performed by routinely drawing blood from a vein. In this case it is necessary do this fence on an empty stomach. In addition, during the day before donating blood, you must give up heavy physical activity, smoking, and drinking alcoholic beverages. It is advisable to avoid emotional stress before donating blood.

Norm of indicators

The results of the lipid profile are compared with the acceptable values ​​of the corresponding indicators. The meanings of these boundary indicators are given in table 1.

Table 1

Example of a lipid profile obtained for patient N. (age -74 years, preliminary diagnosis - ischemic heart disease and angina pectoris 2 FC) are shown in table 2.

table 2

Based on the results of this lipid profile, Ka was calculated:
Ka=(4.94-1.04)/1.04=3.94.

Decoding results in adults

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

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

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

The example results of a lipid profile of a real patient (Table 2) are quite correspond to the above decoding. Indeed, despite the fact that total cholesterol and triglycerides are normal, HDL is quite low and is on the border of the acceptable range, and LDL is outside the acceptable range. Therefore, the patient is diagnosed presence of atherosclerosis and ischemic heart disease, which is confirmed by the low HDL value (1.04 mmol/l) and the high Ka value (3.94).

Desired indicators

In order for fat metabolism in the body was normal, we must strive for the following indicators:

• total cholesterol - no more than 5 mmol/l;
• LDL - no more than 3 mmol/l;
• HDL - at least 1 mmol/l;
• triglycerides - no more than 2 mmol/l;
• Ka - no more than 3.

Lipidogram in the treatment of heart and vascular diseases

As a rule, a cardiologist prescribes a patient for a lipid profile. Thanks to the results of PH, it is possible to diagnose diseases such as myocardial infarction, stroke, kidney disease and other diseases.

If elevated levels of LDL, which is bad for blood vessels, are detected, the doctor may prescribe statin treatment(lovastatin, rosuvastatin, simvastatin). The presence of a large amount of TG also requires treatment with drugs. But if the patient's blood contains a large amount of HDL, then such treatment may be premature. In this case, sometimes you can make do with usual measures, including following a diet, increased consumption of seafood and fish, leading a healthy lifestyle without smoking and drinking alcohol.

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

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

If statins are prescribed, after some time it is prescribed repeat lipid profile. Based on its results, the doctor determines the effectiveness of treatment and, if necessary, makes adjustments.

Prices at Invitro

When a lipid profile is prescribed by the attending cardiologist at the clinic, the analysis is performed free of charge. In other cases, such a test can be done at various medical centers.

The cost of such an analysis is range from 1000 to 1500 rubles.

For example, in the Invitro company in Moscow such an analysis costs 1080 rubles plus 199 rubles for blood sampling, and in St. Petersburg the same analysis can be done in the NML company for 1300 rubles.

A lipid profile (LPG) is a blood test that quantifies lipids in the human body. In simple words, LPG is a blood test that helps determine the amount of cholesterol and other substances containing fats.

This study helps to most accurately assess the degree of risk of progression of atherosclerosis(cholesterol deposits deposited on the walls of blood vessels, thereby narrowing the lumen of the vessel and impairing blood flow).

This blood test does not indicate specific diseases, but only records the indicators of fatty compounds in the blood.

To accurately diagnose diseases, additional hardware tests are prescribed. Preparing for analysis requires certain actions. The lipid profile is deciphered by a qualified attending physician.

How much does the analysis cost?

The pricing policy for taking lipid profile tests is acceptable, making it not only effective and informative, but also affordable.

Prices for a hemotest in Moscow fluctuate on average about 800 rubles, but they may vary depending on the clinic conducting the study.

The average price for Kyiv for a lipid profile is 300 hryvnia, but can also change when choosing a particular laboratory.

The cost of a comprehensive lipid profile analysis is 350 UAH. (3580 rub.), plus the cost of blood sampling 30 UAH. (200 rub.).

What is included in LPG?

Research using lipid profile analysis implies a more detailed and focused study of lipid parameters than in a simple biochemical blood test.

That is why this analysis is much more effective for diseases associated with impaired cholesterol concentrations.

