High cholesterol liver problems. Medications that lower cholesterol. Where is cholesterol stored?
An increase in cholesterol levels is regarded as a risk factor for the development of atherosclerosis, the formation of stones in gallbladder, the occurrence of various disorders in the work of the heart and other diseases. Unhealthy diet, metabolic disorders and other factors contribute to the increase in cholesterol levels.
What is cholesterol for?
In the human body, cholesterol is found in the liver, spinal cord and brain, adrenal glands, sex glands, and adipose tissue. It is part of the membranes of almost all cells. 90% of cholesterol is found in tissues and 10% in the blood. More than 8% of the dense substance of the brain consists of cholesterol.
The higher the blood value, the better. First of all, says nutritionist Meg Angela Möcksbauer, the amount of dietary cholesterol you eat has little effect on your blood cholesterol levels. healthy people because elevated cholesterol levels are usually genetically determined. However, many studies have shown that a balanced low-calorie diet has a positive effect on cholesterol levels. "It is important to give Special attention those dietary fats that are hidden in food and food products”, explains Möcksbauer.
Most cholesterol is produced by the body itself, much less comes from food. Approximately 80% of this substance is synthesized in the liver, the rest is produced in the wall of the small intestine and some other organs.
Without cholesterol, normal life is impossible important organs and our body systems. It is part of cell membranes, providing their strength and regulating their permeability, as well as influencing the activity of membrane enzymes. (The membrane is surface structure cell, consisting of several molecular layers. It serves, on the one hand, as a barrier between the contents of the cell and the external environment, and on the other hand, as a semi-permeable partition through which water molecules and some of the substances dissolved in it can pass.)
And what is positive for our cholesterol levels? “Various factors that favorably influence cholesterol levels: a combination exercise, healthy eating and normal weight body,” Möcksbauer says. Good and bad cholesterol. Although our liver produces cholesterol itself, we also consume it in a small percentage of our diet.
Previously, foods containing cholesterol were on the forbidden list for a balanced diet. "More importantly, however, cholesterol levels are the fats we eat every day," Möcksbauer says, adding that saturated fatty acids can raise "bad" cholesterol levels and thereby negatively affect cholesterol levels. They are especially present in animal products such as cheese, meat, butter and sausage. But also important role play the so-called trans-fatty acids, which occur during the industrial hardening of fats.
Cholesterol is involved in metabolic (exchange) processes, the production of bile acids and various steroid hormones, including sex hormones. With its direct participation in the body, vitamin D is synthesized, which plays a key role in the metabolism of calcium and phosphorus, adrenal hormones (cortisol, cortisone, aldosterone), female sex hormones (estrogens and progesterone), and the male sex hormone testosterone. Therefore, for example, long-term adherence to cholesterol-free diets often leads to sexual dysfunction in both men and women.
Excessive consumption of trans fats can negatively affect cholesterol levels. Transfats are found, for example, in chips, donuts, potato chips or nougat creams. Studies show that trans fats are significantly worse for their health than saturated fatty acids, while simple and polyunsaturated fatty acids are good and healthy. In general, the less animal fats you eat, the less cholesterol and saturated fats you consume.
cholesterol-containing diet. Although general diet plays only a minor role in cholesterol levels, people with only elevated cholesterol levels can regain control of their cholesterol-conscious diets. Consuming cholesterol consciously does not mean that you should now follow a strict diet. The most important rules are: do not consume more calories than the body consumes, and, as far as possible, replace animal fats with plants. Physical activity may also help minimize other risks of heart disease, such as overweight, diabetes, or high blood pressure, so the American Heart Association recommends that you get at least 30 minutes of exercise daily.
According to the latest scientific data, cholesterol directly affects the intellectual abilities of a person, as it takes part in the formation of new synapses by brain neurons, which provide the reactive properties of the nervous tissue.
