What does the coefficient of atherogenicity according to Klimov mean. What is the coefficient (index) of atherogenicity? Norms and calculation of the indicator. Video: What the tests say. Cholesterol

Every person at least once in his life passed a biochemical blood test for detection. In the form of the results of the analysis, various indicators of a particular substance found in the test material are indicated. Among them is the coefficient of atherogenicity (CA). What does it mean? And what are the consequences for health in case of its decrease or increase? Let's talk about it.

What does the coefficient of atherogenicity mean? This medical term refers to the ratio between high and low density lipoproteins. For a more understandable reflection of the essence of the analysis, a special coefficient is used.

It is determined by biochemical analysis of venous blood, which is usually taken on an empty stomach. To obtain more accurate results, 8 hours before the test, you must adhere to a diet - you can not drink or eat anything.

To determine the coefficient of atherogenicity, either the Ilk method or the Abel method is most often used. It is thanks to these methods that it is possible to determine the level of fat-like substances. The norms of KA in each laboratory are “their own”. They are necessarily indicated in the form of analysis results and depend on the equipment used and the method used to calculate the CA.

A laboratory study of blood makes it possible to determine the ratio of fatty acids in the test material after its precipitation. At the same time, the doctor, studying the results of the analysis, must necessarily take into account the following indicators:

• total blood cholesterol level;
• HDL;
• LDL;

All these substances are very important for the normal functioning of the body. But their increase or decrease can cause a blood clot to form on the inner walls of blood vessels. For example, an increased atherogenic coefficient in the blood indicates a high content of LDL in the test material, that is, low-density lipoproteins (bad cholesterol), which can lead to the development of thrombophlebitis or heart disease.

Triglycerides (TG) perform the function of transportation. If the coefficient of this indicator is increased, this indicates a high risk of developing atherosclerosis.

Fundamentals of the formation of the spacecraft

Together with food, fat enters the body, which, during digestion, is broken down into glycerol and fatty acids. This process occurs due to the synthesis of bilirubin and digestive enzymes.

After that, glycerin enters the bloodstream and begins to actively interact with cholesterol. As a result of this process, the formation of chylomicrons occurs, which penetrate the liver and are converted into bad and good cholesterol.

An increased content of LDL leads to the fact that fatty acids begin to accumulate in the body and form fat cells. HDL contribute to the destruction of these cells and the removal of their decay products.

In the human body, these substances must be in a certain balance. Its violation reflects the coefficient of atherogenicity. Identification of TG allows you to determine and on the basis of only its data, the diagnosis is not made. It is important to take into account the coefficient of atherogenicity of all indicators. If they deviate from the norm, the patient is sent for an additional examination.

HDL is a substance whose main function is to prevent the accumulation of lipids in cells. In order for fatty acids not to accumulate, they must be transported, while defatting the liver cells. And the higher the level of HDL in the blood, the lower the atherogenic coefficient.

Saturate body tissues with LDL fats. And the more of them are contained in the studied material, the higher the CA. With their excess in the blood, there is a high risk of developing diseases of the cardiovascular system, which can even cause death.

At the same time, there is no general value, what should be the coefficient of atherogenicity of HDL and LDL. It is calculated from the received data. Each person has a different total cholesterol level in the blood, for example, one has 6 mmol / l, and the other has 5 mmol / l. And these values ​​are normal. But at the same time, HDL and LDL can be different. For example, if a person's cholesterol is formed mainly from LDL, then this is no longer the norm, although the general indicators are without deviations.

It is most often observed in people who have a disturbed metabolic process or in those who neglect the rules of a healthy diet. Eating a large amount of fatty foods, which contain various oils, leads to an increase in LDL levels. Against this background, changes in lipid metabolism occur. It is this moment that determines the KA, that is, the difference between HDL and LDL.

In the absence of any disturbances in the body, CA should not exceed 2-2.5 units. In this case, HDL should be 2-3 times more than LDL. If the value of the latter exceeds 2-4 times, then this already indicates the deposition of fatty substances on the walls of the vessels.

With the development of atherosclerosis, this coefficient can reach 7 units. In this case, the patient needs to undergo an urgent course of medical treatment. Otherwise, after a while, quite serious disturbances in the functionality of the heart may occur.

What is the coefficient of atherogenicity in a biochemical blood test, we have already considered. Are there any ways to reduce it? The CA between HDL and LDL depends not only on the patient's overweight or nutrition. Other factors also influence this.

For example, during pregnancy in women, the atherogenic coefficient increases at the physiological level. This happens due to the fact that the fetus needs fats, which the body deposits.

An increase in CA can also be observed with long-term maintenance of strict diets that lead to resource depletion, as a result of which the liver begins to produce a lot of LDL to cover energy costs.

CA can also be increased while taking certain drugs that cause the body to start accumulating fat. Most often, its increase occurs as a result of long-term use of hormonal drugs. Elevated CA in this case is a concomitant condition.

In other words, if, according to the results of a biochemical blood test, you have a high coefficient of atherogenicity, you must first determine the exact cause of this condition and try to eliminate it. Tactics for the treatment of elevated CA is determined individually, depending on the underlying factor. Therefore, in this case, the only right decision will be to adhere to all the recommendations of the doctor.

Video about the atherogenic index

It is worth knowing that the coefficient or index of atherogenicity is the ratio between "good" and total cholesterol, which can later be converted into LDL - low density lipoproteins. Cholesterol (cholesterol), which is in the blood vessels, can be "bad" and "good". Both of these fractions are of great importance for metabolism and have different effects on human health.

What is the atherogenic index for?

All people's knowledge about cholesterol often ends with the fact that its elevated blood level is bad. And having learned from the results of the tests about its presence and not understanding these values, the patient independently begins to take drugs that reduce cholesterol, or follows a strict diet.

However, it is not enough just to see that the level of a given substance has increased, you must be able to read the results of tests that require compliance with certain rules. If you look at individual graphs, you will not be able to correctly understand and determine all the processes occurring in the human body. Therefore, in order to be able to determine the development of dangerous pathologies that are directly or indirectly affected by “bad” cholesterol, such a medical indicator as the atherogenic coefficient was introduced.

To understand what it means, you need to know that cholesterol is divided into "good" or HDL, as well as "bad" or LDL. The “good” cholesterol molecules are too large to be absorbed into the cells of the body, so they concentrate the bad fat molecules around them and then send them to the liver for processing. In turn, “bad” cholesterol is attached to the walls of blood vessels and, thanks to the plaques formed there, narrowing of the gaps occurs, which significantly impairs blood circulation. But, besides this, in the human blood there is also total cholesterol, which is endowed with an “unbound” state.

Also, the determination of the atherogenic index is necessary in the following cases:

• during the first examination of the patient;
• control of cholesterol dynamics, which is necessary during drug therapy;
• diagnosis of the development of pathologies of liver and thyroid cells.

Types of cholesterol and coefficient of atherogenicity

Most cholesterol (about 80%) is produced in the liver, the rest of it enters the body along with food. Cholesterol takes an active part in the synthesis of cell membranes, hormones and bile acids. Since it is almost insoluble in liquid, a special shell is formed around the cholesterol particles, consisting of proteins, which is necessary for the transport of cholesterol.

This shell-compound is called lipoproteins, while several of its varieties circulate in the blood vessels of people, which differ in the proportion of the components that make up:

1. LDL - low level of lipoproteins.
2. HDL - high level of lipoproteins.

HDL contains very little cholesterol, so it is almost entirely made up of protein. The main function of "good" cholesterol (HDL) is to transport its excess fractions to the liver for processing. HDL accounts for approximately 30% of total blood cholesterol. If the concentration of LDL exceeds HDL, this leads to the appearance of cholesterol plaques that accumulate in the vessels, gradually narrowing them and impairing blood circulation, which causes various diseases, such as stroke, heart attack, and so on.

In the medical calculation of the coefficient of atherogenicity, the following formula is used:

KO = (Total Cholesterol - HDL) / HDL

A normal and acceptable coefficient for a healthy person varies in different laboratories and ranges from 2-2.5 units. Moreover, this index should not exceed 3.2 for females and 3.5 for males.

An increased index indicates the development of certain diseases in the body, while if the atherogenic coefficient is lowered, this is not a cause for concern, since the risk of cholesterol plaques, and hence various diseases, is extremely small.

Therefore, if the question arises that the atherogenic coefficient is lowered what it is, then you need to remember that this fact is not diagnostically valuable and only indicates that the patient has an increased level of HDL in the body, which does not pose any danger to his health. Before embarking on medical therapy, doctors try to normalize the CA or lower it.

What to do with high odds

This can be achieved in the following ways:

• lifestyle and diet changes;
• taking special drugs.

In connection with the lifestyle, the coefficient increases for the following factors:

1. Bad habits, such as smoking, drugs and drinking alcohol, cause a violation of the synthesis of fat metabolism, and also greatly inhibit it.
2. A sedentary and inactive lifestyle causes stagnant processes, as a result of which fats are synthesized very actively.