Each of the indicators listed below is included in the lipid profile:

• Cholesterol, or more simply put, total cholesterol. This indicator is the most important number that is part of the LPG. Based on their origin, there are two types of cholesterol, which are concentrated in the body 50 to 50. The first type is synthesized by the human body (in the liver), and another half of the cholesterol enters the body with the food consumed.
  The indicator is very important, since it participates in the formation processes of absolutely all tissues and cells of the human body. Cholesterol is also responsible for nutrient absorption, puberty, overall body functioning and growth. It is also a precursor to growth hormone;
• HDL or high density lipoprotein– a type of “good” cholesterol. Its main function is to move free cholesterol out of cells. After this, they transport it to the liver, where fat metabolism occurs and fatty acids are removed from the body;
• LDL or low-density lipoprotein– a type of “bad” cholesterol. This indicator is the most significant for diagnosing cholesterol problems.
  If the levels of total cholesterol are within normal limits, and this indicator is increased, then this indicates a violation of fat metabolism and the risk of progression of the deposition of atherosclerotic plaques on the walls of blood vessels.
  It is these lipids that can be deposited on the walls of blood vessels, provoking the development of atherosclerosis;
• VLDL or very low density lipoproteins- is included in the analysis indicators in some laboratories when they determine the cholesterol profile. But there are no exact indications for diagnosing diseases based on this indicator;
• TG or triglycerides– elements found in plasma that are represented by VLDL components, which are converted into LDL. This is why it is important to track this indicator.
  The main function of triglycerides is energy function. Their quantitative presence in tissues is insignificant; they are mainly located in adipose tissues.
• KA or atherogenic coefficient. This indicator is not determined by direct blood testing; it is calculated based on all of the above values. It is defined to capture the normal relationship between the above values.

In most cases, it is measured using the following formula:

When is the test scheduled?

An appointment for a biochemical analysis of the lipid spectrum can occur both to determine the risk of progression of diseases associated with cholesterol deposits, and to monitor and correct therapy for already diagnosed diseases.

Among the pathological conditions for which a lipogram is necessary: ​​insufficient blood supply to the heart (caused by atherosclerotic deposits in the coronary arteries), diabetes mellitus, and a constant increase in blood pressure (caused by narrowing of the pulmonary artery).

Also, a lipid profile is indicated for people who are prescribed a diet with a reduced amount of cholesterol, and who use medications to reduce the quantitative concentration of cholesterol deposits.

General indications for prescribing a lipid profile:

• For people over twenty years of age, preventive testing is required every five years. With the help of such preventive actions, it is possible to determine the progression of atherosclerosis and apply effective treatment in a timely manner. This will protect you from possible serious complications of the heart and blood vessels;
• Increase in total cholesterol levels in biochemical analysis;
• Smoking, which leads to serious vascular diseases;
• Diabetes;
• Age category, both men and women over fifty years of age;
• Death of heart tissue or stroke. In the presence of these pathological conditions, testing for lipid levels is necessary up to twice a year;
• Sedentary lifestyle and excessive excess weight. These factors significantly increase the deposition of cholesterol in blood vessels and provoke various pathologies associated with the heart and blood vessels;
• Genetic disposition. People whose relatives had pathologies of the heart and blood vessels are at risk. Lipid levels should be monitored especially carefully if relatives died before the age of forty from cardiovascular pathologies.

Blood lipid spectrum decoding

Normal values ​​vary depending on age category and gender. For adults, the norm will be different from for children, which is important to consider when deciphering. Below are tables with normal indicators for all five components of the lipid profile.

Total cholesterol.

HDL

LDL

Triglycerides

Atherogenic coefficient

What complications does the increase in indicators indicate?

In the table we consider all possible complications when certain indicators decrease and increase.

Importance in diagnosing diseases of the cardiovascular system

When performing a lipid profile, you can accurately assess the risk of progression of quite dangerous diseases that can lead to death.

Among the identified diseases of the cardiological group, the risk of which can be assessed using a lipid profile, are:

• Death of heart muscle tissue;
• Stroke;
• Pathological conditions of renal tissue;
• Pathologies caused by high concentrations of cholesterol.

The diagnosis determines what further examination and treatment will be prescribed. Also, the doctor needs to take into account many factors that influence the deviation of indicators from the norm.

LDL plays a major role in influencing the progression of pathologies of the heart and blood vessels, since it is this cholesterol that is “harmful” and settles on the walls of blood vessels more than others.