"Good" and "bad" cholesterol
AT recent times an increase in the level of cholesterol in the body is regarded as a direct risk factor for the development of atherosclerosis, obesity and many other diseases. Indeed, between the prevalence cardiovascular diseases and the concentration of cholesterol in the blood serum there is a certain relationship. The higher the level of serum cholesterol in the blood of patients, the more often they have violations in work. cardiovascular systems s. What is it connected with?
Do you also count among the people who have a guilty conscience at every breakfast? Not necessarily, because eggs dangerously raise cholesterol levels - this is one of those myths that is as strong as spinach and muscles. The breakfast egg has been clouded as a cholesterol bomb for years. Although eggs contain a lot of cholesterol. However, studies have shown that chicken eggs have little effect on cholesterol levels - apparently, intestinal cells form a kind of impenetrable filter.
Some people even respond to eggs with lower cholesterol levels. There is no evidence that more frequent consumption of eggs negatively affects blood cholesterol levels and heart health. They are very well tolerated in children, but also in the elderly. In addition, eggs are healthy because they contain many valuable nutrients With low content fat and low in calories.
Cholesterol is insoluble in water and in blood plasma. The transfer of this substance circulatory system in various tissues of the body is carried out with the help of compounds that are highly soluble in water with complexes of proteins and fats - lipoproteins.
Some lipoproteins are able to penetrate the walls of blood vessels, transferring cholesterol there, and form so-called cholesterol plaques. Others not only are not atherogenic, that is, factors leading to the development of atherosclerosis, but, on the contrary, protect vessels from atherosclerotic changes. Let us consider in more detail the compounds with cholesterol, some of which doctors consider useful, while others are harmful.
Despite cholesterol's bad reputation, it's essential for survival. Cholesterol is a lipid produced by the body for the absorption of food. Cholesterol and dietary cholesterol are often confused. Blood cholesterol refers to the amount of cholesterol in the blood.
How is cholesterol made?
Most of your cholesterol is produced by the body, but some of them eat high-cholesterol foods that are found in animal products. About 80% of the cholesterol in the body is produced inside the body from nutrients in your body, in the synthesis of membranes such as the liver, central nervous system and reproductive organs. The liver is the main source of cholesterol production. The liver creates lipoprotein and circulates through the blood to be deposited in body tissues and blood plasma.
Lipoproteins differ in density, as well as solubility and tendency to precipitate cholesterol crystals, which form atherosclerotic plaques in the walls of blood vessels, increasing the risk of heart attacks and strokes, especially in older people.
The main characteristic of lipoproteins is density. According to this indicator, they are divided into the following groups:
very low density lipoproteins (VLDL, or VLDL): diameter - 21-70 mmkm, contain more than 45% cholesterol;
low density lipoproteins (LDL, or LDL): diameter - 19 mmkm, contain 40-45% cholesterol;
lipoproteins high density(HDL, or HDL): diameter - 8-10 mmkm, contain 20% cholesterol.
Good cholesterol vs bad cholesterol
The other 20 percent of the cholesterol in the body comes from the foods you eat, such as the fats in dairy products and any type of meat. Use a large number foods containing saturated fats can cause the liver to produce more cholesterol than the body needs, which can put you at risk for cardiovascular disease or coronary heart disease. High level blood cholesterol is associated with poor diet, smoking, inactivity and hereditary factors.
High-density lipoprotein cholesterol is often referred to as "good" cholesterol. High molecular weight lipoproteins are highly soluble in water and are able to remove cholesterol from vascular wall thus preventing the development of atherosclerosis. Lipoproteins of low and very low density, large and loose, tend to precipitate cholesterol crystals. They are the ones who develop various diseases blood vessels and heart, so the cholesterol of such lipoproteins is called "bad" cholesterol.
You have almost certainly heard many times that high cholesterol is bad for your health. There are many problems and diseases that can occur due to excessive cholesterol levels, such as arteriosclerosis, ischemic disease heart disease, angina, or stroke.
