Determination of atherogenicity coefficient. The likelihood of developing pathologies is increased - the atherogenic coefficient is increased. Factors influencing the result of the analysis

What do we know about cholesterol? The information that most of us have is that this substance is harmful to our health, promotes the development of atherosclerosis and increases the risk of heart attack in adulthood. Therefore, it should be reduced by all means and avoid eating foods that increase cholesterol. Everything is true, but this is only one side of the coin. The other is that cholesterol is vital for our body, but not all of it, just the “good” one. Therefore, general indicators are not enough to identify the risk of developing certain diseases. For this reason, a coefficient such as the atherogenicity index is included in the mandatory one. It allows you to determine the relationship between and gives a more complete picture of the patient’s health status within the framework of a given issue.

An excursion into history, or what we know about cholesterol

This substance was discovered back in the 18th century by French scientists. It was obtained from gallstones and had the properties of fat. It was then that it was given the name that we actively use to this day - cholesterol. But a century later, researchers came to additional conclusions that this substance belongs to the class of alcohols. In this regard, the name was changed to “cholesterol”, which, however, did not take root in our country.

Another 100 years later, in the 20th century, a real boom against cholesterol began in our country. It was recognized as dangerous to health and all sorts of measures began to be taken to combat the harmful substance. But then world medicine was stunned by new discoveries. It turns out he's not all bad. Moreover, the “correct” cholesterol is vital for our body. It is needed for normal digestion, is involved in the synthesis of hormones and vitamin D, as well as in the construction of membranes and the molecular structure of brain cells. The functioning of many systems and organs is disrupted not only by excess, but also by lack of cholesterol. The main thing is to recognize which part of it predominates in the body. This is why the atherogenicity index is used.

What is the atherogenic coefficient and how is it determined?

This indicator is an important signal about the risk of developing vascular and heart diseases. Therefore, it is determined by making the Atherogenic Index calculated as the ratio of “bad” cholesterol to “good”, on the basis of which a conclusion is made about the presence of certain problems in the body. But how to understand which one is necessary and which one is harmful?

"Bad" and "good" cholesterol

The fact is that cholesterol is insoluble in water. Therefore, in order to move throughout our body, it is combined into a complex with apoproteins - special proteins. Such compounds are called lipoproteins. Not all of them are the same. These complexes differ depending on the ratio of the elements they contain.

Thus, lipoproteins are isolated:

• high density(HDL);
• low density (LDL);
• very low density (VLDL).

There are also triglycerides, which are formed by combining glycerol and fatty acids. They are the main energy sources of the body. As for lipoproteins, the “good” ones are those that have the “bad” cholesterol, which clogs the arteries, forming plaques in them. So is its “twin” - VLDL, which carries cholesterol to other organs and precipitates, clogging blood vessels.

Calculation of the atherogenic coefficient

When the overall indicator (HC) is determined, all the values ​​are added up, which gives a not entirely clear picture of the real state of affairs. After all, even if the level is high, the ratio may be in favor of HDL, and vice versa. In order to understand, you need to determine the atherogenicity index.

The formula for calculating it looks like this:

(TC - HDL) / HDL.

It is usually important to know the exact values ​​of all indicators, that is, the level of cholesterol. They are measured in millimoles per liter - mmol/l.

Values ​​of the atherogenic coefficient and other indicators of cholesterol levels

What should the atherogenicity index ideally be? Norm for healthy person should not exceed 3-3.5. Values ​​above 3.5-4 indicate an excess of “bad” cholesterol and the risk of developing atherosclerosis. An atherogenic index below normal (less than 3) has no clinical significance.

Along with AI, you need to know other indicators. So, the following values ​​are considered normal:

• TC - 3.8 - 5.02 mmol/l;
• HDL - 1-1.2 mmol/l;
• LDL - maximum 3 mmol/l;
• triglycerides - 1.77 mmol/l.

If the atherogenic index is increased, this indicates an increase in the level of “bad” cholesterol. LDL deposits fat on the walls blood arteries, from which plaques form over time. Gradually, they can completely block the lumen in the vessels and block the movement of blood. Nutrients and oxygen will no longer flow into the tissues, which contributes to the occurrence of ischemia in them. In the brain, this situation will lead to a cerebral stroke, in the heart - to myocardial infarction. There are also less serious ones, but still Negative consequences increase in LDL - depression, decreased immunity and development infectious diseases. If the tests reveal that the atherogenic index is increased, what should you do? Is it possible to somehow lower its level without resorting to drug treatment? If the increase is insignificant, then you can change the situation on your own. We'll talk about how to do this further.