While high levels of HDL are indicative of the fight against blockage of the ducts, so the prescribed medications may be less strong. And high levels of triglycerides will lead to the appointment of more effective and potent treatment.

Also, a blood test is an effective method for correcting and assessing the effectiveness of prescribed therapy, and when following a diet.

A study of five forms of lipids is also prescribed before using statins. In addition to analyzing the lipid profile, in most cases, a study of ALT and AST is prescribed, which are directly related to cholesterol, as they indicate functional processes of the liver.

What symptoms require a lipid profile?

Long-term absence of symptoms is inherent in the process of formation of atherosclerotic deposits. This happens because the process of their accumulation is quite long, but can be detected in the results of biochemistry, even before the onset of symptoms.

The manifestation of symptoms will depend on the location of the vessel affected by cholesterol plaques. Depending on which organ fed the canal and how much the lumen is blocked, symptoms of varying severity appear in different organs.

If you have the following symptoms, you should urgently consult a doctor to conduct tests to control your lipid spectrum and order additional studies:

Symptoms depend on the channel affected by cholesterol and can manifest themselves in different ways. To avoid serious consequences, you must immediately consult a doctor, otherwise serious complications may arise.

How to properly prepare for the test?

In order to obtain the most accurate indicators of cholesterol metabolism on a lipid profile, you should follow a certain list of steps to prepare for the analysis. If the following steps are not followed, the result may be false, which will lead to incorrect diagnosis and useless treatment.

The final results may be affected by some external factors. That is why it is important to exclude them on the eve of analysis.

Follow these steps to get the most accurate lipid profile results:

• The analysis is given on an empty stomach. Eating must be stopped at least twelve hours before it is time to donate blood;
• At least one day before blood sampling, it is recommended to stop eating fatty, highly salted, spicy or spicy foods;
• Give up alcoholic beverages at least 24 hours in advance;
• Half an hour before the test you need to stop using cigarettes;
• An hour before the analysis, avoid physical and emotional stress;
• If the patient is taking medications, they must be stopped at least 48 hours before blood sampling. If you continuously use drugs, you need to notify your doctor about this so that he takes into account all the corrections in the test results, which will contribute to an accurate diagnosis.

The following factors give deviation in lipid profile analysis:

• Strong physical activity the day before;
• Traumatic conditions;
• Certain diets;
• Pathological conditions of the liver or kidneys with impaired functioning;
• The period of bearing a child. During this period, strong hormonal changes occur in the body of the expectant mother;
• Use of certain medications. Those that increase cholesterol include beta-blockers, which are often prescribed for pathological conditions of the heart and blood vessels, as well as hormonal agents, diuretics and tranquilizers, which increase cholesterol.
  Drugs from the groups of androgens, estrogens, statins, fibrates, etc. can cause a decrease in total cholesterol.
  An increase in total cholesterol, as well as LDL and HDL cholesterol, is provoked by corticosteroid drugs. And when using hormonal contraceptives, cholesterol and LDL increase, but HDL decreases, which is reflected in the results of the lipid profile.

What are the preventive actions for atherosclerosis?

Cholesterol deposits are recorded quite often and are a very common disease. By following some recommendations, you can significantly reduce the risk of vascular damage from atherosclerotic plaques.

• Get rid of excess weight and obesity (if any);
• Normalize the state of the nervous system;
• Maintain a daily routine and a balance between work and proper sleep;
• Monitor blood pressure levels;
• Eat properly;
• Lead a more active and healthy lifestyle;
• Stop smoking and drinking alcohol.

Photo gallery: Prevention of atherosclerosis

Video: Three tests for obese people.

What are the forecasts?

Further prognosis of the patient’s life depends on the location of the vessel blocking by an atherosclerotic plaque, and the degree of its blocking.

With slight increases in lipid profile, a proper diet and a balanced lifestyle are used, this normalizes cholesterol levels and removes atherosclerotic plaques.

The outcome in this case is favorable.

In the case of an average increase in lipid profile, drug treatment is used in combination with proper nutrition and lifestyle. Additional studies of the blood vessels are also necessary to determine whether they are narrowing.

If you do not take prescribed medications, or if they are not effective, as well as if you do not follow a diet and a healthy lifestyle, complications occur. The level of lipid profile indicators becomes the highest, which indicates a serious condition of the body.