To normalize the level of the coefficient, it is necessary to lead a healthy and active lifestyle, as well as give up bad and harmful habits.

A sharp increase in the atherogenic index in connection with the diet is caused by the use of products such as sausage, high-fat sour-milk products, spread and margarine, which are based on palm oil.

You need to reduce their consumption as much as possible by including the following foods in your diet:

• boiled fish;
• natural chocolate;
• green tea;
• fruits and vegetables, beets are useful;
• different types of nuts;

It will also be possible to reduce the indicators of the atherogenic index with the help of drug therapy (statins).

However, they have a large number of side effects, so they should be taken only on the recommendation of a specialist, only according to indications, in special cases.

What can affect blood test results

When determining the coefficient of atherogenicity, it is necessary to take into account factors that can significantly change the results of the analyzes.

These include the following factors:

1. Compliance with a strict and rigid diet, almost starvation. In order for the body to avoid exhaustion and take strength and energy, it has to be content with fat reserves, as a result of which lipoproteins penetrate into the vessels and can lead to an artificial increase in the index.
2. The use of hormonal drugs.
3. Smoking and alcohol abuse, as well as drug use.
4. Hormonal imbalance as a result of taking medications, pregnancy, menopause and menstruation.

Indicators of the coefficient of atherogenicity will be lowered in cases where:

• the patient is taking cholesterol-lowering medications;
• the patient follows a hypocholesterol diet;
• the patient is constantly involved in sports and performs physical activity (however, this has not been fully proven).

It turns out that CA is a kind of proportion of total cholesterol to high density lipoproteins.

I recently did a lipidogram in the laboratory, it turned out that my atherogenic coefficient is normal. However, in order to keep it that way, I think to stop eating sausage - as follows from the article, this product helps to increase CA.

My grandmother, who is already 85 years old, has a reduced atherogenic coefficient and is credited with treatment. It turns out that there is nothing dangerous in the reduced coefficient of atherogenicity, why then is treatment prescribed?

Atherogenic coefficient - what is it

Many have heard about the dangers of cholesterol and serious diseases associated with it.

Due to the lack of knowledge, some people go on strict diets, begin to clean the vessels with folk methods, or, even worse, take medications that can harm their health.

However, cholesterol is present naturally in the body and performs important functions. It differs in fractions, some of which are beneficial, others harmful. In order to distinguish between good and bad cholesterol, a biochemical blood test is performed, where the atherogenic coefficient (KA) is detected.

The term atherogenicity determines the ratio of cholesterol fractions, where “bad” prevails.

Thus, the calculation of the coefficient of atherogenicity allows you to determine the degree of risk of atherosclerosis.

Cholesterol is found in the blood in the form of complex compounds that are soluble. It is in conjunction with proteins, and such a compound is called lipoprotein (lipoprotein).

There are the following lipoproteins:

• high molecular weight HDL are characterized by high density;
• low molecular weight LDL have a low density;
• very low molecular weight VLDL compounds have a minimum density.

In order to determine the risk of vascular disease, it is desirable to calculate all groups of complex compounds (lipoproteins). For a doctor studying a lipid profile, indicators of total cholesterol, its fractions and triglyceride are important. The latter refers to fats and is a product of carboxylic acids and the trihydric alcohol glycerol.

How is the cholesterol coefficient of atherogenicity formed?

Approximately 80% of cholesterol is produced in the liver, gonads, adrenal glands, kidneys and intestines. The rest enters the body with food. Cholesterol interacts with apoliproteins (proteins), forming compounds of high and low density.

If cholesterol enters the body from the outside, then it is part of the chylomicrons, which are synthesized in the intestine. The compound is then released into the blood.

Low molecular weight lipoproteins are transported from the liver to tissues, high molecular weight - to the liver, and chylomicrons - to the liver and peripheral tissues.

HDL is produced by the liver. Chylomicrons, getting into the liver, are converted into LDL and HDL, depending on the apolyprotein with which cholesterol forms a compound.

Low density lipoproteins are called atherogenic. If they are produced in large quantities, then more fatty acids enter the cells. Fats are removed from cells by binding them to HDL. Once in the liver, cholesterol is finally hydrolyzed.

The atherogenic coefficient shows which lipoproteins are more present in the blood. If low molecular weight, then the likelihood of developing atherosclerosis increases.

The ratio of "good" and "bad" cholesterol

Blood cholesterol levels can vary. For one person, it will be 7 units, for another - 4. The total cholesterol (OH) does not give a complete picture of whether there is a risk of cholesterol deposits in the vessels or not.

For example, if in the first case a high cholesterol level is achieved due to increased HDL, then the likelihood of atherosclerosis is low. High-density lipoproteins are responsible for transporting fats from cells to the liver, where they are processed. If HDL is high, then they talk about anti-atherogenicity.

In the second case, LDL can be increased, and the level of macromolecular compounds is low. This situation characterizes high atherogenicity.

For the development of atherosclerosis, a strong excess of the level of low molecular weight compounds is not necessary. Low HDL levels can also cause pathological processes.

In order to correctly determine whether there are violations or not, the difference between these indicators is calculated. For example, with a ratio of 2 mmol / l, LDL is twice as high.

Indicators of the coefficient of atherogenicity:

• up to 3 - within the normal range;
• up to 4 - an increased indicator, which can be reduced with the help of diets and increased physical activity;
• above 4 - high risk of developing atherosclerosis, which requires treatment.

High levels of "bad" cholesterol are caused by an unbalanced diet. Eating a large amount of fatty foods disrupts lipid metabolism, which leads to an increase in the amount of low-density lipoprotein.

High-molecular compounds are synthesized only in the liver. They do not come with food, but polyunsaturated fats, which belong to the Omega-3 class and are present in fatty fish, can contribute to an increase in this fraction.

About the causes of atherosclerosis

The main reason for the development of atherosclerosis is considered to be an increased level of low molecular weight fractions of cholesterol in the blood. Cholesterol settles on the walls of blood vessels, and over time, deposits grow, narrowing the lumen and forming plaques.

In places where cholesterol accumulates, calcium salts are deposited, which cause pathological changes in blood vessels: loss of elasticity and dystrophy.

However, this is not the only cause of atherosclerotic vascular changes. The disease can develop against the background of viral infections, age-related changes, unhealthy lifestyle and a number of diseases. Therefore, we can talk about a group of people who are most susceptible to the development of pathology.

• heredity;
• age-related changes after 50 years;
• gender (in men, pathology occurs more often);
• increased body weight;
• low level of physical activity;
• diabetes;
• hypertonic disease;
• infections (cytomegalovirus, herpes, chlamydia);
• smoking.

With an atherogenic coefficient above 3 mol / l, cholesterol begins to linger on the walls of the vessels. If this indicator is higher, then the process goes faster.

As a result, cholesterol plaques are formed, which can collapse, turning into blood clots. In this case, a person is diagnosed with such a dangerous disease as thromboembolism, which can lead to sudden death.

Atherogenic index: the norm in women and the reasons for the increase in the atherogenic coefficient

Atherosclerosis of the vessels often affects men, therefore, the norms established for them are higher than for the fair sex. The atherogenic coefficient is lowered in women due to the action of the hormone estrogen.

The hormone has a positive effect on the walls of blood vessels, providing them with good elasticity, which protects against the formation of cholesterol deposits. Cholesterol settles on damaged areas of blood vessels.

If the vessels have become inelastic, then as a result of blood turbulence, multiple damage to the walls occurs, and cholesterol is fixed in these places. Due to the natural mechanism of vascular protection, women are less likely to be diagnosed with diseases such as strokes and heart attacks.

The coefficient of atherogenicity is reduced in women only up to 50 years. After the onset of menopause, the hormone ceases to protect the vessels and women become susceptible to the development of atherosclerosis in the same way as men.

The level of lipoproteins up to 50 years (mmol / l):

• total cholesterol - 3.6-5.2;
• high density lipoproteins - 0.86-2.28;
• low molecular weight compounds - 1.95-4.51.

The calculation of the atherogenic index is carried out according to the formula, where AI is determined by the difference between total cholesterol and high density plipoproteins, divided by the HDL index.

Atherogenic index in women: norm by age (mmol / l):

• up to the age of thirty - up to 2.2;
• after thirty - up to 3.2.

After the age of fifty, the atherogenic index in women is calculated according to the norm for men.

Reasons for the increase in performance in women

The first reason for the increase in CA in women is malnutrition. If the diet contains a lot of fatty foods: pork, butter, sour cream, etc., then this contributes to the accumulation of fats in the body. Cells do not need LDL in large quantities, so they constantly circulate in the blood in large quantities.

Another reason is related to the first. If fat is not consumed as a result of physical activity, then it accumulates in the cells and the level of low molecular weight lipoproteins in the blood also increases.

Smoking slows down the metabolism of fats, which also leads to an increase in blood cholesterol levels. It is noteworthy that alcohol enhances the process of lipid metabolism.