High rates of IA: treatment

First of all, it should be said about what contributes to the increase in “bad” cholesterol. Mainly, these are bad habits and not healthy image life:

• smoking and alcohol abuse;
• lack of physical activity;
• the predominance of animal fats and fast food in the diet;
• overweight.

In this case, everything depends entirely on us. By gradually giving up bad habits and getting rid of extra pounds, you can count on multiple improvements in your health and AI indicators. Age also influences the increase in this coefficient. So, in men after 45, and in women after 55 years, the level of “bad” cholesterol, as a rule, increases. Heredity may also play a minor role. However, if you lead a healthy lifestyle and exercise daily, then these minor factors will not have such a strong impact.

If the atherogenic index is increased, treatment should include a set of measures:

• diet with predominance plant food and reduction of animal fats;
• limiting salt intake;
• moderate physical activity (dancing, yoga, daily walking);
• giving up alcohol and tobacco;
• reduction of stress and fatigue (both physical and emotional);
• taking dietary supplements that regulate and reduce the absorption of dietary fat;
• in some cases it will be necessary additional dose drugs - statins (to lower cholesterol), but they should be taken only on the recommendation of the attending physician.

What you can and cannot eat with high AI

So, if the atherogenicity index is increased, you need to avoid:

• premium bread and various baked goods;
• soups with meat broth;
• fatty dairy and fermented milk products;
• fatty meat, sausage, offal, caviar;
• margarine and butter;
• mayonnaise and sour cream sauces;
• chips and fried potatoes, ice cream, milk chocolate.

In this case, the diet should be enriched with foods that help normalize cholesterol levels. This is, first of all:

• vegetables and fruits, vegetable soups;
• sea ​​fish and seafood;
• lean beef, turkey and chicken;
• low-fat dairy products;
• sunflower, olive oil;
• marmalade, candied fruits, fruit sorbet;
• grain bread;
• soy sauce.

A qualitative change in your diet will not only reduce the content of “bad” cholesterol and increase the level of “good” cholesterol, but also reduce body weight (if necessary). This type of nutrition will promote physical activity, energy, good mood and improving immunity. The risk of cardiovascular disease will be reduced.

Juice therapy as a way to reduce IA

Therapy with freshly squeezed juices can also normalize cholesterol levels. It should be carried out no more than once a month for 5 days. It consists in the fact that you need to drink half a glass of carrot juice every day, each time combining it with one of the following (to choose from):

• a quarter glass beet juice and the same amount of cucumber;
• a third of a glass of celery juice;
• a quarter glass apple juice and the same amount of celery;
• a fifth of a glass of cabbage juice;
• a glass of orange juice.

This therapy will help reduce cholesterol levels to normal level subject to other above recommendations. In order to control the atherogenicity coefficient, an appropriate analysis should be carried out at least once every one to two years.

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

For research purposes, blood is taken from a vein from the patient. To ensure that the results do not turn out to be distorted, you should properly prepare for the analysis. You need to start following a number of rules a couple of weeks before going to the clinic:

• do not disrupt your usual diet and diet - at least 1-2 weeks before the analysis;
• abstain from drinking alcohol for 24 hours;
• Stop eating 12 hours before (you are allowed to drink water);
• half an hour before the start of the study, exclude any kind of emotional and physical stress;
• 30 minutes before the test do not smoke;
• Five minutes before donating blood, take a sitting position.

Compliance with these measures will allow you to avoid deviations in the results and obtain more accurate values ​​of total cholesterol, HDL and LDL, as well as find out the atherogenicity index.

Overestimation and underestimation of AI indicators

What can influence the distortion of the obtained indicators? Factors that increase the cholesterol ratio include:

• taking the test in a standing position;
• smoking before the study;
• prolonged fasting;
• consuming large amounts of animal fats a few days before the test;
• androgens and anabolic steroids;
• pregnancy.

At the same time, a low (that is, underestimated) atherogenicity index can be obtained in the following cases:

• taking the test in a supine position;
• excessive physical activity shortly before the start of the study;
• diet with high content polyunsaturated fatty acids and low content cholesterol;
• reception before taking the test antifungal drugs, estrogens, erythromycin, etc.

It is also not recommended to take an analysis to determine cholesterol ratio after recent serious illnesses. So, after surgery or a heart attack, at least six weeks must pass, after which a lipid profile can be performed.

Conclusion

Now you know that not all cholesterol is harmful to the body, and some are even vital. The relationship between them is determined by conducting a biochemical analysis and calculating a special cholesterol coefficient. We looked at what its normal values ​​are, low and high, what factors influence both. From the article you learned when the atherogenicity index is increased, what to do in this case, what independent measures to take. In addition, we told you how to properly prepare for the analysis in order to prevent distortion in the results. We hope you found this information useful. Monitor your cholesterol and take the necessary measures on time.