The most common cause of hypercholesterolemia is to eat a diet rich in saturated fat or cholesterol, but there are people who suffer from this problem, leading to seemingly healthy life. Let's see what can cause more reasons in blood.
However, the names "good" and "bad" cholesterol or "good" and "bad" lipoproteins are rather conditional: firstly, as a substance, cholesterol is the same everywhere, and secondly, our body needs both those and other lipoproteins.
Low and very low density lipoproteins transport cholesterol to peripheral tissues from the liver, where it is synthesized. When low and very low density lipoproteins are formed too much or their breakdown is disturbed, excess cholesterol accumulates in the blood. They hit the walls blood vessels, narrowing their lumen and impeding blood flow: the so-called atherosclerotic plaques are formed.
Situations that change lipids
Excess triglycerides or insufficient levels of "good" cholesterol in the blood may be associated with an increase total cholesterol. There are some facts that are the usual reason for this, eg. Overweight: The accumulation of excess body fat can cause adipose tissue will turn into triglycerides, the excess of which is associated with a decrease in "good" cholesterol. This means that even with adequate nutrition, if you still have a few extra pounds, it will be difficult to control them. Diabetes is poorly controlled: the liver can use glucose to make triglycerides, which we have seen can cause problems. Smoking or alcohol consumption: Tobacco can reduce concentration good cholesterol. Drinking too much alcohol can also increase the bad because the liver will be busy getting rid of alcohol toxins. Certain medicines: It is possible that certain medicines produce an excessive increase in triglycerides in the blood, which may be accompanied by an excess of cholesterol.
- The more glucose in the blood, the greater the risk of this.
- Among them we can single out steroids or some atypical antipsychotics.
"Good" high molecular weight lipoproteins deliver cholesterol to the liver.
The fact is that high and low density lipoproteins exchange cholesterol with each other, and the flow of cholesterol is directed towards HDL. "Good" lipoproteins receive cholesterol from "bad" ones upon contact with cells, and then transport it to the liver, where bile acids are formed from it. Thus, cholesterol is excreted from the body.
The body itself makes it a part, and this endogenous cholesterol is needed for the production of hormones, in addition to being one of the main components of cell membranes. However, sometimes its production is excessive, due to genetic reasons which cause the body to produce more cholesterol than it really needs.
If, despite following these tips, cholesterol remains high, it is advisable to notify the doctor, as this may even be an indicator of certain failures in the body. For example, it can happen that bile salts get stuck in the intestines, which thyroid does not produce enough hormones or that the kidney does not filter properly, so problems need to be identified as soon as possible.
Cholesterol-consuming cells have special receptors for recognizing "bad" lipoproteins. Cellular cholesterol uptake is regulated by changing the amount of these receptors on the cell surface. With a decrease in the cell's need for cholesterol, the number of receptors decreases. And this process is controlled by cholesterol itself in the cell, which regulates the activity of apoproteins, with the help of which cell receptors interact with LDL.
It is also possible that we are simply consuming excess saturated fat without realizing it, with fried foods or inadequate dressings. Endocrinology and nutrition. More than 20 years ago the results of lipid clinical studies. Primary prevention 1, 2, first major clinical trial on cardiovascular prevention with a lipid-lowering drug confirmed the lipid theory of atherosclerosis, demonstrating a reduction in the incidence of heart rate coronary arteries in relation to cholesterol reduction achieved with cholestyramine.
If this well-established mechanism fails, various diseases develop. Violation of the natural balance in the content of lipoproteins in the blood plasma is called dyslipoproteinemia.
However, in the development of various diseases, an important role is played not only by an increase in the concentration of “bad” cholesterol in the blood, but also by a violation of the normal ratio between lipoproteins of various densities. This ratio is regulated by the body itself and is achieved at a certain concentration of cholesterol, depending on the amount of this substance entering the body and on the human genotype (on the inherent activity of enzymes that control the synthesis and breakdown of cholesterol). For most people, this concentration lies in the range of 150-250 mg per 1 dl of blood.