However, you should not use it for this purpose, since alcohol causes other dangerous diseases, and also interferes with the normal functioning of the liver, which is important for the synthesis of HDL.

The reason for the deviation of the atherogenic index from the norm in women may be heredity, which negatively affects lipid metabolism.

One way or another, an increase in CA is promoted by a violation of protein-fat metabolism. Therefore, when analyzing blood, such an indicator as the level of triglycerides is also taken into account.

• 1.78-2.2 - norm;
• 2.2-5.6 - elevated level;
• above 5.6 - high concentration.

On the Internet, women are interested in the question: what to do if the atherogenic coefficient is increased in the form of a blood test. Such an indicator of CA can occur for various reasons, so the approach to treatment should be individualized.

Depending on the value of the coefficient, cholesterol reduction can be achieved with a diet that excludes animal fats, sports or drug therapy aimed at reducing cholesterol synthesis.

In order to exclude the negative effect of cholesterol on blood vessels, concomitant diseases should be treated: cytomegalovirus or chlamydial infection, diabetes mellitus, hypertension. During menopause, women are prescribed estrogen replacement therapy.

Atherogenic coefficient: the norm in men and methods for lowering cholesterol in the blood

If women atherosclerosis of vessels affects after sixty years, then in men it develops earlier. The atherogenic index is increased due to the fact that the vessels lose their elasticity faster, and therefore, the risk of developing vascular pathologies is higher.

The level of lipoproteins in men (mmol / l):

• total cholesterol - 3.5-6.0;
• high density lipoproteins - 0.7-1.76;
• low molecular weight compounds - 2.21-4.81.

After years, normal values ​​​​may change, as the natural processes of protein-fat metabolism are disturbed.

Atherogenic coefficient: norm in men by age (mmol / l):

Reasons for the increase in indicators in men

The causes of an increase in CA, just like in women, are a violation of protein-fat metabolism. These include oversaturation of the body with animal fats, a sedentary lifestyle, stress, smoking and other factors that negatively affect the metabolism of fats.

In some cases, the coefficient of atherogenicity can be increased in the process of taking hormonal drugs. However, this occurs only for the duration of treatment, and after stopping the medication, the patient sees the atherogenic index as the norm on the test form.

In a biochemical blood test in men, the level of lipid energy reserve in the body is also revealed. The norms of triglycerides coincide with the standards established for women.

First of all, men should change their lifestyle: give up bad habits, increase physical activity and reduce the amount of animal fats consumed. Of course, you should not become a vegetarian if you are used to meat.

However, you should choose lean beef or fish and steam rather than fry. If you can’t seriously go in for sports, then regular walking will help. For example, you can walk to work instead of using public transport.

If the CA is exceeded significantly, the doctor prescribes conservative treatment, which consists in taking satins that reduce the synthesis of cholesterol in the body.

Atherogenic index: how to calculate and what to do to reduce it

To determine CA, blood is taken from the patient and a biochemical analysis of the material is performed. Blood is taken from a vein in the morning, as before taking the test, you can not eat for eight hours.

To determine the fractions of lipid compounds in the laboratory, precipitation and photometry methods are used. Then the calculation of the coefficient of atherogenicity is performed.

Having become acquainted with the concept of the atherogenic index, we will consider how to calculate it using different formulas below.

The basic formula for the atherogenic index, which is usually used in the processing of blood test data, looks like this: AI \u003d (Cholesterol - HDL) / HDL, where AI is the atherogenic index, cholesterol is total cholesterol, HDL is a high molecular weight compound.

In some cases, it is required to calculate the atherogenic coefficient index taking into account low and very low density lipoproteins. The latter are detected through an indicator of the concentration of triglycerides. VLDL = TG / 2.2. Thus, the general formula is as follows: AI \u003d (LDL + TG / 2.2) / HDL.

The atherogenic coefficient, the norm of which is exceeded, requires the establishment of the cause of such a condition. Not necessarily there is a violation of lipid metabolism, an increase in CA can be caused by pregnancy or other temporary hormonal disruptions. Therefore, you should not self-medicate, otherwise you can disrupt the natural mechanisms of the body.

In some diseases, treatment with hormonal drugs is prescribed, in which the norm of the atherogenic coefficient increases. The course of treatment is controlled by a doctor who determines the risks, and if another pathology is suspected, the therapy can be changed.

Diets contribute to the reduction of the atherogenic coefficient. However, this approach can also have a downside. For example, a severe restriction of a person in fats, on the contrary, provokes an increased production of lipids in the body. Therefore, catering without excess fat should be competent.

Foods to Avoid:

• sausage and other products containing animal fat;
• lard, fatty pork and lamb, butter, sour cream, egg yolks;
• trans fats, which are part of margarine, spreads and other similar products.

Products that need to be consumed to replenish the body with fats:

• sea ​​fish of fatty varieties;
• nuts, especially walnuts;
• vegetable oils: olive, linseed, sunflower.

A good addition to proper nutrition will be green tea and freshly squeezed juices from fruits and vegetables. Do not forget about clean water, which contributes to the natural cleansing of the body. It should be drunk at least 1.5 liters per day, not including other drinks.

If the atherogenic index is significantly increased, then the doctor prescribes drug therapy. Of the drugs, satins are used, which reduce the production of cholesterol, cation exchangers, which bind bile acids in the intestines, and drugs with omega-3 fats, which lower HDL levels.

An alternative to drug treatment is the procedure of mechanical blood purification, which is called extracorporeal hemocorrection. For this purpose, the patient's blood is taken from the vein, passed through special filters and injected back into the vein.

What forms a low coefficient of atherogenicity:

• taking blood tests in the supine position;
• diets that exclude animal fats;
• active sports or other physical activity;
• taking a number of drugs: medicines containing estrogens, colchicine, antifungal agents, clofibrate, satins.

A low atherogenic coefficient characterizes clean vessels and does not require any treatment. Such tests are often observed in young women, and this is considered the norm.

If, against the background of a decrease in total cholesterol levels, HDL decreases, then this cannot be called a good treatment. In this case, taking satins that reduce cholesterol production is considered ineffective and dangerous, since the body is deprived of an important component that regulates natural processes.

Remember that self-medication is dangerous for your health! Be sure to consult with your doctor! The information on the site is presented for informational purposes only and does not claim to be reference and medical accuracy, is not a guide to action.

naive look

for a serious life

It is not the cholesterol level itself that is harmful, but the atherogenic coefficient. There is also such an indicator of the ratio of harmful and beneficial cholesterol in the body - this is the coefficient of atherogenicity. The coefficient of atherogenicity is within the normal range if it is from 2 to 3 units.

Atherogenicity is a concept that reflects the ratio between bad and good fats. To identify this indicator, a special coefficient has been introduced. The coefficient of atherogenicity is determined on the basis of a biochemical analysis of blood, which is taken in the morning from a vein on an empty stomach. The obtained norms differ in each laboratory, but the level of atherogenicity is not distorted.

For example, high atherogenicity is determined by the presence of the LDL fraction. The HDL fraction is anti-atherogenic. It should be understood that the greater their concentration, the lower the atherogenicity. The higher their concentration in the blood, the higher the atherogenic coefficient. It should be understood that there are no generalized values ​​for assessing atherogenicity. If cholesterol is formed exclusively due to LDL with a low content of HDL - a high coefficient of atherogenicity.

Despite the presence of the above provoking factors, the mechanism of atherogenicity has not been finally elucidated to date. The coefficient of atherogenicity has become an indicator for prescribing anticholesterol drugs by doctors if it exceeds normal values.

Otherwise, the coefficient of difference between different types of cholesterol can “go wild” against the background of other pathological changes. Any average person knows that high blood cholesterol is “bad”.

The atherogenic coefficient is the balance of "good" cholesterol and total cholesterol, which in the future can go into a bound state (LDL), is their proportional ratio. The norm of the atherogenic index varies from laboratory to laboratory; in general, this indicator is normal in the range from 3 to 3.5 (sometimes referred to as 4.5) units.

However, the coefficient alone does not allow us to accurately state the presence of the disease. If the atherogenic index is below the specified norm, this is not a cause for concern. If the results of laboratory studies revealed a high coefficient, this indicates that the body produces mainly “bad” cholesterol. Taking medications is another way to reduce the atherogenic index.

Thus, the index (or coefficient) of atherogenicity is the proportion of total cholesterol to high density lipoprotein complex. Cholesterol in women and men in medicine is usually distinguished into bad and good.

Atherogenic coefficient - what is it? What is the norm?

Remember, the normal level of cholesterol in the blood is the health of your blood vessels. I have a total of 7.0 (clearly large), HDL = 2.6, so the coefficient is 1.69, that is, below normal and normal.

If the coefficient of atherogenicity is increased (more than 3-4 units), this indicates a relatively high risk of developing atherosclerosis. Its lowest value is observed in newborns (as a rule, they have an atherogenic coefficient of 1), and over the years it constantly increases.