It is important for every person to know what the atherogenicity index is and how to calculate it, since deviation of this indicator from the norm (in particular, an increase in the level) leads to atherosclerosis, obesity, and the appearance of cholesterol plaques in vessels. And all this is the result of the accumulation of cholesterol in the blood due to proper nutrition, abuse of fatty foods and fast foods.

The harmfulness of cholesterol has been known for a long time, but only in the 20th century did doctors start talking about its vital necessity for the body in moderate quantities. In fact, cholesterol can be both good and bad, and is not so bad if it is present in the body.

It is required:

• to maintain digestive functions;
• to take part in the synthesis of hormones;
• to build the structure of cells in the brain.

Excess (as well as deficiency) leads to dysfunction of many body systems.

Which part is predominant in the body can be identified by taking a blood test for biochemistry, thereby recognizing your atherogenicity coefficient. How to calculate it?

The atherogenicity coefficient of cholesterol is checked by studying the indicators of a biochemical blood test for the ratio of cholesterol levels to lipoproteins (special proteins) moving in a complex throughout the body.

After eating and breaking down food, high, medium or low density lipoproteins are released, fatty acid compounds and triglycerides are formed in the blood vessels.

There is nothing terrible if, even with a high level of cholesterol in the blood, the ratio between these hypoproteins remains normal.

The atherogenic coefficient is calculated using the formula: TC-HDL/HDL cholesterol and is measured in mmol/l, where the cholesterol value is denoted as:

1. THC - total cholesterol.
2. HDL cholesterol is high density cholesterol.

Normally, the atherogenic coefficient in an adult is 3.5 mmol/l. Exceeding the mark above 4 mmol/l already indicates the presence of bad cholesterol in the blood, initial stage development of atherosclerosis. A decrease in AI norm below 3 mol/l does not have any particular clinical significance for the body.

It is the increase in the index that poses the danger, as evidenced by:

• about the deposition of fat in the blood arteries;
• about the formation of plaques;
• about blocking, narrowing of arterial lumens;
• about blocking the outflow of blood;
• about lack of oxygen, nutrients to the brain;
• about the development of anemia, cerebral stroke, heart attack.

Negative consequences when the level of the atherogenic index in the blood is exceeded are inevitable. With an increase in lipoprotein levels and a decrease in immunity, the patient begins to suffer from depression and various infectious diseases.

A blood test to detect AI indicators is carried out by collecting biological material from a vein.

The procedure requires the patient to preliminary preparation to get more reliable results:

1. Adjustment of nutrition in 2 weeks with refusal to eat fatty, fried foods, fast food.
2. Avoid eating 12 hours and drinking water 1 hour before the test.
3. Stop smoking within 3 hours.
4. To eliminate any emotional stress, it is important to remain calm when donating blood.

Thus, after studying the main blood parameters, it will be possible to find out whether the atherogenic index indicators are underestimated or overestimated.

But they can be greatly distorted if the described rules are not followed before preparing for the procedure:

• smoking;
• prolonged fasting;
• taking the day before fatty and sweet food, fats of animal origin, also anabolic steroids;
• in women during pregnancy.

If a person has previously suffered from a serious illness, for example, myocardial infarction, or has undergone surgery, then at least 6-7 weeks must pass before a lipid profile can be performed to identify indicators of the atherogenic index.

The main thing is to identify the reason that led to an increase in AI and bad cholesterol levels, calculate the atherogenicity coefficient and try to bring the resulting level back to normal.

You can, of course, resort to taking medications, but doctors advise first of all to follow some rules.

1. Eliminate bad habits - smoking and alcohol.
2. Avoid a passive sedentary lifestyle and eating foods of animal origin and fast food.
3. Fight excess weight, especially for people over 45 years old, when the so-called level begins to increase bad cholesterol.
4. Maintain a healthy lifestyle.
5. Follow a diet that includes only plant foods and a complete rejection of animal fats in case of higher level atherogenic index.
6. Reduce salt intake.
7. Dose physical exercise, do dancing, yoga.
8. Walk more.
9. Avoid overwork and emotional exhaustion.

You need to completely avoid taking certain foods:

• rich meat soups;
• lactic acid dishes;
• premium bread;
• fat sour cream;
• mayonnaise;
• margarine;
• sausages;
• offal;
• fried potatoes;
• chips;
• hot sauces;
• ice cream;
• chocolate products.

And proper nutrition will help:

• regulation of the atherogenic index;
• increasing good cholesterol, eradicating bad cholesterol;
• normalization of body weight.

