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How to read your medical test report: Lipid profile

How to read your medical test report: Lipid profile

All you need to know about reading your lipid profile test report.

Written by Dr Anitha Anchan |Updated : April 6, 2016 6:50 PM IST

Cholesterol is a fat/lipid. It is produced by the liver and is required at a certain level in the blood for the proper functioning of the body. Normal levels of cholesterol help the blood to flow freely through the blood vessels. Increased levels cause the cholesterol to be deposited on the walls of arteries (plaque). This results in conditions like high blood pressure (hypertension), chest pain (angina), heart attacks, strokes, etc.

Particles called lipoproteins carry cholesterol through the blood. There are three types of lipoproteins: low-density lipoprotein (LDL), high-density lipoprotein (HDL) and triglycerides. LDL is the bad cholesterol . It is the primary reason for the buildup of plaque on the arterial walls. HDL is often called good cholesterol . It helps get rid of excess cholesterol. Cholesterol and triglycerides form blood fat.

Lipid profile what is it?

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It is a simple blood test that can tell you about your cholesterol levels. It measures the levels of cholesterol (VLDL, LDL and HDL) and triglycerides in your blood. Your lipid profile shows if you re at risk for coronary heart disease (CHD). You may need to fast for 9 to 12 hours before the test.

When is the test recommended?

The test is recommended when the risk for coronary heart disease (CHD) needs to be assessed. A borderline or high-risk inference helps make decisions about the management required. The test may also be advised to monitor the efficacy of treatment. If there are no risk factors present, then the test may be performed every five years. In the presence of risk factors, the test is advised at regular intervals.

Reading yourlipid profile

Lipid levels within the desirable range help to keep your heart healthy and also lower the risk of heart attack or stroke. Borderline or slightly above values are no cause for alarm. At times, they could be due to genetic predisposition. But you need to be watchful. There are various causes of high cholesterol. Altering your diet, exercising regularly and keeping you weight in check can help lower your cholesterol levels.

1. Low-density lipoprotein (LDL)

LDL is often called the bad cholesterol. It tends to deposit blood cholesterol on the walls of the arteries. High blood LDL levels cause the formation of clots (plaques) in the blood vessels and cause narrowing of the vessels. This narrowing increases the risk of high BP, chest pain, heart attacks, strokes and peripheral vascular diseases. Studies have linked too low level of LDL (<50 mg %), to conditions such as depression, cancer, anxiety, impulsivity and aggression.

LDL values and inference: < 100 mg/dL is optimal

100-129 mg/dL is above optimal

130-160 mg/dL is borderline high

> 160 mg/dL is high

A high saturated fat and cholesterol diet, being overweight and lack of exercise raises LDL. Metabolic syndrome and stress levels have also been shown to elevate LDL levels. Changes in your diet and exercising regularly help drop cholesterol levels. Stay away from foods that increase your cholesterol level. Consume foods that bring down cholesterol levels. Cholesterol-lowering statin medication may be prescribed when cholesterol levels do not drop by diet modification and exercise. Statins reduce the amount of LDL cholesterol your body makes. The drug ezetimibe helps lower cholesterol level by blocking the absorption of cholesterol from food and bile juices.

2. High-density lipoprotein (HDL)

30% of the cholesterol in a healthy individual should be HDL, the good cholesterol . It reduces the level of bad cholesterol (LDL) by transporting it back to the liver where it is recycled. Some scientists have hypothesized that HDL cholesterol may contain both protective and non-protective components. HDL cholesterol with a certain small protein on the surface may elevate heart disease risk whereas HDL cholesterol without the protein may particularly be heart protective. According to researchers, high levels of HDL and low levels of LDL could mean lower chances of Alzheimer s disease. The readings are correlated with lower amyloid plaque deposition in the brain which is a hallmark of Alzheimer s disease.

HDL values and inference: < 40 mg/dL in men and < 50 mg/dL in women is a major risk factor for heart disease. HDL value of 60 mg/dL and above is considered protective against heart disease.