It is known that with the accumulation of "harmful" lipids in the body, the tendency to deposition of fatty plaques in the walls of blood vessels increases - atherosclerosis. To make it clear to readers what's what in the mechanisms of fat metabolism, we suggest considering the topic in more detail.

If you look at the form of a biochemical blood test, next to the effective value, it contains wide limits of the norm, which allow you to unify the method separately for each laboratory. Lipidogram reflects the level of various fractions of lipids (fatty acids) in the blood serum after precipitation. Each of these compounds performs its function and affects the formation of cholesterol plaques in the vessel wall.

Triglycerides are a transport form. As a result, with an increase in their values ​​in the blood, we can talk about a high risk of atherosclerosis. When fatty acids are ingested with food, they are broken down in the gastrointestinal tract with the help of enzymes and bilirubin.

Further, glycerol in the blood interacts with cholesterol. Low density lipoproteins are atherogenic, since the more they are produced in the body, the higher the concentration of fatty acids delivers into the cells. The remnants of fats after their conversion in the cell are removed by binding to high density lipoproteins. Transport form - triglycerides are an indirect indicator that reflects the total level of fat in the body.

Good" cholesterol (HDL) is a fraction that prevents the accumulation of lipids in the cell. In order for fats not to concentrate, they must be transported and detoxified in the liver. This task is assigned to high density lipoproteins.

The norm of cholesterol in the blood in women

High-density lipoproteins bring fats into tissues. They found that excessive deposition of fatty acids in the vascular wall is combined with its damage and subsequent accumulation of calcium in the plaque.

At the first stage, the wall of the vessel is affected, and cholesterol deposits accumulate in the cells (coefficient greater than 2.5). Then a fibrous plaque is formed that clogs the lumen of the vessel. Finally, in the advanced stage, the plaque can break away from the primary location and cause thromboembolism. The complex molecules of good cholesterol are too large to be absorbed into the tissues, they "collect" the molecules of "bad" fatty alcohol and forward them to the liver for processing.

Thus, the coefficient of the difference in atherogenicity between the content of LDL and HDL reflects the likelihood of atherosclerosis. To calculate the atherogenic coefficient, you first need to determine the total cholesterol level and the level of high-density lipoprotein (HDL).

Atherogenic coefficient (KA): what is it, the norm in the blood, why is it increased, how to lower it

In the form of a biochemical blood test, after the list of all cholesterols, there is such an indicator as the atherogenic coefficient (KA). It is clear that its values ​​are calculated, and this is done quite quickly, using a special formula, however, the entire lipid spectrum, which is the basis of these calculations, is classified as a rather laborious analysis.

In order to obtain adequate CA values, it is desirable to know the concentrations of all cholesterol (total, high and low density) and triglycerides, although the most “running” calculation formula includes only indicators of total cholesterol and high density lipoproteins.

atherogenicity

Atherogenicity is the correlation between harmful and beneficial cholesterol in human blood, which forms the basis for calculating a special indicator called the atherogenic coefficient or index.

• The norm of the coefficient of atherogenicity ranges from 2 to 3 (conventional units or without any units, since this is still a coefficient);
• Fluctuations of CA within 3-4 already indicate that not everything is fine in the body, however, the probability of vascular damage remains moderate and with the help of a diet it is still possible to correct the situation;
• Scores above 4 indicate a high risk of developing atherosclerosis and coronary heart disease, so such people already need a diet, periodic monitoring of lipid parameters, and possibly prescription of drugs that reduce the level of harmful lipids in the blood.

The coefficient of atherogenicity in men is somewhat higher than in women, but normally it should still not exceed 3 conventional units. True, after 50 years, when a woman is left without hormonal protection, gender has less and less effect on the atherogenic index, and the risk of atherosclerotic process formation under certain circumstances becomes high in both cases. By the way, after 50 years, people of both sexes should pay maximum attention to the values ​​of the lipid spectrum and CA, since metabolic processes are inhibited, and the body begins to gradually lose the ability to cope with food and other loads in the same mode.

It is known that such an indicator as total cholesterol in a biochemical blood test provides insufficient information to judge the state of lipid metabolism. Here it is very important to know the ratio of atherogenic (bad, bad) cholesterol - low and very low density lipoproteins (LDL, VLDL), and anti-atherogenic (useful, protective) high density lipoproteins (HDL).

Penetrating into the blood as a result of fat metabolism, all fractions are sent to the intima of the blood vessels, however, LDL carries cholesterol with it to leave it there for metabolism and accumulation, and HDL, on the contrary, is constantly trying to take it out. It is clear: what cholesterol will be more - he will win.

The accumulation in the body of bad (atherogenic) fats that we consume with food leads to the fact that they begin to be deposited on the walls of blood vessels, affecting them. These deposits, known as atherosclerotic plaques, give rise to the development of such a pathological process as atherosclerosis. Atherosclerosis, depending on the location of the lesion, forms other diseases of the cardiovascular system, which are currently often the cause of human death. In general, everyone is well informed about atherosclerosis, plaques, cholesterol, but the last indicator of the lipid spectrum (atherogenicity coefficient) remains a mystery for many people.

Meanwhile, it is precisely one figure (KA) that can tell whether the atherosclerotic process is underway and how high the degree of its progression is, whether it is worth actively fighting bad cholesterol, up to taking special drugs called statins, or you can continue to allow yourself your favorite diet, ignore active lifestyle and nothing to worry about.

Great analysis and simple calculation

In order to calculate the coefficient of atherogenicity, it is necessary to perform several biochemical laboratory tests, namely: to determine the concentration of total cholesterol and the level of high-density lipoprotein (anti-atherogenic). However, in most cases, for people who have problems or suspicions of them, it is advisable to study fat metabolism on a larger scale, that is, to actually analyze the lipid spectrum:

• Total cholesterol, which includes high, low and very low density lipoproteins (therefore, when calculating HDL KA, we subtract - to leave LDL + VLDL);
• High density lipoproteins (HDL), which have protective properties against the formation of atherosclerotic plaques;
• Low density lipoproteins (LDL), which form cholesterol plaques on the walls of blood vessels;
• Triacylglycerides (TG) are esters of higher fatty acids that are formed in the liver and released into the blood as part of very low density lipoproteins (VLDL). A high concentration of TG in the blood makes the analysis difficult.

The atherogenic index is calculated by the formula:

This expression can be replaced by another relation:

In the latter case, in order to calculate the atherogenic coefficient, in addition to HDL, it becomes necessary to precipitate low-density lipoproteins and calculate very-low-density lipoproteins through the concentration of triglycerides (ChClonp = TG (mmol / l) / 2.2). In addition, in some laboratories, doctors use other formulas when the above-mentioned lipoproteins are involved in the calculations. For example, the calculation of the coefficient of atherogenicity can be represented as follows:

It is obvious that fluctuations in CA and the transition beyond the limits of the norm are affected by the concentration of lipid spectrum parameters, mainly total cholesterol, which includes low and very low density lipoproteins, too, and anti-atherogenic HDL.

When the index is raised

An increased coefficient of atherogenicity (above 4) already indicates that atherosclerotic plaques begin to be deposited on the walls of blood vessels (and what to do with LDL and VLDL, which are constantly present in high concentrations?). At the same time, it should be noted that with a significant progression of the atherosclerotic process, this index can be so high that it is several times higher than the number 4, which we took as a guideline.

Meanwhile, many people are wondering why one can do everything (and at the same time the low atherogenicity of blood plasma is maintained), and the other - continuous restrictions. Here, too, everything is individual. A high level of total cholesterol due to low-density lipoproteins (along with the influence of nutrition) is typical for people with other pathologies or lifestyles that contribute to its formation:

1. Burdened heredity in relation to cardiovascular pathology, the development of which is based on the atherosclerotic process;
2. Constant psycho-emotional stress;
3. Excessive body weight;
4. Bad habits (smoking, alcohol, drugs and other psychotropic substances);
5. Endocrine diseases (diabetes mellitus - in the first place);
6. Wrong lifestyle (sedentary work and lack of desire to do physical education in your free time).

It should be noted that in other cases, this indicator is not increased due to a violation of lipid metabolism in the patient. Doctors go for a deliberate increase in the level of the atherogenic index by prescribing individual hormonal drugs. However, as you know, the lesser of two evils is chosen ... Moreover, if you follow all the recommendations, this will not last long, and the KA will not exceed the values ​​\u200b\u200ballowable in such situations.

The cholesterol coefficient of atherogenicity can be increased if a blood test is done at the time of conditions that are significantly dependent on hormones (pregnancy, menstruation).

Oddly enough (for those who are going to starve), but “quick” diets for the purpose of losing weight will only increase the indicator, because, without getting the right food from the outside, the body will actively begin to use its own fat reserves, which, getting into the bloodstream, will certainly affect results of a blood test, if performed at that time.