It is useful to carry out juice therapy to normalize cholesterol levels and reduce indicators. For example, combine carrot juice with beetroot or cucumber, drinking 0.5 cups per day in combination. You can take celery, apple, cabbage, and orange juice for 5-6 days until your cholesterol levels return to normal. Thus, you can control your atherogenic coefficient in the blood and bring its value to a normal level.

Knowing that cholesterol can be both harmful and beneficial is important for everyone: in order to check their AI, it is recommended that an adult undergo and take a blood test for biochemistry at least once a month, thereby calculating his atherogenic coefficient and achieving a regulation of the level.

Of course, this will not be possible if you do not eliminate the provoking factors and improve your diet by refusing to eat fatty carcinogenic foods.

To fight with high cholesterol definitely necessary.

Its accumulation in the blood leads to many troubles:

• clogged blood vessels;
• the appearance of cholesterol plaques;
• failure in metabolic processes;
• obesity.

A healthy lifestyle will definitely benefit you. It's always nice to cleanse the body of accumulated harmful substances, and blood vessels - from unnecessary bad cholesterol, if you carry out a simple calculation of your AI using the above formula.

In order to correctly explain and evaluate the results of individual analyzes taking into account summary data, the concept of coefficient, or index, of atherogenicity (CA, IA) was introduced in medicine.

KA in a biochemical blood test is an established ratio, a connection between good and bad cholesterol, thanks to which it is possible to recognize cardiovascular diseases at the initial stage, as well as the degree of their risk.

Cholesterol cannot move throughout the body on its own because it does not dissolve in liquid. Therefore, it is transported as part of lipoproteins - chemical compounds, which are proteins containing lipids (fats).

Lipoproteins vary in density and functional purpose. Thus, complex high-density proteins (HDL, or good cholesterol), clearing the walls of blood vessels of excess cholesterol, send it to the liver for further processing.

Low-density lipoproteins (bad cholesterol), on the contrary, move cholesterol from the liver to peripheral tissues, creating on the inner walls of blood vessels. With a high concentration of deposits in the vessels, obstruction may occur with dangerous consequence– stroke or heart attack.

Very low density is characterized by large particles of lipoproteins (VLDL, very bad cholesterol), which deliver contents to the tissues of the peripheral systems of the body. If lipid metabolism fails, it is important to monitor the level of VLDL, an elevated value of which indicates serious illnesses kidneys, liver, endocrine system, heart and blood vessels.

How to calculate CA

To calculate this value it is necessary to have correct data, initially depending on the patient's discipline. There are rules for preparing the body that will help you get real, not conditional, indicators. In this regard, you need:

• observe prescribed by a doctor food 10-14 days before blood donation;
• do not overload yourself with physical and mental work;
• do not smoke 30 minutes before the test;
• do not eat for 12 hours;
• not to drink alcoholic drinks 24 hours.

The doctor should know whether the patient is taking specific medications and prescribe recommendations before the analysis, since some drugs (especially antifungal and hormonal) can distort the indicators. Also, the biased value of CA will be when donating blood in menstrual period or during .

If the patient has suffered serious disease or surgery, then a lipid profile (analysis of blood lipid composition) should be postponed for 1.5 months.

If these rules are followed, the patient will not have to donate blood again, but will purposefully move forward to establish a diagnosis and subsequent treatment.

CA is found using a special calculation formula:

KA = (total cholesterol - HDL) / HDL

The numerator indicates the value of LDL and VLDL, which is obtained by subtracting the HDL value from the level total cholesterol.

By substituting the obtained values ​​of the analysis results into the formula, you can easily obtain the CA. For example, if a patient has a cholesterol level of 6.19 mmol/l and HDL cholesterol of 1.06 mmol/l, the atherogenic coefficient will be 4.8.

In order to accurately determine KA, it is necessary to conduct a thorough study not only of the components of this indicator, but also of other values ​​that affect the actual diagnosis: low and very low density lipoproteins, triglycerides (neutral fats). Thus, you can see a complete picture of the composition of the blood and the exact amount of all components.

Norm of indicators

The normal atherogenicity coefficient is 2-3 units, which takes into account the error of laboratory equipment. In other words, the amount of LDL should be 2-3 times higher than the value of HDL.

If the KA level has exceeded 3 units, this indicates moderate vascular damage, which can be corrected by diet. An index value approaching 4 indicates a risk of developing atherosclerosis.

When the coefficient crosses the border of 4 units, then it is necessary to start emergency treatment With drug therapy, and control of KA in the blood.

A significant increase in CA to 7 or more requires surgical treatment to prevent heart failure.