Complications from atherosclerotic plaques are serious, and if the vessel is completely blocked by the plaque, hypoxia occurs in the organs to which the vessel led.

Gradual death of tissue occurs; in the absence of surgical intervention, serious consequences are possible (heart attack, stroke, gangrene, complete death of organs), which ultimately lead to death.

The presence of cholesterol deposits in the blood requires immediate treatment to prevent the progression of diseases associated with high cholesterol concentrations.

If you notice symptoms or suspect high lipid values, or are at risk, consult a doctor and undergo a lipid profile and possible other tests.

Do not self-medicate and be healthy!

Which allows you to objectively assess disorders in the fat metabolic process. Even minor deviations from the norm in a blood lipid test can mean that a person has a high probability of developing various diseases - blood vessels, liver, gall bladder. In addition, regularly performed blood tests for lipids allow doctors to predict the development of a specific pathology and take timely measures for prevention or treatment.

When to do a blood lipid test

Of course, every person who cares about their own health can go to a medical institution at any time and undergo this type of examination. But there are specific indications for performing a lipid profile:

• extrahepatic type;
• nephrotic syndrome;
• first and second types;

Rules for the procedure

Patients should be aware that blood sampling for this examination is carried out on an empty stomach in the morning, approximately within 8-11 hours. The day before, the last meal should be taken no later than 8 hours before the scheduled time of testing. Doctors recommend not drinking alcohol and quit smoking a few days before the scheduled day of the examination.

Decoding the lipid profile

As part of the examination in question, the levels of cholesterol, high-density lipoproteins, low-density lipoproteins, very low-density lipoproteins, triglycerides and the atherogenic coefficient are determined.

Cholesterol

This is the main lipid that enters the body along with animal products. The quantitative indicator of this lipid in the blood is an integral marker of fat metabolism. The minimum level is determined only in newborns, but with age its level inevitably increases and reaches its maximum in old age. It is noteworthy that even in old age men have lower blood cholesterol levels than women.

Normal cholesterol levels when testing blood for lipids: 3.2 – 5.6 mmol/l.

Interpretation of analyzes

Elevated cholesterol levels may indicate the following pathologies:

• familial dysbetalipoproteinemia;
• familial hypercholesterolemia;
• polygenic hypercholesterolemia;
• combined hyperlipidemia.

The above pathologies refer to primary hyperlipidemias, but high cholesterol levels may also indicate the presence of secondary hyperlipidemias:

• chronic course;
• cardiac ischemia;
• chronic type;
• long-term adherence to a diet rich in fats and carbohydrates;
• malignant neoplasms in the pancreas;
• myocardial infarction;

If the level of cholesterol in the blood is significantly reduced, this may indicate:

• fasting;
• megaloblastic anemia;
• sepsis;
• cachexia;
• hyperthyroidism;
• chronic obstructive pulmonary disease;
• Tangier disease;
• thalassemia;
• hepatocarcinoma;
• cirrhosis of the liver in the thermal stage;
• severe infectious diseases.

High density lipoproteins (HDL)

These lipids are the only ones that do not participate in the formation of atherosclerotic plaques in blood vessels. Women's levels of high-density lipoprotein are always higher than men's.

Normal HDL levels are 0.9 mmol/l.

Decoding the results

An increase in high-density lipoprotein levels indicates:

• Cushing's syndrome;
• obstructive jaundice;
• chronic renal failure;
• about obesity;
• nephrotic syndrome;
• pregnancy;
• diabetes mellitus of the first and second types.

In addition, high levels of the lipid in question in the blood can be detected while following a diet rich in cholesterol.

A decrease in the level of high-density lipoproteins is detected against the background of:

Low-density lipoproteins (LDL)

The lipoproteins in question are considered the most atherogenic lipids. They are the ones who transport cholesterol into the vascular system and form atherosclerotic plaques there.

Normal LDL levels are 1.71 – 3.5 mmol/l.

An increased level of low-density lipoproteins means the development of the following pathologies in the patient’s body:

• obstructive jaundice;
• nephrotic syndrome;
• Cushing's syndrome;
• diabetes mellitus type 1 and 2;
• obesity;
• renal failure in a chronic form;
• hypothyroidism

In addition, high LDL levels can be due to pregnancy or a diet rich in cholesterol. Blood tests for lipids will give the same results with long-term use of certain medications - diuretics, glucocorticosteroids, androgens.