Low atherogenicity

No one is fighting this phenomenon, because there is no concern about the development of atherosclerosis, and there is no talk of other diseases in such cases. Meanwhile, the coefficient of atherogenicity is sometimes less than the above figures (2 - 3), although in healthy young women it often fluctuates between 1.7 - 1.9. And this is considered the absolute norm. Moreover - a very good result, which can be envied: clean elastic vessels without any plaques and other signs of damage. But, as mentioned above, in women after 50 years, everything can change - estrogens decrease and cease to protect the female body.

Also, a low atherogenic index can be expected in the following cases:

• A long-term diet that provides for a targeted reduction in cholesterol (foods low in “bad” fats);
• Treatment with statin drugs for hypercholesterolemia;
• Active sports, which, however, causes conflicting opinions of experts.

The atherogenic index is one of the main criteria that determine the effectiveness of lipid-lowering therapy. KA helps the doctor to monitor the course of treatment and choose the right drugs, because the goal of statins is not only to lower total cholesterol and calm down. These drugs are designed to increase the concentration of a useful, anti-atherogenic fraction - high-density lipoproteins, which will protect the vascular walls. The decrease in HDL during treatment with statins suggests that the treatment is not chosen correctly, and continuing it not only makes no sense, but is also harmful, because in this way it is also possible to accelerate the development of atherosclerosis. Probably, the reader has already guessed that reducing the atherogenic coefficient with statin drugs on their own initiative can bring irreparable harm, so doctors strongly do not recommend experimenting in this way. The patient himself can reduce the concentration of bad cholesterol and reduce the values ​​of KA, but these will be completely different measures.

How to help your vessels?

First of all, a patient who has taken a course to reduce cholesterol containing low and very low density lipoproteins should radically change their lifestyle, diet and give up addictions.

If physical activity is limited due to another disease, you need to visit a doctor and develop an individual plan of feasible physical exercises. But do not forget: movement is life!

In the absence of contraindications, especially lazy people who are not used to leaving a cozy apartment can organize physical education at home for 30-40 minutes every other day. Well, the "fast on the rise" on weekends can go for walks, ride a bike, play tennis, swim in the pool. It is both useful and pleasant, and there is always time if you wish.

As for the diet, it is not at all necessary to join the ranks of vegetarians. Being by nature a "predator", a person needs animal products that contain amino acids that are not synthesized by the human body. It is simply desirable to give preference to low-fat varieties of meat and fish, and heat treatment should be carried out by steam or boil (do not fry!). It is good to add various teas to the diet that lower cholesterol levels (green tea, infusions and decoctions of medicinal herbs).

And finally: if a person wants to get an adequate result of his lipid spectrum and CA, then he should come to the blood test not only on an empty stomach, but fast for hours the day before - then there will be no unnecessary excitement, and the study will not need to be repeated.

Atherosclerosis is a disease, the dangerous consequences of which have been discussed recently. It has been established that people suffering from atherosclerosis have an increased atherogenic coefficient (CA). They are 6-8 times more likely to see a doctor with symptoms of coronary heart disease and 4 times more likely to be hospitalized with suspected myocardial infarction or stroke. The pathogenetic mechanism of the development of the disease consists in impaired fat metabolism and the formation of so-called “cholesterol plaques” on the inner surface of the vessels, which significantly narrow the lumen of the vessels, disrupt the blood supply to all organs and can increase the risk of acute diseases of the heart and brain.

It is possible to assess the risk of developing cardiovascular complications of atherosclerosis in each individual patient by determining the coefficient (index) of atherogenicity. A high atherogenic coefficient is a reason to start treatment aimed at lowering blood cholesterol levels.

Atherogenic coefficient - a key indicator of the lipid profile

The coefficient of atherogenicity is an integral formula for the ratio of high and low density lipoproteins, reflecting the degree of development of atherosclerosis.

All lipids in the body either come from food or are synthesized in the liver. Since fats are hydrophobic in nature, they cannot circulate freely in the blood. For their movement, special carrier proteins, apoproteins, are required. The chemical combination of lipids and proteins is called lipoprotein.

According to the molecular structure, fats can have different densities. Therefore, all fats circulating in the blood are divided into low density lipoproteins (LDL) and very low density lipoproteins (VLDL). LDL and VLDL are considered "bad" fats. In excess, they settle on the walls of the arteries, strengthened by connective tissue, calcifications and form atherosclerotic (cholesterol) plaques. Such plaques significantly narrow the lumen of blood vessels, disrupting the blood supply to organs and tissues. The heart and brain are especially affected, constantly needing large amounts of oxygen and nutrients. High-density lipoproteins, on the contrary, are called "useful" lipids, as they carry fat into the cells of the body and, consequently, reduce its concentration in the blood, and cleanse the vessels of fresh lipid deposits.

The atherogenic coefficient is an indicator of the ratio of "useful" and "harmful" fats. It is determined after receiving the results of a biochemical blood test for lipids and is calculated by the formula:

KA = (total cholesterol - HDL) / HDL

KA = ( + VLDL) / HDL(the formula requires an extended lipidogram with the study of not only high-density lipoproteins, but also low-density lipoproteins).

Its rate depends on the equipment of a particular laboratory, but on average it is 2-3. If the level of HDL is insufficient, it will be elevated. In some cases, it can reach 7-8 and requires serious therapeutic measures. rare in medical practice.

What does a high atherogenic index mean?

An increased level of atherogenicity coefficient is an unfavorable sign. Since this is an integral value, it can fluctuate throughout life and be different even in patients with the same cholesterol level. For example, the index of cholesterol in the blood of both visitors to the clinic is 5.5 mmol / l. In one of them, it is represented mainly by high-density lipoproteins, therefore, the atherogenic index will be within the normal range, and the risk of developing atherosclerosis will be low. On the contrary, with the predominance of LDL over HDL, even with a normal cholesterol level, the coefficient will be increased, and the patient will be recommended treatment aimed at lowering it.

If the atherogenic index is elevated at high values ​​of total cholesterol, this means that the patient has most likely already developed atherosclerosis, and the risk of developing cardiovascular complications is extremely high.

Thus, the atherogenic index can be called a prognostic indicator: it assesses the risk of complications of atherosclerosis (acute myocardial infarction, stroke) in a patient with high cholesterol. High cholesterol is not always a symptom of atherosclerosis. If it is formed mainly due to HDL, the risk of vascular disease is small. More dangerous is the predominance of LDL in the structure of fats present in the body. If the atherogenic index is elevated, it is necessary to contact your doctor to draw up a plan of treatment and preventive measures.

Reasons for increasing the coefficient

An increased atherogenic index often goes unnoticed by the patient. The main risk factor is a lifestyle that is formed in childhood, and a person follows it throughout his life. Therefore, when detecting elevated lipid parameters in the patient's blood, it is recommended to check his family members.

Causes of increased atherogenic coefficient:

1. Wrong eating habits. Of course, fats are an important and necessary substance for a person that performs many functions in the body (for example, cholesterol is a building material for cell membranes and adrenal hormones, LDL is a transport form of fats that delivers them from the small intestine for further biochemical transformations to the liver, HDL - lipoprotein, which transports fats from the liver to cells throughout the body). Therefore, it is possible and even necessary to include fats in your daily diet. But not all fats are created equal. The reason for the increased coefficient of atherogenicity is the excessive consumption of animal fats contained in fatty meat, lard, bacon, offal (kidneys, brains), sausages, butter, fat milk and dairy products, egg yolk.
2. Arterial hypertension can also increase the coefficient of atherogenicity. According to statistics, high blood pressure is a problem for 35-40% of people in developed countries over 45 years old. Pressure more than 140/90 mm Hg. Art. provokes increased vascular tone, which negatively affects the blood supply to organs and tissues. The fact is that the arteries are designed for a certain pressure: their short-term narrowing is possible during sports or stressful situations, such a load “mobilizes” the internal reserves of the body, redistributing the blood flow. In arterial hypertension, constantly increased vascular tone contributes to their damage, and low-density lipoprotein molecules quickly settle on microtraumas.
3. Smoking can also increase the atherogenic coefficient. Regular inhalation of tobacco smoke leads to a decrease in blood oxygen saturation and permanent microdamage to blood vessels. Lipids, together with platelets, quickly fill these lesions, and an atherosclerotic (cholesterol) plaque is formed.
4. Alcohol abuse leads to a pathological redistribution of vascular pressure. Peripheral (superficial) arteries expand, and visceral arteries that feed the heart, brain and other internal organs narrow. Thus, the blood supply to organs and systems is disturbed, microdamages are formed in the constricted vessels, and cholesterol plaques are formed.
5. Another reason for the increased rate is type II diabetes. This metabolic disease is characterized by an excess of glucose (sugar) in the blood. Its molecules damage the delicate inner wall of the arteries, and a large number of cholesterol plaques form. In addition, in diabetes, not only carbohydrate, but also fat metabolism is disturbed: patients with this disease are prone to obesity even when dieting. An excess of lipids in the body with diabetes can also lead to an increased coefficient.
6. Obesity is another reason that can increase the atherogenic coefficient. There are several factors leading to obesity, the most common are alimentary (regular consumption of high-calorie, fat-rich foods) and endocrine (various violations of the hormonal regulation of vital processes). With obesity, the level of lipids in the blood increases, the risk of an increased indicator and the development of atherosclerosis increases.
7. Family history. Doctors note that most often the coefficient of atherogenicity is increased in people whose close blood relatives suffered from atherosclerosis, cardiovascular diseases and suffered one or more heart attacks or strokes. Therefore, all persons with a burdened family history are recommended to undergo regular examinations and take tests for cholesterol and lipid profile.
8. A sedentary lifestyle relatively recently began to be attributed to factors that can increase the coefficient of atherogenicity. It has been proven that people who lead an active lifestyle are less likely to experience an increased level of atherogenicity.