A reduced index of 2 units or less is not a threat to health and shows no risk of developing atherosclerosis.

With age, metabolic processes in the body slow down, and the atherogenicity coefficient may increase. However, an AI value above 3.5 in patients of both sexes over 60 years of age requires close medical attention.

In young people under 30 years of age, KA is normally no higher than 2.5. From 30 to 40 years permissible male norm the atherogenic coefficient is 2.07-4.92. With satisfactory heart function in representatives of the stronger sex 40-60 years old, AI should be within 3-3.5 units. If the index in the blood of men increases, additional examinations are prescribed, the causes are studied and eliminated.

For women 20-30 years old, the AI ​​norm is up to 2.2; from 30 to 40 years – 1.88-4.4; after 40 years, the coefficient is considered normal to 3.2 or less. With the onset of menopause in women over 50 years of age, there is a risk of vascular damage by atherosclerosis. Taking this into account, the KA for older women is calculated as for men: 3-3.5 units.

A reduced atherogenicity coefficient in young women indicates clean blood vessels and is not a health hazard. If a middle-aged woman has a lower KA than normal due to a decrease in HDL (good cholesterol), then in this case there is a suspicion of problems in the body that need to be identified and eliminated.

Increased CA

A cholesterol coefficient of atherogenicity exceeding 4 units indicates the presence of atherosclerotic plaques on the walls of blood vessels, which impede the passage of blood to the organs and increase the risk of heart and vascular disease. With the active development of this process, the CA can be several times higher than 4.

The composition of total cholesterol plays an important role. With the same value in two patients normal index The patient has a predominance of high-density lipoproteins. If there is more LDL in the blood, then KA will be elevated and treatment is necessary to reduce this indicator. Two elevated indicators - the atherogenic index and cholesterol - indicate a high risk of cardiovascular problems.

The absence of expressive symptoms of increased KA for a long time may one day turn into a serious complication and even fatal. Therefore, it is necessary to regularly take a biochemical blood test to determine KA.

Reasons for deviations

There are factors influencing the increase in the atherogenicity coefficient:

• regular smoking and drinking alcohol, which lead to damage to the internal walls of blood vessels and the formation of plaques that disrupt normal blood supply;
• deficit active movements, against the background of which rapid formation of fats occurs;
• excess weight that occurs due to excess caloric nutrition and metabolic disorders;
• insufficient liver function;
• hypertension, which negatively affects the strength of the walls of blood vessels;
• diabetes mellitus, in which glucose molecules, passing through blood vessels, damage the walls, on the defects of which atherosclerotic plaques are firmly established;
• heredity as one of the most common causes;
• nervous stress, which affects the condition of blood vessels.

Treatment of the disease

To normalize the atherogenic coefficient, you need to change your attitude towards bad habits, pay attention to physical activity, use foods that do not contain a large number of animal fat.

Gradual cessation of smoking and self-restraint will improve health and help reduce coronary artery disease.

Concerning physical exercise, then in the absence of additional diseases you can exercise 4 times a week for 30-40 minutes a day. If the patient has a disease, the doctor adjusts the exercises in a more gentle direction, taking into account the characteristics of the course of the disease. pathological process. Hiking and cycling, tennis, swimming are very useful. Statins, fibrates, bile acid sequestrants.

Low atherogenicity

An underestimated AI indicator is considered to be favorable, since it indicates the correct ratio of good and bad cholesterol in the blood and the presence of healthy blood vessels. As already mentioned, a low index value occurs in young women (less than 1.9), which is the norm considering age. In addition, a decrease in AI is possible if:

• the patient is on a long-term cholesterol-lowering diet;
• Treatment is carried out with drugs of the statin group;
• there is increased physical activity (professional sports activities).

Low KA occurs in people who follow balanced diet, physical activity, which has a beneficial effect on the functioning of the body.

For preventive purposes, you need to regularly (every 3-5 years) donate blood for the atherogenic index and, if necessary, adjust your lifestyle: eat right, move a lot. In this case, all paths to atherosclerosis are cut off.

Controlling IA will ensure cleanliness of blood vessels, health of the body and an optimistic mood in the soul.

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

In order to obtain adequate CA values, it is advisable to know the concentrations of all cholesterols( , ) and, although the most popular 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 the calculation of a special indicator called the coefficient or atherogenicity index.

The atherogenic coefficient in men is slightly higher than in women, but normally it should still not exceed 3 conventional units. True, after 50 years, when a woman remains without hormonal protection, gender influences the atherogenicity index indicators less and less, and the risk of the formation of an atherosclerotic process under certain circumstances becomes high in both cases. By the way, after 50 years, people of both sexes have lipid spectrum and KA should be given maximum attention, since metabolic processes are inhibited, and the body begins to gradually lose the ability to cope with food and other loads as before.