A decreased level of low-density lipoprotein indicates:

• Reye's syndrome;
• chronic anemia;
• Tangier disease;
• multiple myeloma;
• of different etiologies.

A decrease in the level of these lipids can occur against the background of nutritional disorders (foods rich in polyunsaturated fatty acids are eaten) or acute stress disorder.

Very low density lipoproteins (VLDL)

These are highly atherogenic lipids that are produced by the intestines and liver.

Normal VLDL levels are 0.26 – 1.04 mmol/l.

An increase in the level of very low density lipoproteins is observed with:

• obesity;
• nephrotic syndrome;
• pituitary insufficiency;
• diabetes mellitus;
• hypothyroidism;
• Niemann-Pick disease;
• chronic alcohol intoxication.

In addition, the type of lipids in question can be detected during pregnancy (in the 3rd trimester).

Triglycerides

These are the names of neutral fats that circulate in the blood plasma in the form of lipoproteins. They are produced by the liver, intestines and fat cells themselves, and also enter the body along with food. Triglycerides are the main energy source of cells.

Normal triglyceride levels are 0.41 – 1.8 mmol/l.

Decoding the analysis results

High levels of the lipids in question can be detected against the background of primary hyperlipidemia:

• LCAT (lecithin cholesterol acyltransferase) deficiency;
• familial hypertriglyceridemia;
• simple hypertriglyceridemia;
• chylomicronemia syndrome;
• complex hyperlipidemia.

Triglycerides may be elevated due to:

• atherosclerosis;
• coronary heart disease;
• hypertension;
• nephrotic syndrome;
• thalassemia;

A decrease in the level of the lipid in question in the blood will be present against the background of:

Atherogenic coefficient

This is the ratio of the atherogenic fractions of low and very low density lipoproteins to the antiatherogenic fraction of high density lipoproteins. It is the indicator under consideration when conducting a blood test for lipids that allows you to “visually” assess the likelihood of the formation of atherosclerotic plaques.

Normal readings for the atherogenic coefficient are 1.5 – 3.0.

Interpretation of test results:

• low probability of formation of atherosclerotic plaques – atherogenicity coefficient less than 3.0;
• moderate risk of formation of atherosclerotic plaques – atherogenicity coefficient is 3. - 4.0;
• high risk of formation of atherosclerotic plaques - atherogenic coefficient more than 4.0.

When does a doctor necessarily prescribe a blood test for lipids?

If the patient has already been diagnosed with certain diseases, the doctor always prescribes a blood test for lipids . These pathologies include:

1. Gout – cholesterol levels will be significantly increased.
2. Myocardial infarction – increased levels of both cholesterol and triglycerides.
3. Obliterating atherosclerosis of the lower extremities - increased levels of triglycerides and cholesterol, decreased levels of high-density lipoproteins.
4. Arthritis – low-density lipoprotein levels are significantly reduced.
5. Hyperthyroidism – cholesterol, low-density lipoprotein and triglyceride levels are reduced.
6. Diabetes mellitus type 1 and 2 – increased levels of low-density lipoproteins, increased levels of triglycerides, cholesterol and very low-density lipoproteins.
7. Chronic – cholesterol levels are significantly reduced.
8. Hyperthyroidism – low levels of triglycerides, cholesterol and low-density lipoproteins.
9. Nephrotic syndrome - increased levels of all lipids in the blood.
10. Chronic pancreatitis - increased levels of very low density lipoproteins, cholesterol and triglycerides.
11. Acute glomerulonephritis – increased cholesterol levels.
12. Reye's syndrome - low levels of low-density lipoprotein.
13. Anorexia nervosa - decreased cholesterol levels, increased levels of high-density lipoproteins.
14. Hypothyroidism – increased levels of high and low density lipoproteins, cholesterol.
15. Primary hyperparathyroidism – low triglyceride levels.
16. Chronic renal failure - increased cholesterol levels, decreased (in some cases increased) levels of high-density lipoproteins.
17. Liver cirrhosis - with the biliary type of pathology, a high level of cholesterol will be detected, with classic cirrhosis - an increase in triglyceride levels, in the thermal stage of liver cirrhosis - a decrease in cholesterol levels.
18. Chronic glomerulonephritis – increased cholesterol levels.
19. Obesity – increased levels of cholesterol, triglycerides, low-, high- and very low-density lipoproteins.
20. Burn disease - cholesterol levels can be either high or low depending on the severity of the disease.
21. Systemic lupus erythematosus – increased levels of very low density lipoproteins.
22. – increased triglyceride levels.