All these causes affect the body for a long time, so an increase in the atherogenic coefficient is more common in people over 40 years of age. However, in the last decade, an increased atherogenic index has also been found in adolescents aged 13-15, so the study of the lipid profile is becoming increasingly popular.

What is the danger of increasing the coefficient?

For years, an increased level of atherogenicity is asymptomatic, so many people get the impression that this condition is not dangerous and does not require treatment. It is for this misconception that atherosclerosis has received the name "gentle killer", since the danger of cholesterol plaques and a high coefficient of atherogenicity lies in serious complications that can lead to death.

Complications of an increased coefficient of atherogenicity.

Acute myocardial infarction. The heart muscle is the most enduring in the body. She does a colossal job of pumping a huge amount of blood throughout a person's life. Therefore, the blood supply to the tissues of the heart must occur without delay. Oxygenated blood flows to the heart through the coronary arteries.

With an increased coefficient of atherogenicity, there is a high risk of formation of cholesterol plaques on the inner surface of all vessels of the body, including coronary ones. Even a slight narrowing of the lumen of the arteries that feed the heart leads to serious disturbances in its blood supply. They are manifested by pulling, burning pains behind the sternum, aggravated by physical exertion. If the lumen of the coronary arteries is literally “clogged” with fatty deposits, sooner or later such a serious disease as myocardial infarction may occur.

Myocardial infarction is the death of the heart muscle, which occurs suddenly and is characterized by severe, unbearable pain behind the sternum, perspiration, cold sticky sweat. If the area of ​​necrosis (tissue death) is significant, then the heart cannot cope with its work, heart failure and death may develop.

Recovery of patients after myocardial infarction is long and difficult. Such patients require lifelong follow-up by a cardiologist and regular rehabilitation.

Stroke or acute cerebrovascular accident. The brain is another organ that needs a regular supply of oxygen, glucose, and nutrients. Insufficient blood supply to the nervous tissue in atherosclerosis can lead to such an acute condition as a stroke - the death of a section of brain tissue with the development of neurological symptoms - paralysis, loss of consciousness, swallowing and breathing disorders, up to coma and death.

How to reduce the coefficient of atherogenicity: principles of treatment

If an elevated HDL level is observed in blood tests, the atherogenic coefficient is also likely to be higher than normal. Therefore, the main goal of treatment with a high atherogenic index is to reduce the concentration of "harmful" lipoproteins and total cholesterol in the blood by increasing the "useful" HDL.

The atherogenic coefficient can be reduced by the following general measures:

1. Diet. Reducing high cholesterol is a long process. The first step is always non-drug treatment and, in particular, diet. Therapists recommend limiting or completely eliminating cholesterol-rich foods from the diet - fatty pork and lamb meat, lard, bacon, sausages and sausages, heavy cream and other dairy products, egg yolk. All these substances are a source of a large amount of cholesterol and are undesirable with a high coefficient of atherogenicity. On the contrary, include in the diet foods rich in healthy unsaturated fatty acids and HDL. These include: vegetable oils (doctors recommend making vegetable salads daily, dressing them with sunflower or olive oil), red fish, nuts.
2. Lifestyle change. To reduce the rate, you need to stop smoking and drinking alcohol. It is recommended to take daily walks in the fresh air, do light exercises, engage in sports agreed with the doctor (swimming, trekking, walking, equestrian sports, etc.).
3. Treatment of concomitant diseases. Regular intake of antihypertensive (lowering blood pressure) drugs for arterial hypertension: target pressure values ​​in hypertensive patients should remain at the level of 130-140/80 mm Hg. Art. and below. Also, patients with diabetes mellitus, who have an increased atherogenic index, are shown to follow a diet not only with the restriction of animal fats, but also easily digestible carbohydrates and sugar. Often, the desired blood glucose concentration is achieved by taking hypoglycemic drugs.
4. Reducing excess body weight in obesity. Nutritionist consultation.
5. If possible, eliminate or minimize stressful situations at work and at home.

Drug treatment of an increased level of the coefficient of atherogenicity is to reduce the concentration of low-density lipoproteins and total cholesterol in the blood, to eliminate pathogenetic risk factors for the development of atherosclerotic plaque. Drugs that reduce the coefficient of atherogenicity include:

• Statins (Atorvostatin, Rosuvostatin, Simvastatin) are the most effective drugs that can reduce the atherogenic coefficient. They reduce the synthesis of cholesterol in the liver by 30%, reduce the concentration of low density lipoproteins and increase - high. According to statistics, regular use of statins for 5 years or more reduces the risk of developing cardiovascular complications of atherosclerosis by 40%.
• (Ciprofibrate, Fenofibrate) is another group of drugs for reducing total cholesterol and atherogenic coefficient. Like statins, fibrates lower LDL and increase HDL.
• Bile acid sequestrants (Cholestyramine) are agents that bind fatty acids in the intestines and prevent their absorption into the blood. Previously used as drugs for weight loss. Often prescribed in addition to statins and fibrates to enhance their effect.

A decrease in this indicator usually occurs as part of the complex therapy of atherosclerosis. As a rule, such patients are already registered with a therapist and are observed for coronary heart disease or dyscirculatory encephalopathy (). They may complain of frequent nagging, aching chest pains, shortness of breath, exercise intolerance, headaches, memory loss. Usually in the analyzes of such patients there is a significant increase in total cholesterol and significant dyslipidemia.

Often, lipid metabolism disorders become an accidental finding during a standard examination of a patient during emergency hospitalization for myocardial infarction or stroke. These serious complications can develop suddenly and cause serious harm to health.

Therefore, it is important to pay attention to the increase in the coefficient of atherogenicity at the very beginning of the disease, when the effects of lipid metabolism disorders are slightly expressed. Even absolutely healthy people who do not have any complaints are recommended to be tested for cholesterol and lipoproteins once every 3-5 years. Careful attention to your health and regular preventive examinations will help maintain health and longevity.

Atherosclerosis is one of the most widespread chronic diseases among the adult population with a progressive course. With it, there is a violation of fat, carbohydrate, protein metabolism, which leads to the accumulation of cholesterol and unsaturated fatty acids in the body.

They are deposited in the walls of the arteries of the elastic and muscular-elastic type, causing a local inflammatory reaction in their lumen with the formation of atherosclerotic plaques that narrow the lumen of the vessels. Depending on the location of the lesion, the following pathologies can develop:

• IHD, myocardial infarction, sudden coronary death;
• transient ischemic attacks, strokes;
• intestinal infarction;
• violation of the trophism of the limbs up to gangrene.

When contacting a cardiologist with suspicion of vascular pathologies, a biochemical blood test and a lipid profile with the calculation of the atherogenic coefficient will be prescribed.

Atherogenicity is the ability of certain substances to cause the development of atherosclerotic changes in the body, due to pathological changes in the functioning of the metabolic system.

To assess the risk of developing atherosclerotic lesions of the heart and blood vessels, most laboratories use the term atherogenic coefficient (CA). This indicator allows you to assess the state of fat metabolism based on the determination of the ratio of different fractions of lipoproteins.

What affects performance?

There are several groups of factors that can cause changes in AI. If it is elevated, most people think that this confirms the presence of the disease. It is not always so. A high CA indicates the need for further examination and correction of fat metabolism indicators. Among non-modifiable factors, an important role is played by a genetic predisposition to elevated cholesterol levels.

Modifiable factors include bad habits (smoking, excessive consumption of carbonated and alcoholic beverages), a passive lifestyle, physical inactivity. Malnutrition with excessive consumption of sugar, animal fats, their artificial substitutes leads to obesity and also significantly increases the likelihood of developing cardiovascular pathology. Constant stressful situations, neuropsychic stresses have a negative impact.

A physiological increase in IA is observed in pregnant women and during the postpartum period (42 days from the date of birth). Certain groups of medicines have a negative effect on cholesterol levels:

• glucocorticosteroids (Prednisolone, Dexamethasone, Betamethasone);
• beta-blockers (Bisoprolol, Metoprolol);
• antiarrhythmic drugs (Amiodarone);
• combined oral contraceptives with estradiol and progestins;
• diuretics (Furosemide, Hydrochlorothiazide, Torasemide);
• anabolics (testosterone);
• cyclosporins.