You should boost your HDL level as it is considered protective against heart disease. Smoking may lower HDL by as much as 15 %. You can increase your good cholesterol by eating right, exercising regularly, maintaining a healthy weight and quitting smoking. There are some foods which increase your HDL levels.

3. Triglycerides

Your body stores excess ingested fat in the form of triglycerides. These fat stores are used as per the body s requirement for energy between meals. Triglycerides combine with cholesterol to form a compound called plasma lipids. These plasma lipids get deposited in your blood vessels. Hypertriglyceridemia, or high levels of triglycerides, is a risk factor for coronary artery disease, hypertension and other heart diseases. It is often caused or worsened by uncontrolled diabetes and obesity. A triglyceride level above 1,000 mg/dL can cause a serious inflammation of the pancreas (acute pancreatitis).

Triglyceride values and inference: < 150 mg/dL is normal

150-199 mg/dL is borderline high

200-499 mg/dL is high

> 500 mg/dL is very high

High level of triglycerides in blood arises out of unhealthy lifestyle like consumption of foods rich in starch and carbohydrate, alcohol intake, etc. Obesity, decreased thyroid hormone (hypothyroidism), diabetes and kidney disease contribute too. High triglyceride level with low HDL level is seen in metabolic syndrome. An Ohio State University study has discovered that stress slows the body s metabolism of triglycerides, allowing the fat to remain in the blood longer. You need modify your lifestyle to reduce your triglyceride levels naturally. Statins, fibrates or niacin may be prescribed to lower the triglycerides level.

4. Very low-density lipoprotein (VLDL)

VLDL has the highest quantity of triglycerides. VLDL cannot be measured directly. Hence, it is mostly estimated based on your triglycerides level. It is approximately 20% or about one fifth of your triglycerides level. Lowering your triglycerides level can help reduce your VLDL level.

5. Total Cholesterol

Your total cholesterol is HDL + LDL + VLDL (one fifth of your triglyceride level). The lower your cholesterol, the better is it for your heart. High cholesterol level may be due to genetic predisposition or due to a high saturated fat diet. Most often, high total cholesterol level is due to high bad (LDL) cholesterol. Rarely, it could be due to high good (HDL) cholesterol in which case high total cholesterol isn t harmful. Some natural remedies can help lower cholesterol levels.

Total cholesterol values and inferences: < 200mg/dL in adults and <170 mg/dL in children is desirable

200-240mg/dL in adults and 170-200mg/dL in children is borderline high

> 240mg/dL in adults and >200mg/dL in children is high

Total cholesterol/HDL ratio: 3.0 is desirable

5.0 is borderline

6.0 is high risk

Total cholesterol falls significantly immediately following a heart attack1. According to a study, LDL cholesterol level lesser than 62.5 mg/dL and triglycerides level lesser than 110 mg/dL after a heart attack significantly elevated the risk of death2. There may be a normal rise in cholesterol levels during pregnancy. Corticosteroids and certain birth control pills can raise cholesterol levels. Anabolic steroids often lower HDL levels.

References

1. Barth JH, Jackson BM, Farrin AJ, Efthymiou M, Worthy G, Copeland J, Bailey KM, Romaine SP, Balmforth AJ, McCormack T, Whitehead A, Flather MD, Nixon J, Hall AS; SPACE ROCKET Trial Group. Change in serum lipids after acute coronary syndromes: secondary analysis of SPACE ROCKET study data and a comparative literature review. Clin Chem. 2010 Oct;56(10):1592-8. doi: 10.1373/clinchem.2010.145631. Epub 2010 Aug 20. Review. PubMed PMID: 20729301.

2. Cheng KH, Chu CS, Lin TH, Lee KT, Sheu SH, Lai WT. Lipid paradox in acute myocardial infarction-the association with 30-day in-hospital mortality. Crit Care Med. 2015 Jun;43(6):1255-64. doi: 10.1097/CCM.0000000000000946. PubMed PMID: 25738856.

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