The reasons for treating hypercholesterolemia are numerous. The obvious reason is the severity of dyslipidemia, as in the case of familial hypercholesterolemia, which is difficult to control even with maximum doses statins. Obviously, for many patients, this goal is even more difficult to achieve. Other reasons for treating cholesterol are cost high doses statins and fear of them side effects, especially since the withdrawal of cerivastatin due to myopathic toxicity 16. Finally, traditional cholesterol lowering drugs that can be combined with statins to improve cholesterol lowering are generally poorly tolerated, so long-term adherence to these treatments is poor.
To date, scientists have proven that for the prevention of atherosclerosis, it is not enough to reduce the level of "bad" cholesterol. It is also important to maintain the required concentration of "good", without which normal work is impossible. internal organs and systems, including the brain, blood vessels and heart.
age disorders
Scientists have found that there is a direct relationship between age and increased cholesterol levels: the older the person, the higher the risk of this disorder. Last but not least, this is due to the fact that in an elderly person, the production of sex hormones decreases - estrogen in women and testosterone in men. These hormones increase the level of "good" cholesterol and reduce the level of "bad".
Therefore, although effective, isolated inhibition of cholesterol synthesis with statins has limitations that prevent achievement of therapeutic goals in a significant percentage of high-risk individuals, so it is desirable to reduce the amount of cholesterol supplementing synthesis inhibition. This is, logically, inhibition of intestinal absorption of cholesterol, the second pathway in cholesterol homeostasis in the body.
Cholesterol homeostasis in the body is maintained by balancing endogenous steroid synthesis with its intestinal absorption and biliary secretion of bile acids and cholesterol 18. Figure 1 schematizes the interaction between peripheral tissues, liver, and intestines in maintaining cholesterol homeostasis. In a situation of homeostatic equilibrium, the amount of cholesterol excreted daily in the faeces is equal to the amount synthesized by the tissues, and which was facilitated by nutrition. The liver regulates the body's cholesterol balance because it processes cholesterol-containing high-density lipoproteins from tissues and chylomicron remnants that provide cholesterol to the gut at the same time that it synthesizes bile acids from cholesterol and releases the steroid into bile along with bile acids .
Especially careful you need to be women over 50 years old, entering the period of menopause - hormonal changes in the body associated with aging. During menopause, the ovaries gradually stop producing eggs and no longer produce estrogens, which eventually leads to the final cessation of the menstrual cycle.
Due to a violation in the interaction of a number of endocrine glands (pituitary gland, adrenal glands, thyroid gland) under the influence of neuro-reflex and hormonal causes at this time, the functions of many organs and systems are disrupted in a woman. There are shifts in metabolism: the intensity of oxidative processes decreases and the main metabolism slows down, as a result of which subcutaneous tissue fat begins to be deposited intensively, mainly on the hips and abdomen. The development of obesity in menopause also explained by an increase in the secretion of antidiuretic hormone by the pituitary gland, as a result of which water metabolism is disturbed. In more rare cases, on the contrary, there is a noticeable emaciation, despite good nutrition.
Within 3-5 years after the cessation of menstruation, the hormonal function of the ovaries is still preserved. Then comes the period of senile involution, which lasts until the end of life and is characterized by the cessation of ovarian activity and the progression of atrophic processes throughout the body. Cardiovascular diseases develop, bone fragility increases significantly.
Aging male body is also quite vulnerable, and in men, violations hormonal balance may appear in more early age than in women. This imbalance in men is common cause not only obesity and cardiovascular disease, but also sexual dysfunction. This is due to the reduced production of somatotropic hormone in such patients, which is responsible for the mobilization of fat from fat depots, as well as testosterone, the main male sex hormone. More than half of overweight men suffer from various violations sleep, namely in the deep phases of sleep and these hormones are produced.