This indicator may be below normal with increased sports, a low-fat diet and the use of acetylsalicylic acid, estrogens, thyroxine, certain antibiotics (Erythromycin, Neomycin) and antifungal agents (Ketoconazole). This proves the absence of signs of vascular damage.

The norm of the atherogenic index in a blood test, calculation

In the case of obtaining the results of a lipid profile in which this coefficient has not been calculated, you can do it yourself, knowing how to calculate it. To do this, you need to know the level of total cholesterol and its main fractions (LDL, HDL). The most commonly used formula is:

LDL / HDL = AI.

Sometimes the LDL field is left blank on the form. Its value can be found by subtracting the number of high-density lipoproteins from total cholesterol.

There are significant differences in the interpretation of the results of men and women of different ages. However, for all patients over the age of 45 with signs of ischemic coronary artery disease or impaired cerebral circulation, exceeding 3.0 is unacceptable.

A high risk of vascular and heart pathology is indicated by a level of 3.1-4.9. An indicator >5 needs medical correction and indicates the progression of atherosclerotic lesions in the body. Also, some laboratories set their average norms, but this fluctuation is no more than +/-0.1.

In men

Males are more prone to diseases of the vascular system and the development of atherosclerosis. This is due to the fact that cholesterol is used for the synthesis of the male sex hormone testosterone. After 40-45 years, the need for the hormone decreases, cholesterol remains unused.

The indicators should be:

1. In young men under the age of 30, the normal value of the atherogenic level should not exceed 2.5.
2. At the age of up to 40 years, in the absence of coronary artery disease, hypertension, diabetes, values ​​fluctuate from 2 to 4.8.
3. In men aged 40-60 years, the norm is 3.0-3.5.

Among women

The main hormone of the female reproductive system - estradiol, has a protective effect on blood vessels, ensures their tone and elasticity, helps maintain normal levels of HDL, CL. Given this, in healthy women of childbearing age, the CA does not exceed the bar of 2.2.

Upon reaching the age of premenopause and menopause, the concentrations of sex hormones gradually decrease, which leads to an increase in total cholesterol with an unchanged level of high density lipoproteins. As a result, the norm in women of mature age (45-65 years) is considered to be 2.4-3.2.

Reasons for the high ratio

The discrepancy between the results of the analysis and the average indicators does not always indicate the development of the disease, so it is worth finding out the reasons why the atherogenic index can be increased:

Reasons for the low ratio

Among the main reasons, when the atherogenic coefficient is lowered (corresponds to a value of less than 2), the most common is hard physical labor or increased sports. Also, the level of CL will be lower in people who follow a diet with a reduced content of animal and transgenic fats.

In addition, when determining CA, it is imperative to take into account which drugs a person uses. The ability to reduce atherogenic indicators is possessed by:

• hormones (estradiol, progesterone);
• non-steroidal anti-inflammatory drugs (acetylsalicylic acid);
• antimycotic drugs (ketoconazole);
• antibiotics (erythromycin, neomycin).

Despite the fact that this is not a pathology and indicates a good condition of the vessels, a low cardiovascular risk, patients are advised to retake the lipid profile after a few weeks.

What to do if the coefficient is not normal

In case of deviations of analyzes from the norm, patients are recommended to normalize their lifestyle:

1. One of the most important points is the proper organization of the regime of work and rest. It should include a full eight-hour night's sleep and moderate exercise.
2. The diet should include foods containing unsaturated fatty acids: nuts, fish, flax seeds, olive and sesame oils, avocados. Foods rich in fiber block the absorption of cholesterol in the intestines, so bran, whole grain bread, cereals, raw fruits and vegetables are indispensable when following a diet. Dark bitter chocolate and green tea have a stimulating effect on metabolic processes.

It has long been known about the ability of garlic to significantly lower the level of CL and LDL. Allicin contained in its composition is able to inhibit the synthesis of cholesterol in the liver. Garlic can be used raw as an addition to salads and meat dishes, as well as to prepare a special infusion.

To do this, 300 g of peeled cloves are passed through a meat grinder or rubbed on a grater, pour 500 ml of vodka. Insist in a dark cool place for several days, then strain. Store the finished infusion in the refrigerator, consume 1 tablespoon three times a day after meals. In the pharmacy you can buy tablets with garlic extract, they are drunk 1-2 pieces 2 times a day.

With a significant increase in the atherogenic index and the ineffectiveness of the diet, drug therapy may be necessary. In modern medicine, the following groups of drugs are used for this purpose:

Vascular health directly depends on lifestyle and diet. Following a simple diet, engaging in moderate physical activity, you can significantly improve your well-being, appearance and avoid long and expensive drug treatment.

The index (coefficient) of atherogenicity is a value that characterizes the likelihood of a person developing atherosclerosis. This indicator is determined when passing a general biochemical blood test or in the course of a more highly specialized study - a lipid profile. The index is indispensable for the early detection of lipid imbalance in the blood, as well as for evaluating the effectiveness of atherosclerosis therapy.

The atherogenic index is a characteristic of the ratio between "bad" and "good" cholesterol, or rather lipoproteins - compounds that ensure the delivery of cholesterol to the tissues of organs and systems. Unlike total cholesterol, the index gives more information about fat metabolism.

This is due to the fact that cholesterol (natural fatty alcohol) in the body is present in the composition of 2 types of compounds:

• increase in total cholesterol;
• the growth of "bad" lipoprotein compounds (LDL and VLDL);
• reduction of "good" cholesterol (HDL).

The atherogenic index is an assessment of all 3 processes, expressed in one figure.

The coefficient makes it possible to immediately answer such questions:

• whether there is a tendency to atherosclerotic processes;
• how fast the diagnosed atherosclerosis progresses;
• whether dietary or lifestyle changes are required;
• whether there is a need to prescribe drugs to lower cholesterol.

It should be noted that although an increase in blood cholesterol is considered the main condition for the development of atherosclerosis, the disease can also be diagnosed in people with normal value on the background:

• obesity;
• bad habits;
• metabolic disorders;
• high pressure.

How to calculate the atherogenic index

Formally, to calculate the atherogenic coefficient, it is necessary to know only two values ​​- total cholesterol and "good" cholesterol (HDL). However, since the study is prescribed for people who already have symptoms or suspected diseases, blood chemistry or lipid profile (a highly specialized analysis for assessment of fat metabolism) include an assessment of the concentration of:

To calculate the coefficient (depending on the laboratory and indications), the following ratios are used:

• Ka (atherogenic coefficient)\u003d (Ktot - Kvp) / Kvp. According to this formula, the calculation can be made knowing only 2 parameters;
• Ka \u003d (Klnp + Klonp) / Kvp. This formula is more illustrative, it shows that the atherogenic index is the ratio of "bad" cholesterol to "good";
• Ka \u003d (Klnp + TG / 2) / Kvp. This calculation is similar to the previous one, however, it involves the determination of very low density lipoproteins through triglycerides.

Norms for men and women

The atherogenic index is an indicator whose normal values ​​depend on gender and age.

The norms are presented in the table:

Age, years	Norma Ka (men)	Norma Ka (women)
20–30	less than 2.5	less than 2.2
30–39	2,1–4,9	1,9–4,4
40-60 (in the absence of coronary heart disease)	3,0–3,5	less than 3.2
40–60 (if coronary heart disease is present)	3,5–4,0	3,5–4,0

Values ​​exceeding 3.2, but not reaching 4, are appropriately called marginal. This result of the calculation suggests that atherosclerotic changes can occur soon, provoking thrombosis and ischemic disorders (therefore, in ischemia, such values ​​are considered acceptable).

Reasons for increasing the coefficient of atherogenicity

An increase in the atherogenic index to 4 or more (with rapidly progressive atherosclerosis, the index often increases several times) indicates that cholesterol is deposited and accumulates inside the vascular highways.

The reason for the process is a large concentration of "bad" lipoproteins, which do not wash cholesterol out of the vessels, but leave it there.

Despite the fact that only 20–30% of cholesterol enters the body with food (the main volume is synthesized by the liver, kidneys, adrenal glands, intestines), nutrition should be mentioned among the factors that increase the atherogenic coefficient.

Among the negative features of the diet should be noted:

• binge eating;
• abundant consumption of trans fats and "fast" carbohydrates (flour and confectionery, fast food, chips, popcorn);
• dietary deficiency:

1. fiber;
2. polyunsaturated fatty acids (omega-3-6-9);
3. vitamins (E and group B);
4. trace elements and minerals (calcium, magnesium, iodine).

• insufficient intake of lipotropic substances into the body, contributing to the normalization of lipid metabolism and protection of the liver from fatty damage. The deficiency of lipotropes can be replenished by adding to the menu:

1. beef;
2. chicken eggs;
3. lean fish and cottage cheese;
4. soy flour.