It is known that such an indicator as total cholesterol in a biochemical blood test does not provide enough information to judge the state of lipid metabolism. Here it is very important to know the ratio of atherogenic (harmful, bad) cholesterol - low and very low density (LDL, VLDL), and anti-atherogenic (beneficial, protective) high-density lipoprotein (HDL).

Penetrating into the blood as a result fat metabolism, intimately blood vessels All fractions are sent, but LDL carries cholesterol with it in order to leave it there for metabolism and accumulation, and HDL, on the contrary, is constantly trying to take it out from there. It’s clear: whichever cholesterol has the most will win.

The accumulation of bad (atherogenic) fats in the body, which 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, give rise to the development of a pathological process such as atherosclerosis. Atherosclerosis, depending on the location of the lesion, forms other diseases of cardio-vascular system who are currently often cause death person. In general, everyone is well informed about atherosclerosis, plaques, and cholesterol, but the last indicator of the lipid spectrum (atherogenic coefficient) remains a mystery for many people.

Meanwhile, exactly one number (KA) can tell whether the atherosclerotic process is in progress and how high is the degree of its progression, is it worth actively fighting bad cholesterol, even to the point of taking special drugs, called statins, or you can continue to indulge in your favorite diet, ignore an active lifestyle and not worry about anything.

Great analysis and simple calculation

In order to calculate the atherogenic coefficient, it is necessary to perform, namely: determine the concentration of total cholesterol and the level of high-density lipoproteins (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 lipid spectrum indicators:

• Total cholesterol, which includes high, low and very low density lipoproteins (therefore, when calculating the CA of HDL, we subtract - to leave LDL + VLDL);
• High-density lipoproteins (HDL), which have protective properties regarding 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 analysis difficult.

The atherogenicity index is calculated using the formula:

This expression can be replaced by another relation:

In the latter case, 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 (CSlponp = 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 atherogenic coefficient can be presented in this way:

It is obvious that fluctuations in KA and the transition beyond normal limits are influenced by the concentration of lipid spectrum parameters, mainly total cholesterol, which includes low- and very low-density lipoproteins, as well as anti-atherogenic HDL.

When the index is raised

An increased atherogenicity coefficient (above 4) already indicates that atherosclerotic plaques begin to be deposited on the walls of blood vessels(Where should LDL and VLDL, which are constantly present in high concentrations, go?). It should be noted that with 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 guide.

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

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

It should be noted that in other cases this indicator is increased not at all due to the patient having a lipid metabolism disorder. Doctors deliberately increase the level of the atherogenic index by prescribing certain hormonal drugs. However, as is known, one chooses the lesser of two evils... Moreover, if you follow all the recommendations, this will not last long, and the CA will not exceed the permissible limits. similar situations meanings.

The cholesterol coefficient of atherogenicity can be increased if a blood test is done during 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 receiving the necessary food from the outside, the body will actively begin to use its own fat reserves, which, entering the bloodstream, will certainly affect results of a blood test, if performed at that moment.

Low atherogenicity

No one is struggling with this phenomenon, because there is no concern about the development of atherosclerosis, and in such cases there is no talk of other diseases. Meanwhile, the atherogenicity coefficient is sometimes less than the above figures (2 – 3), although in healthy young women it often fluctuates between 1.7 and 1.9. And this is considered the absolute norm. Moreover - very good result, which can be envied: clean elastic vessels without any plaques or 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 low index atherogenicity can be expected in the following cases:

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

The atherogenic index is considered one of the main criteria that determines the effectiveness of lipid-lowering therapy. CA helps the doctor monitor the progress of treatment and select the correct medications, because the goal of statins is not only to reduce total cholesterol and calm down. Data medicines are designed to increase the concentration of the beneficial, anti-atherogenic fraction - high-density lipoproteins, which will protect vascular walls. A decrease in HDL during treatment with statins gives reason to believe that the treatment was not chosen correctly, and continuing it not only makes no sense, but is also harmful, because in this way you can also accelerate the development of atherosclerosis. The reader has probably already guessed that reduction of the atherogenicity coefficient by statin drugs own initiative may cause irreparable harm, Therefore, doctors strongly do not recommend experimenting in this way. The patient himself reduces concentration bad cholesterol and it can reduce the values ​​of KA, but these will be completely different measures.

How to help your blood 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, nutrition and give up bad habits.

If physical activity is limited due to another disease, you need to visit a doctor and develop an individual plan for feasible physical exercise. But don’t forget: movement is life!