Due to violation fat metabolism aging increases the risk of diseases such as angina pectoris, myocardial infarction and cerebral stroke. Atherosclerotic lesions of the cerebral vessels leads to a decrease in working capacity, deterioration of memory, fatigue. Elevated blood cholesterol levels may indicate liver disease, gastrointestinal tract, as well as violations of the activity thyroid gland, pituitary gland, hypothalamic centers, decreased activity of the gonads, changes in trophic function nervous system. Therefore, diagnostic and medical measures in old age should not be aimed at finding out the reasons for the increase in cholesterol levels as such, but at identifying the main age-related changes and diseases associated with this disorder, as well as the elimination of hypercholesterolemia (increased blood cholesterol levels).
Not quantity, but quality
A modern person receives with food much more calories than he is able to spend with a sedentary lifestyle, and much less vitamins and essential nutrients. fatty acids than required for normal operation organism. However, thoughtless restriction of nutrition is unlikely to add health. Nutritionists say that to maintain health, it is not a quantitative restriction of fats that enter your body that is required, but an attentive attitude to their qualitative composition.
Eating a lot of refined carbohydrates and animal fats leads to exhaustion of the systems antioxidant protection organism and, as a consequence, to the activation of free radicals. Entering into chemical reactions, these compounds damage enzyme systems, lipids (fats), proteins, and lead to cell dysfunction. As a result, diseases such as atherosclerosis and secondary immunodeficiencies leading to premature aging.
And if we add to this such factors as the impact of poor ecology and other adverse factors - overwork, all kinds of stress, a sedentary lifestyle, drinking alcohol, smoking, frequent medication and hereditary predisposition, then the likelihood of developing various diseases of the digestive system, disturbances in work endocrine, nervous and cardiovascular systems increases many times over.
Lifestyle change and rational diet usually help lower cholesterol levels by 5% in patients suffering from certain comorbidities, and by 10-20% in practically healthy middle-aged and elderly people. Hypercholesterolemia - serious problem and needs to be addressed in a timely manner. After all, our body functions as a single mechanism, and the “breakage” of any link of this mechanism in one way or another affects the work of all other links. Fortunately, the same can be said about wellness activities.
Sometimes it is enough to eliminate at least a few damaging factors, such as smoking, insufficient sleep or physical inactivity, and the functions of all organs and systems gradually return to normal. Of course, taking care of your health is not easy. But the result is worth it!
Maria ANTONOVA Magazine "60 years is not age" 3.10.11
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Today, the word "cholesterol", sounding from all sides, is perceived extremely negatively. Every person knows that high content This substance in the blood leads to the appearance of atherosclerosis and other diseases. People who adhere to healthy eating systems try to eat only those foods in which there is no cholesterol or its content is minimal.
But, everything is far from being as simple as it seems at first glance. Cholesterol as such is not harmful substance. On the contrary, it is vital for the normal functioning of many internal organs and systems.
By the way, both increased and reduced level this substance.
With food, only 20% of cholesterol enters the body, the remaining 80% is produced by the liver and other internal organs. It is not cholesterol itself that is in the blood, but its compounds with protein - the so-called lipoproteins. The particles of this compound can have different densities, which determine their properties.
High-density lipoproteins are called "good" or "useful" cholesterol, which prevents the development of atherosclerosis. Low-density lipoproteins are precisely the "bad cholesterol". It can be oxidized and, having transformed into an unstable molecule, penetrate the walls of blood vessels.
During examinations, 4 indicators can be taken into account: the number of high and low density lipoproteins, triglycerides and general level cholesterol.
Functions of cholesterol:
- Takes part in the synthesis of sex hormones.
- It is required for the activity of serotonin receptors located in the brain.
- This substance is the basis for the formation of bile.
- Protects intracellular structures from free oxygen radicals that have a destructive effect.