A blood test for lipids is considered a fairly informative study, which allows not only to confirm the expected diagnosis, but also to prevent the development of many pathologies.

Tsygankova Yana Aleksandrovna, medical observer, therapist of the highest qualification category

Impaired fat metabolism and atherosclerosis are the main causes of heart and vascular diseases. It is possible to determine the degree of risk of developing atherosclerosis or fat metabolism disorders, while there are no intravascular plaques recorded by ultrasound sensors, using laboratory methods. In this case, a lipid profile comes to the rescue - this is a study of the entire lipid spectrum of the blood.

One of the components of fat metabolism in the body is cholesterol. It is its concentration that reflects the risk of developing vascular pathology. A blood test for cholesterol, carried out as part of a biochemical blood test, gives an idea of ​​the amount of this substance in a person. Data on total cholesterol do not always allow one to draw a conclusion about the presence of pathology. This is where a lipid profile comes to the rescue, which helps determine not only quantitative, but also qualitative characteristics of lipid metabolism.

Who is prescribed

• Observation by a cardiologist. The study is almost always prescribed for people seeing a doctor for cardiovascular disease. This does not have to be atherosclerosis - a lipid profile is also indicated for patients with heart defects or disorders of the structure of blood vessels.
• Metabolic disorders. Using this analysis, the dynamics of the condition of patients with diabetes mellitus, pathologies of the thyroid gland and pituitary gland are studied.
• Smoking and alcoholism. These dependencies can aggravate all metabolic disorders and themselves lead to metabolic pathologies.
• Arterial hypertension. Lipid metabolism disorders increase the risk of vascular accidents with high blood pressure.
• Obesity, physical inactivity. These risk factors for the development of vascular diseases enhance the negative impact of lipid imbalance on the vascular wall.

If the patient has suffered a heart attack or stroke, then a lipid profile is recommended several times a year. For people with a genetic predisposition (stroke, heart attack in close relatives or hereditary lipid metabolism disorders), doctors advise that after 30 years of age, undergo an examination annually.

Preparing for research: on the way to reliable results

In order to study the lipid spectrum of blood, an analysis of venous plasma is performed. Blood sampling takes place in the morning. In this case, the person being examined must comply with strict restrictions before the procedure.

• On the eve of the study. It is necessary to give up fatty foods, alcohol and smoking, avoid physical activity, and eliminate stress. If you had to drink alcohol, it is better to immediately reschedule the examination to another day.
• 12 hours before the examination. You can't eat. You are allowed to drink only clean water.
• In the morning before the analysis. It is advisable to completely relax and calm down. It is imperative to warn medical professionals about the medications you take regularly, as they can greatly affect the results.

What is a lipid profile: what do the indicators say?

A lipidogram shows the content of substances or fractions in the blood such as:

• total cholesterol or cholesterol (TC);
• high density lipoproteins (HDL);
• low density lipoproteins (LDL);
• triglycerides (TG);
• atherogenic coefficient.

Cholesterol is one of the fundamental substances in the body. It takes part in puberty and is found in the membranes of all cells of the body. That is why the liver synthesizes 80% of the cholesterol determined by the analysis. And only 20% of the substance detected by the lipid profile is due to food intake.

Cholesterol is a fat-soluble substance. It cannot be transported by blood in its pure form. That is why the body “packs” it into protein containers. Such protein-lipid complexes are called lipoproteins. There are two main types of these complexes:

• high density lipoproteins- are responsible for the transfer of cholesterol from cells throughout the body to liver cells, they are also called “good” cholesterol;
• low density lipoproteins- often linger on the vascular walls, which leads to the appearance of cholesterol plaques on the vessels during atherosclerosis, which is why they are called “bad” cholesterol.

The most important indicator of a detailed lipid profile is the amount of low-density lipoproteins. Since they contribute to the development of atherosclerosis, another name for them is “atherogenic”. High-density lipoproteins, on the contrary, are called “anti-atherogenic”. The risk of developing atherosclerosis depends on the ratio of these two fractions.