In the absence of contraindications, especially lazy people who are not used to leaving a cozy apartment can organize physical exercise at home - 30 - 40 minutes every other day. Well, those who are “fast on the uptake” can go for walks, ride a bike, play tennis, or swim in the pool on weekends. It’s both useful and pleasant, and there’s always time if you want.

As for, it is not at all necessary to join the ranks of vegetarians. Being a “carnivore” by nature, a person needs products of animal origin that contain non-synthesizable human body amino acids. It’s just advisable to give preference to lean varieties of meat and fish, and heat treatment should be done by steaming or boiling (do not fry!). It is good to add various teas to your 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 KA, then he should come for a blood test not only on an empty stomach, but fast for 12-16 hours the day before - then there will be no needless worries, and the study will not need to be repeated.

Residents of megalopolises and large cities are increasingly at risk of cardiovascular pathology due to atherosclerosis before the age of 50 years. This may mean that the reason for this is the lifestyle that has been developing over the years, namely incorrect eating habits, hormonal disorders and constant stress. IN medical practice The concept of atherogenicity is being actively introduced - the ability to increase cholesterol levels. If you regularly take a biochemical blood test, you may notice an increase in “bad” cholesterol and a decrease in “good” high-density lipoproteins. A violation of the ratio between “useful” and “harmful” lipids in the body is guaranteed to lead to the appearance of cholesterol plaques in blood vessels and the development of atherosclerosis.

In order to assess the degree of risk of atherosclerosis and its complications, a formula for calculating the atherogenicity coefficient was derived.

What is the atherogenic coefficient? This is an integral formula for the relationship between “healthy” and “harmful” fats (lipids) in the body, allowing a large share probability to assess the likelihood of developing cardiovascular and neurological complications atherosclerosis in each individual patient. There are several formulas for calculating the atherogenic coefficient, but the calculation of each of them requires knowledge of the basic biochemistry of fat metabolism in the body.

Classification of lipids in the body

In order to calculate the atherogenic index, it is necessary to remember some features of the structure and movement of fats in the body through the bloodstream. Fat is the main source of energy, capable of being “stored” for future use, a component of cell membranes, and a precursor substance to some hormones. It not only enters the body with food (as part of fatty meat, lard, offal, butter - up to 25% of the total cholesterol in the body), but is also synthesized in the liver (up to 75%).

Lipids are hydrophobic in nature, which means they cannot independently circulate in the blood. Therefore, they are transported by special proteins apoproteins, and the fat + protein complex is called lipoprotein. Depending on the structural and chemical differences in the structure of fats, lipoproteins have high or low density. Thus, all the fat circulating in the blood is called total cholesterol, and it is divided into high-density lipoprotein (HDL), low-density lipoprotein (HDL) and very low-density lipoprotein (VLDL). This key moment in understanding the purpose of determining the atherogenicity coefficient.

LDL and VLDL when exceeded normal values in a biochemical blood test they can be deposited on the inner walls of blood vessels, narrowing their lumen and forming so-called atherosclerotic plaques. This may mean the development of atherosclerosis in the active stage. HDL, on the contrary, is beneficial for the body: this lipoprotein “cleans” blood vessels, drawing out the smallest fat molecules from its surface, and prevents the formation of cholesterol plaques. Therefore, the more low-density lipids in the body, the higher the atherogenicity coefficient, and therefore the risk of developing atherosclerosis and its complications.

Desired HDL values ​​– best protection from the formation and growth of cholesterol plaques.

Index calculation

The atherogenicity coefficient (index) is a value that changes throughout life. It depends not only on the nature of nutrition, but also on lifestyle, concomitant diseases. The main purpose of determining this coefficient is to calculate the ratio of “harmful” and “good” fats in the body and, if necessary, prevent or treat atherosclerosis (deposition of cholesterol plaques). There are several formulas for calculating the atherogenic coefficient:

1. The most common formula for the atherogenic coefficient does not require an extended lipid profile; it is enough to take tests for total cholesterol and HDL. KA = (total cholesterol - HDL) / HDL
2. This formula is similar to the previous one, but has more precise values. It requires extensive lipid testing. KA = (LDL + VLDL) / HDL

In some laboratories, the coefficient is calculated automatically; in some, the laboratory assistant (or doctor) determines it independently. are individual for specific equipment, but on average should be at level 2-3.

If the level of total cholesterol is below 5.2 mmol/l, and the atherogenic index is in the range of 3 – 3.5, this indicates that there is no risk of developing atherosclerosis and the patient’s cardiovascular system is in good condition. It is enough to follow the principles of proper nutrition, lead a healthy lifestyle and monitor the atherogenicity coefficient (index) once every 3-5 years.