- Participates in the synthesis of the fat-soluble form of vitamin D.
Why cholesterol levels are disturbed
As part of bile, this substance enters small intestine. During digestion, part of the cholesterol returns to the liver, and a certain amount enters the large intestine. healthy body in the process of such a hepato-intestinal cycle, it removes its excess with feces.
But the output of bile is reduced in many liver diseases and "bad" cholesterol begins to accumulate in the body. Also, when too much of this substance is taken in with food, its synthesis is also activated, that is, the liver produces cholesterol more actively.
main danger advanced level cholesterol is the risk of atherosclerosis. A lot of this substance in the blood is observed with hypertension, violations cerebral circulation, obesity. In a number of liver diseases, cholesterol is also elevated (for example, in the presence of hemangioma or other neoplasms).
How to normalize cholesterol levels?
First you need to do tests and consult with a specialist. A lot of cholesterol in the blood is a high risk of developing a number of diseases. In some cases, the problem can be dealt with by simply adjusting the diet. But, as mentioned above, most of this substance in the body is synthesized by the liver. Therefore, sometimes it is impossible to do without drugs that inhibit the production of cholesterol. You can take them long time, sometimes throughout life, but this should be done under the supervision of a doctor. The specialist determines how often it is necessary to do control tests, and according to their results, he can adjust the treatment.
Relationship between hepatitis and cholesterol levels
When hepatocytes are damaged due to inflammatory process- hepatitis, the liver stops decomposing excess cholesterol. But the synthesis of this substance in the liver continues. As a result of this, so-called cholesterol stones are often formed in patients with hepatitis. The answer to the question of what to do in such a situation can only be given by a doctor!
Patients with hepatitis are usually advised special diet, which limits the intake of cholesterol-rich foods. Thanks to the diet, the synthesis of cholesterol in the body also decreases. Also, in many forms of this disease, doctors prescribe medications which reduce or completely block the synthesis of cholesterol.
It is important to know that with hepatitis it is necessary to control the level of cholesterol and, if necessary, adjust it. But only a doctor should do this, self-medication is unacceptable.
Normal values of gamma-glutamyl transpeptidase (GGT)
Gamma-glutamyl transpeptidase is involved in amino acid metabolism. GGT is found in many tissues of the body, but its greatest activity is observed in the kidneys. However, the increase GGT level in many cases (about 90%) indicates liver disease. A number of medications can also increase GGT levels (for example, oral contraceptives, rifampicin, estrogen).
An increase in the level of GGT by 2–5 times is characteristic of infectious hepatitis and fatty degeneration of the liver. GGT immediately responds to the occurrence of diseases caused by alcohol abuse (for example, cirrhosis). High levels of GGT may indicate neoplastic liver disease.
It is advisable to donate blood to determine the level of GGT on an empty stomach, the analysis is done within one day. If deviations from the GGT norm are detected, the doctor must decide what examinations should be done next.
Liver tests during pregnancy
The load on the liver during childbearing increases significantly. Therefore, at least 1 time it is necessary to do a blood test, which allows you to identify the presence of pathologies in the work of this organ. It is important to know that a number of changes are quite normal. If deviations in the analyzes are a consequence of pregnancy, most often after childbirth everything returns to normal.
Such a neoplasm is diagnosed with the help of ultrasound or MRI. It is also imperative to make general analysis blood.
If the hemangioma does not increase in size and does not bother the patient in any way, usually nothing needs to be done. To the question why the development of hemangioma begins, today there is no answer.
Hemangioma is removed surgically in the following cases: large size of the tumor, compression of internal organs by it, infection, risk of degeneration into malignant neoplasm. Cirrhosis is a contraindication to surgery; it is also impossible when the tumor has affected large veins liver.
Also, hemangioma in many cases is treated hormone therapy and non-surgical methods (for example, cryodestruction, electrocoagulation, laser therapy).