There are few triglycerides in the blood; they mainly perform storage and energy functions and are deposited in adipose tissue. However, they are part of low-density lipoproteins and very low-density lipoproteins. Therefore, this indicator must be kept under control.

The atherogenicity coefficient is also one of the important indicators. It is determined solely by calculation and represents the ratio of different types of lipoproteins. Typically, the formula used to calculate it is: (TC-HDL)/HDL. The higher the number obtained, the higher the likelihood of vascular diseases.

When the analysis is normal

The following average values ​​can be considered as a normal lipid profile in adults:

• atherogenic coefficient - 2.2 - 3.5;
• TG level - up to 2.8 mmol/l;
• HDL level - not lower than 1.0 mmol/l;
• LDL level - up to 3.37 mmol/l;
• total cholesterol - up to 5.6 mmol/l.

These lipid profile values ​​reflect the norm for middle-aged men.

What pathology does it reveal?

Most often, in the case of pathology, interpretation of the lipid profile in adults reveals high levels of cholesterol in the blood - hypercholesterolemia. If cholesterol levels are elevated, this may indicate the presence of the following diseases and conditions:

• pregnancy;
• lung diseases;
• alcoholism;
• pancreatitis;
• excess weight;
• diabetes;
• hypothyroidism;
• rheumatoid arthritis;
• megaloblastic anemia;
• kidney diseases.

But most often hypercholesterolemia reflects the presence of atherosclerosis. Moreover, the cause of its occurrence is not only poor nutrition. Since 80% of cholesterol is produced by the body itself, most often it is endogenous disorders of lipid metabolism, inherited or acquired during life, that cause high levels of the substance in the blood.

What do triglycerides and lipoproteins indicate?

When the concentration of triglycerides in the blood is more than 2.3 mmol/l, this often reflects developing atherosclerosis. Values ​​from 1.8 to 2.2 mmol/l indicate that the body is fine. Triglyceride levels are also high during the development of diabetes mellitus. An increase or decrease in the level of these substances relative to the norm may also indicate:

• presence of lung diseases;
• viral hepatitis;
• errors in nutrition;
• coronary heart disease;
• obesity;
• hypertension.

If an analysis for HDL cholesterol reveals that the levels are lower than normal (below 1.0 mmol/l), this means that the person has atherosclerosis and, probably, coronary heart disease. An HDL lipid profile may also indicate symptoms of hyperthyroidism, a hereditary disorder of HDL metabolism (Tangier syndrome), hepatic encephalopathy (Reye's syndrome), anorexia, diabetes mellitus, kidney and liver disease, chronic anemia, and excess fat-containing foods.

Pathology can also be determined by testing for LDL cholesterol. This type of lipid profile helps to identify:

• ulcers;
• tuberculosis;
• heart attacks;
• infectious diseases in the acute stage;
• cirrhosis of the liver;
• kidney disease;
• intestinal tumors;
• alcoholism.

Why do you need an atherogenic coefficient?

If the obtained value is less than 3, therefore, the HDL content is high - the development of atherosclerosis is unlikely. If the coefficient falls in the range from 3 to 4, the occurrence of atherosclerosis and ischemic heart disease is predicted with high probability. If the coefficient is greater than 5, then the risk of developing diseases becomes critical.

The influence of gender and age on the result

The analysis values ​​will differ for people from different age groups, as well as depending on gender. Lipid profile norms in women and men can be compared using the data in the following table as an example.

Table - Reference interval depending on gender

Depending on age, the content of the main types of lipids in the body also changes. According to statistics, at the age of 30 years the total amount of cholesterol in women is 3.4-6.3, and after 50 years it reaches 4.0-7.2. After 60 years, the cholesterol level should be 3.5-7.1. The content of all lipoproteins changes in a similar way.

Thus, the lipid profile occupies one of the most important places in the diagnosis of general health. Using this analysis, the development of many diseases can be determined with great confidence. It is important to take into account the presence of many factors: the patient’s gender and age, weight and the presence of bad habits or special conditions. For example, the normal lipid profile in women during pregnancy increases very significantly. And for older people, the limits of normal values ​​will be very different from the expected values ​​for young people.