If the value of total cholesterol in biochemistry is above 5.2 mmol/l, and the atherogenic index is above 4, it is considered that the patient has a borderline risk of developing cardiovascular complications. If a repeat study after 3-6 months shows similar results, the therapist should determine measures to reduce this coefficient. At the first stage of reducing the atherogenicity coefficient, a diet with a restriction of animal fats is prescribed, light physical activity, healthy lifestyle. Monitoring of the atherogenic index at a borderline risk of developing cardiovascular disease is carried out once a year.

A significant increase in cholesterol (above 7 mmol/l) and atherogenicity coefficient (above 5) means a high risk of developing cardiovascular pathology. This atherogenicity coefficient is often determined in the blood of patients with already developed coronary disease hearts, arterial hypertension, dyscirculatory encephalopathy and other diseases.

How is the research conducted?

Since to calculate the atherogenic coefficient it is necessary to determine the level of total cholesterol and lipoproteins, it is necessary to take a biochemical blood test from a vein. For the reliability of the results obtained, it is important to observe the following rules before the study:

• Blood is donated for atherogenicity coefficient in the morning strictly on an empty stomach (it is allowed to drink water without gas);
• The last meal before determining the coefficient must be no later than 19.00 the previous day;
• It is advisable to maintain your usual diet for 1-2 weeks before the study so that the atherogenicity coefficient corresponds to reality;
• Half an hour before the biochemical analysis of the coefficient, it is recommended to limit physical and emotional stress and not smoke.

Blood is donated to study the atherogenic coefficient in a sitting position (since the indicator may decrease in a lying position), usually 4-5 ml of blood is sufficient. Then the tubes with biological material are sent to the laboratory. Determination of the main indicators of the biochemistry of fats, including the coefficient, is carried out on the day of blood sampling.

Currently, much attention is paid to the preventive health care sector, so research into the atherogenicity index is becoming increasingly relevant. The actively implemented screening (preventive) examination program allows us to cover wide sections of the population who rarely go to the clinic.

Determination is carried out:

• As part of a screening examination of all women over 55 and men over 45, once every 2 years;
• Every year for persons with:
  • Smoking;
  • Arterial hypertension (pressure above 140/90 mm Hg);
  • Hereditary factor: stroke or heart attack in close blood relatives under 45 years of age;
  • Angina pectoris, previous heart attack or stroke;
  • Diabetes;
  • Obesity, overweight;
  • Physical inactivity, lack of physical activity;
  • Frequent consumption of foods containing excess animal fats;
  • Alcohol abuse.

All these factors negatively affect fat metabolism in the body and can increase the index.

What do the test results mean?

If the ratio of high and low density lipoproteins shifts towards the latter, the atherogenicity coefficient increases and the risk of developing atherosclerosis increases: LDL, circulating in excess in the blood, is easily deposited on inner wall vessels and clog their lumen. is rare and indicates serious metabolic disorders, for example, with a strict diet, stress, exhausting training.

The atherogenic coefficient may vary depending on various factors. Its deviation from the norm is not always a sign of some disease, but if this index increases, you should consult a doctor.

Since the atherogenic coefficient is an integral formula that reflects the ratio of some lipids to others, it can be different in patients even with the same cholesterol level.

1. For example, patient A. is 38 years old, smokes 1 pack of cigarettes a day for 20 years, suffers from obesity and physical inactivity, and his diet is dominated by high-calorie dishes saturated with animal fats. It is necessary to calculate his risks of developing myocardial infarction and stroke. It turned out that total cholesterol in of this patient is 6.1 mmol/l, and HDL is 0.69 mmol/l. By plugging these values ​​into the formula, you can calculate the value. KA = (6.1 – 0.69)/0.69 = 7.8 – and an extremely high risk of cardiovascular complications.
2. Patient B. is 71 years old; it is also necessary to determine this coefficient and the risks of developing complications of atherosclerosis. B. eats right, leads a healthy lifestyle and exercises skiing. His total cholesterol value is 6.1 mmol/l, and HDL is 1.81. Atherogenic index = (6.1 – 1.81)/1.81 = 2.3 – normal coefficient, no risk of cardiovascular complications.

In cases where the atherogenic index is higher than normal, it is necessary to contact the clinic at your place of residence. Correction of disorders is carried out by the attending physician; it must be comprehensive and, as a rule, long-term. To reduce the atherogenicity coefficient, a diet with a restriction of animal fats is prescribed, physical activity, medications(statins, fibrates, bile acid sequestrants). Monitoring of the lipid profile with the obligatory determination of the coefficient in this case should be carried out at least once every three months.