What do your cholesterol blood tests mean? LDL, Non-HDL, HDL, Triglycerides?
Let’s continue the journey of health empowerment through understand what it is us doctors actually do! Today I’ll go through your cholesterol or lipid profile. This is an incredibly important panel, which pays heavily into the way we understand your cardiovascular risks - i.e. the risk of having a heart attack or stroke.
When it comes to your cholesterol profile we’re looking at the following markers:
Lipoproteins
HDL
Non-HDL
LDL
There’s also VLDL and IDL
Triglycerides
Apolipoproteins (newer more high end markers)
First up I’ve made a video which explains the basic here.
What are lipoproteins?
Lipoproteins are complex molecules composed of proteins and lipids (fats) that transport fats throughout the body, serving as essential carriers for lipid metabolism. These molecules are crucial for maintaining proper lipid balance in the bloodstream and ensuring the efficient transport of lipids to various tissues and organs. Lipoproteins are classified based on their density, which is determined by the ratio of lipids to proteins.
There are several types of lipoproteins, including:
Chylomicrons: These are the largest and least dense lipoproteins. They are formed in the intestine and transport dietary fats, primarily triglycerides, from the intestines to other tissues.
Very low-density lipoproteins (VLDL): These lipoproteins are produced by the liver and contain a high proportion of triglycerides. VLDLs transport triglycerides to various tissues for energy or storage.
Intermediate-density lipoproteins (IDL): IDLs are formed from the metabolism of VLDLs and carry triglycerides and cholesterol.
Low-density lipoproteins (LDL): LDLs are often referred to as "bad cholesterol" because they primarily transport cholesterol to tissues, including arteries. High levels of LDL cholesterol are associated with an increased risk of cardiovascular diseases.
High-density lipoproteins (HDL): HDLs are often termed "good cholesterol" because they transport cholesterol from the tissues back to the liver for excretion, thus helping to prevent cholesterol buildup in the arteries.
Now, let's delve into the lipid panel blood test:
The lipid panel is a blood test that measures various types of lipids in the blood, including total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides. This test provides valuable information about an individual's lipid profile, which is essential for assessing cardiovascular health and the risk of heart disease.
And what about the blood test?
Here's what the lipid panel typically measures:
Total cholesterol: This is the sum of all cholesterol present in the blood, including both LDL and HDL cholesterol. It gives an overall picture of cholesterol levels but doesn't provide details about the distribution of cholesterol between the different lipoproteins.
LDL cholesterol: Often referred to as "bad cholesterol," LDL cholesterol is a major contributor to the build-p of plaque in the arteries, leading to atherosclerosis and increased risk of heart disease. It’s hard to measure LDL directly, so we tend to estimate it based on your other results. For that reason the Non-HDL level (below) is becoming more useful to look at.
HDL cholesterol: Known as "good cholesterol," HDL cholesterol helps remove cholesterol from the bloodstream and transport it back to the liver for excretion. Higher levels of HDL cholesterol are associated with a reduced risk of heart disease.
Non-HDL: This looks at everything that’s not HDL cholesterol and so includes your VLDL and IDLs too.
Triglycerides: Triglycerides are a type of fat found in the blood, primarily derived from dietary fats and stored in fat cells. Elevated triglyceride levels are associated with an increased risk of heart disease and other metabolic disorders.
By analysing the results of the lipid panel, healthcare providers can assess an individual's lipid profile and determine their risk of developing cardiovascular disease. Based on these results, lifestyle modifications, such as dietary changes, exercise, and medications, may be recommended to manage lipid levels and reduce the risk of heart disease. Regular monitoring of lipid levels through lipid panel tests is essential for maintaining cardiovascular health and preventing complications associated with dyslipidaemia.
And how can I improve my cholesterol levels?
Improving cholesterol levels often involves making lifestyle changes and, in some cases, may require medication prescribed by a healthcare professional. Here are some strategies to help improve cholesterol levels:
Healthy Diet:
Focus on a diet rich in fruits, vegetables, whole grains, and lean proteins.
Limit saturated fats and trans fats found in red meat, full-fat dairy products, and processed foods.
Choose healthier fats such as monounsaturated and polyunsaturated fats found in olive oil, avocados, nuts, and seeds.
Incorporate foods rich in omega-3 fatty acids, such as fatty fish (salmon, mackerel, sardines), flaxseeds, and walnuts.
Limit cholesterol-rich foods like egg yolks and shellfish, although for most people, dietary cholesterol has less impact on blood cholesterol levels than saturated and trans fats.
Regular Exercise:
Engage in aerobic exercises such as walking, jogging, swimming, or cycling for at least 150 minutes per week.
Include strength training exercises at least two days a week to improve muscle mass and metabolism.
Exercise helps increase HDL cholesterol (the "good" cholesterol) while lowering LDL cholesterol (the "bad" cholesterol) and triglycerides.
Maintain a Healthy Weight:
Losing excess weight, even a modest amount, can help improve cholesterol levels.
Aim for a healthy body mass index (BMI) between 18.5 and 24.9.
Quit Smoking:
Smoking lowers HDL cholesterol levels and damages blood vessels, increasing the risk of heart disease.
Quitting smoking can improve cholesterol levels and overall cardiovascular health.
Limit Alcohol Intake:
Limit alcohol consumption to moderate levels, which means up to one drink per day for women and up to two drinks per day for men.
Excessive alcohol intake can raise triglyceride levels and contribute to weight gain and liver damage.
Medication:
In some cases, lifestyle changes alone may not be sufficient to improve cholesterol levels.
Medications such as statins, fibrates, bile acid sequestrants, PCSK9 inhibitors, or cholesterol absorption inhibitors may be prescribed by a healthcare provider to help manage cholesterol levels.
Regular Monitoring:
Get regular check-ups and lipid panel tests as recommended by your healthcare provider to monitor cholesterol levels and assess your cardiovascular risk.
Work closely with your healthcare team to develop a personalized plan to improve and maintain healthy cholesterol levels.
By implementing these strategies and working with a healthcare provider, individuals can effectively manage their cholesterol levels and reduce their risk of developing cardiovascular disease.
Going a bit high end with apolipoproteins. We can now measure these.
Apolipoprotein blood tests measure the levels of specific proteins called apolipoproteins in the bloodstream. These proteins are associated with various lipoproteins, including LDL (low-density lipoprotein), HDL (high-density lipoprotein), and VLDL (very low-density lipoprotein). Apolipoproteins play essential roles in lipid metabolism and the transport of cholesterol and other fats throughout the body.
The two main types of apolipoproteins measured in blood tests are apolipoprotein A-I (apo A-I) and apolipoprotein B (apo B). Apo A-I is the primary protein component of HDL particles and is involved in reverse cholesterol transport, helping to remove cholesterol from tissues and transport it back to the liver for excretion. Higher levels of apo A-I are generally associated with a lower risk of cardiovascular disease.
On the other hand, apo B is found on LDL, VLDL, and chylomicron particles and plays a crucial role in delivering cholesterol to tissues. Elevated levels of apo B are associated with an increased risk of cardiovascular disease, as they indicate higher levels of atherogenic particles that contribute to plaque buildup in the arteries.
Apolipoprotein blood tests provide additional information beyond traditional lipid panel tests, offering insights into the composition and functionality of lipoproteins. They can help assess cardiovascular risk more accurately and guide treatment decisions, particularly in cases where standard lipid panel results may not fully reflect the individual's risk profile.
In summary, apolipoprotein blood tests measure the levels of specific proteins associated with lipoproteins and provide valuable information about cardiovascular risk beyond traditional lipid panel tests.