The following diseases and lifestyle features contribute to the increase in the concentration of low molecular weight lipoproteins:

Atherosclerotic changes (and therefore high Ka) are more often diagnosed in men - this is due to the peculiarities of lifestyle (alcohol abuse, smoking) and hormonal levels. Women are in the "risk group" after 50 years - during menopause, when the production of female hormones that protect blood vessels decreases.

The main danger of atherosclerosis is that cholesterol deposits in the vessels disrupt blood circulation in vital organs, causing myocardial infarction (acute circulatory disorder of the heart muscle) or stroke (acute circulatory disorder of the brain).

In addition, cholesterol deposits can lead to the following dangerous conditions:

• atherosclerosis of the aorta;
• vascular aneurysms;
• atherosclerotic narrowing of the abdominal aorta;
• impaired blood supply to the kidneys, up to organ infarction;
• severe form of high blood pressure, accompanied by renal failure;
• ischemic attacks - conditions similar to a stroke, but lasting no more than a day;
• damage to the vessels of the extremities.

Violation of the blood supply to the brain, even without provoking acute conditions, can lead to:

At the same time, even minor atherosclerotic changes in the vessels affect the process of blood supply to any organ, worsening its functioning.

Reduction methods

The atherogenic index is an indicator of fat metabolism in the body, the balance between the production / intake of "bad" and "good" lipoproteins with food. Changing this ratio is a rather lengthy process, involving a complex measures, including:

• making lifestyle changes. Among the general recommendations here will be: quitting smoking and excessive alcohol consumption, normalizing the regime of work and rest, reducing the stress load on the body;
• providing the necessary level of physical activity. In the absence of diseases, you can train 4 times a week for 30-40 minutes - aerobic exercises, running, various areas of training that improve blood circulation and heart function are appropriate. If there are chronic disorders, the doctor may recommend gentle exercise. Even ordinary walking or cycling, swimming can bring tangible benefits;
• elimination of a disease that provokes disorders of fat metabolism- This applies to diseases of the liver and endocrine system. Without preliminary elimination of such violations, the adjustment of the atherogenic index is meaningless.

Nutrition with high cholesterol plays a special role. Not only the composition of the diet is important, but also the basic principles, among them:

type of product	Allowed	Forbidden
Fatty meals	Olive, sunflower, linseed oil - no more than 2 tbsp. l. in a day	Palm and coconut oil, lard, margarine
Meat dishes	chicken; turkey; rabbit meat; skinless veal.	pork; duck; fatty semi-finished products; sausage; sausages.
Seafood	Boiled or steam fish - no more than 2-3 times a week	Fried fish and canned fish
broths	Broths on lean meats or vegetables	"Heavy" meat broths
Eggs and dairy products	egg white; skimmed milk; yoghurts and low-fat cheeses.	whole milk; ice cream; sour cream; cream; butter; condensed milk; high fat cheeses.
Porridge and flour	unsweetened cereals on the water; durum wheat pasta; whole grain bread; cookies with oatmeal.	Sweet pastries
Vegetables and fruits	Any fresh and frozen fruits and vegetables, dried fruits and legumes	Fruits in sugar or syrup, chips, fried potatoes
desserts	fruit ice; baked fruits; sweeteners;	cakes; candies; chocolate; halva; marmalade; cocoa.
Beverages	mineral water; juices; green tea; weak black tea or coffee; wine is limited.	strong coffee; carbonated sweet drinks; alcoholic products.
Sauces	natural spices; pepper; vinegar; mustard; lemon juice; ketchup without sugar and preservatives.	Various sauces, especially mayonnaise.

Medications are prescribed if the increase in the atherogenic index is significant, or if the previously listed measures to change lifestyle and nutrition are ineffective (within 6 months).

In addition, medication is required if you have:

Among the types of medicines used:

• statins- drugs that inhibit the enzymes involved in the production of cholesterol in the body. Statins improve the quality of vascular walls damaged by small deposits and normalize blood viscosity. The latest generation drugs - Atorvastatin, Cerivastatin, Pitavastiatin not only reduce the level of "bad" cholesterol, but also increase the level of "good";
• fibrates- reduce the concentration of fats in the blood plasma, reduce thrombosis, improve the quality of the vascular walls. The drugs are successfully combined with statins. Among modern drugs: Bezafibrate, Ciprofibrate, Fenofibrate;
• sequestrants bile acids- reduce the absorption of cholesterol in the intestines and increase the excretion of bile from the body. They have more side effects, so they are often used in combination. Among the international names of drugs are Cholestyramine, Colestipol, Kolekstran;
• cholesterol absorption inhibitors in the intestines- drugs selectively block the absorption of cholesterol (Ezitimib, Ezeterol). Medicines do not affect the secretion of bile acids and do not change the production of cholesterol in the liver. The disadvantage of drugs is the high cost;
• nicotinic acid (niacin or vitamin B3)- reduces the rate of atherosclerotic processes, is able to dissolve small plaques, and also reduces blood sugar levels. Nicotinic acid is rarely used as an independent drug in the treatment of severe atherosclerosis.

Drugs, especially in combination, have different sets of side effects, so only a doctor can prescribe treatment.

The goal of the therapy is not just to reduce total cholesterol, but to change the ratio of "bad" and "good" lipoproteins. Therefore, constant monitoring of the level of atherogenicity is necessary - if “good” cholesterol begins to fall, therapy must be reviewed.

During treatment, laboratory parameters are also monitored, which may indicate the presence of side effects (monitoring of liver function).

There are methods of mechanical blood purification (extracorporeal hemocorrection). Among them, it should be noted cryoapheresis (exposure to high temperatures on blood plasma) and cascade plasma filtration(a high-tech method of removing selectively “bad” cholesterol and a number of harmful substances from the blood).

The technique is indicated when excess cholesterol is combined with:

• prolonged or severe angina pectoris;
• myocardial infarction (in subacute course);
• atherosclerosis of cerebral vessels;
• plaques in the vessels of the lower extremities;
• temporary disorders of the blood circulation of the brain (transient attacks);
• recovery period after ischemic stroke.

The procedure improves the condition of the walls and vascular tone, quickly corrects the fat balance in the blood.

Reasons for lowering the atherogenic index

A reduced value of the atherogenic index is not a violation - it does not indicate any diseases. In young women, against the background of normal estrogen levels and general health, the index can be 1.7-1.8.

In addition, the cause of a small amount of atherogenic lipoproteins in the blood can be:

• maintaining a diet with a small amount of "bad" cholesterol for a significant period of time;
• nutrition, suggesting a minimum content of animal fats;
• taking drugs to lower cholesterol;
• taking antifungal drugs;
• frequent and intense physical activity.

For a healthy person, low atherogenicity does not pose any threat, moreover, it indicates a good condition of the vessels. However, it is important to pay attention to other indicators of the lipid profile - whether high, low and very low density lipoproteins are normal separately.

If atherogenicity is underestimated against the background of abnormally low concentrations of "bad" cholesterol, this may indicate:

Enhancement Methods

If the problem is poor nutrition, then you can increase cholesterol and its compounds to normal by eating more animal fats. One of the leaders in cholesterol content are egg yolks.

If there is a suspicion of a systemic disease that caused a violation of fat metabolism, further diagnosis and correction is necessary.

How to prepare for the analysis to determine the level of AI?

The atherogenic index is an indicator for the determination of which venous blood sampling is required.

To ensure maximum accuracy of the study, the following preparation algorithm will help:

The study is not carried out after serious illnesses, surgical interventions, myocardial infarction - in such situations, the analysis is postponed for at least 6 weeks.

How the analysis is done

Blood is taken from a vein (the patient must take a sitting position), as a rule, in the morning. The result can be obtained (depending on the laboratory and the scope of the study) in 1-3 days.

The atherogenic index often does not appear as a separate study, however, the calculation of this indicator is included in the screening or extended profile of the study of lipid metabolism.

What factors can affect the result of the analysis?

Deviation in the results of the study may be caused by a violation of the preparation procedure, lifestyle features, or the use of certain medications.

The atherogenic index may be higher than normal (including in a healthy person) in such cases:

• blood sampling in a standing position;
• observance before delivery of a “hungry” (assuming low calorie content) or, on the contrary, diet rich in animal fats;
• taking anabolic or steroid drugs;
• estrogen therapy - if a woman taking hormonal medications has a sharp increase in Ka, it makes sense to visit a gynecologist to assess the appropriateness of replacement drugs;
• hormonal surges - menstruation, pregnancy.

Inadequately low coefficient of atherogenicity can be in the conditions:

The atherogenic index allows one figure to characterize lipid metabolism in the body. This is a calculated indicator that makes it possible to timely identify the risk of arteriosclerosis and correct an undesirable trend - often it is enough to make changes in lifestyle and eating habits.

If drugs are prescribed to lower cholesterol, the calculation of atherogenicity will help assess the safety and effectiveness of therapy.

Article formatting: Vladimir the Great

Video about the atherogenic index

About good and bad cholesterol: