High-density lipoproteins are normal in men. Reduced cholesterol levels

HDL is low, what does this mean? Any blood test must be considered in conjunction with all the elements being studied. In addition, only a specialist should decipher the results, especially something as complex as a “lipoprotein profile.” It contains abbreviations: HDL, LDL, VLDL, which mean nothing to a patient without medical education. In addition, in this study it is necessary to take into account not just the data of the elements being studied, expressed in numbers, but their relationship to each other.

Not so long ago, everyone was sure that cholesterol was evil. Having received the results of a blood test and seeing a cholesterol level in the column that did not correspond to the norm, they were horrified. It was believed that there was serious illness body, including blood. Over time, scientists decided on cholesterol. It turned out that this fat-like substance is vital for the body.

Cholesterol is as important a part of the body as other substances. It belongs to fats (lipids). Participates in the formation of cell membranes of all tissues. Without it, it is impossible to create hormones that are responsible for the reproduction of the human race.

Cholesterol is produced by the liver or comes from food. Its highest content is found in meat and dairy products.

Cholesterol was conventionally divided into two groups:

• good;
• bad.

Only excess amounts cause harm to the body. bad cholesterol in the blood, and the presence of good is necessary.

In the human body, substances are transported only through the bloodstream. But the fats themselves do not dissolve in the blood, so they cannot be transported independently. For transportation through body tissues, they are packaged in special shells made of proteins called apolipoproteins. The complex of cholesterol and apolipoprotein is called lipoprotein. Several types of lipoproteins circulate in the bloodstream.

They consist of identical compounds, differing from each other only in their proportions:

1. (VLDL). Transports lipids synthesized in the liver. Over time, they undergo hydrolysis in the body and turn into LDL.
2. (LDL) low-density lipoprotein (bad cholesterol) is produced in the liver and enters the blood and other organs. It is found in the body most of all. It is he who plays the main role in the formation of atherosclerotic plaques. Increased LDL along with an increase in VLDL, they contribute to the occurrence of atherosclerosis.
3. (HDL) (good cholesterol) consists of a small amount of cholesterol, and the bulk consists of proteins. The main purpose is to transport excess lipids from the blood to the liver. There, bile acids are synthesized from them, then they are utilized. HDL contains about 30% of the total blood cholesterol. It does not take part in the formation of atherosclerotic plaques.

On initial stages A decrease in HDL levels in the blood does not cause symptoms. It is usually diagnosed accidentally during a blood test to diagnose other problems in the body.

After some time, symptoms appear:

• excess weight;
• shortness of breath;
• tachycardia;
• Digestive problems.

Biochemical tests to monitor the amount of cholesterol are required before surgical intervention, replacement medical supplies, tracking treatment results.

Risk factors for decreased HDL levels are observed in diseases:

1. Diabetes.
2. Kidney diseases.
3. Liver problems.
4. Hypertension.
5. Acute infections.
6. Allergy to certain foods.
7. Hypothyroidism ( hormonal disease thyroid gland).

These diseases contribute to pathology metabolic processes, therefore, affect HDL levels and can significantly reduce them.

A day before taking a cholesterol test, you must give up fatty, smoked and fried foods, and alcohol, otherwise the analysis will not be reliable. For research they rent venous blood in the morning, on an empty stomach. It is necessary to simultaneously establish the concentration in the blood of all elements related to cholesterol, not just HDL. The concept of the normal level of HDL (HDL) in the blood is not entirely correct. Its concentration fluctuates constantly and depends on many factors, including age and gender.

In men after 20 years, HDL is in the range of 30–70 mg/dl, in women its level fluctuates within a wide range of 30–80 mg/dl.

By tracking HDL levels, it is possible to obtain the following results:

1. Level reduced. If there is low HDL, then there is a threat to health and even life in the body. Violated lipid metabolism, blood vessels are clogged with plaques. Serious treatment is required.
2. The level is normal. Nothing to worry about.
3. Level increased. It should be taken into account that increased levels reduce the risk cardiovascular diseases, but often these are violations of the body's metabolic processes. Typically, increased concentrations are observed against the background of genetic mutations, when there is overproduction of HDL or a violation of the removal of lipids from the blood. But sometimes this happens due to acquired diseases.

Increased levels of lipoproteins high density a value greater than 80 mg/dL (>2.1 mmol/L) is considered.

They are called:

1. Hereditary predisposition.
2. Liver diseases (hepatitis, cholestasis, cirrhosis).
3. Intoxication of the body, including alcohol.
4. Intense physical activity.

If HDL cholesterol is reduced and LDL concentration is increased, it means that the movement of cholesterol through the vessels slows down, which leads to a supersaturation of the blood with lipids. Plaques form on the walls of blood vessels - harbingers of atherosclerosis.

• stroke;
• heart attack;
• thromboembolism.

For normal well-being, it is necessary to reduce the level of bad cholesterol and increase good cholesterol.

An increase in HDL is possible without drugs, only with healthy way life:

1. Switch to low glycemic foods. Eat more low-fat vegetables fermented milk products, exclude as much as possible White bread, potatoes, sugar, sweet drinks.
2. Regular physical activity should become the norm of life. To improve cardiovascular activity, it is enough to exercise 4 times a week for 40 minutes. But if the exercises are longer, it will not harm the body, but will only help.
3. If you are obese, lose it overweight. This is difficult, but without this you should not expect that HDL levels will begin to increase. As practice shows, reducing weight by 10 kg significantly affects the increase in HDL.
4. Many people do not perceive soy products as a normal diet, only vegetarians. Soybeans, tufu cheese due to the soy protein content, have a slight but level-increasing effect good cholesterol.
5. Quitting tobacco can raise your level. Although the mechanism of the effect of smoking on cholesterol has not yet been studied.
6. Alcohol has a very interesting effect on cholesterol levels. Oddly enough, a small amount of natural red wine can raise the level of HDL in the blood and helps in the fight against atherosclerosis. But this does not apply to vodka and other drinks containing ethyl alcohol.

Even these simple measures allow you to increase the level of good cholesterol in the blood.

HDL levels decrease in pregnant women and also during menopause. Taking certain medications can also reduce it. Such declines must be responded to urgently.

If HDL is low, what does that mean? This means that the amount of cholesterol in the blood has increased because its removal has slowed down. You need to carefully monitor your diet and physical activity. If medication adjustments are required, the tablets should only be prescribed by a doctor.

A decrease in HDL-C concentration less than 0.9 mmol/l is associated with an increased risk of developing atherosclerosis. Epidemiological studies have shown inverse relationship between HDL-C concentrations and the prevalence of IHD. Determination of HDL-C helps to identify the risk of developing coronary artery disease. A decrease in HDL-C concentration for every 5 mg/dL, or 0.13 mmol/L, below the average leads to an increase in the risk of developing coronary artery disease by 25%.

An increased concentration of HDL-cholesterol is regarded as an antiatherogenic factor.

An HDL level is considered elevated if it is more than 80 mg/dL (>2.1 mmol/L).

Elevated HDL levels reduce cardiovascular risk; however, high HDL levels caused by certain primary genetic abnormalities may not protect against cardiovascular disease due to associated lipid and metabolic disorders.

The primary causes are single or multiple genetic mutations that result in overproduction or decreased excretion of HDL. Secondary causes of high HDL levels are chronic alcoholism resulting in cirrhosis of the liver, primary biliary cirrhosis, hyperthyroidism and the use of certain medicines(eg, glucocorticoids, insulin, phenytoin). In case of unexpected clinical findings high levels HDL in patients not taking lipid-lowering drugs should be promptly evaluated for diagnostics secondary causes development of this condition, with mandatory measurement of AST, ALT and TSH; a negative assessment of the result indicates possible primary reasons dyslipidemia.

Cholesteryl ester transfer protein (CTTP) deficiency is a rare autosomal recessive disorder. hereditary pathology caused by a mutation in the CETP gene. CETP facilitates the transfer of cholesteryl esters from HDL to other lipoproteins, and thus CETP deficiency leads to decreased LDL cholesterol and delayed elimination of HDL. Clinically, patients show no symptoms or signs of disease but have HDL levels >150 mg/dL. No reduction in cardiovascular risk was observed. No treatment required.

Familial hyperalphapipoproteinemia is an autosomal dominant hereditary condition caused by various unknown and known genetic mutations, including those that lead to hyperproduction of apolipoprotein A-l and apolipoprotein C type III. The pathology is usually detected incidentally when plasma HDL levels are >80 mg/dL. The patients do not have any other clinical symptoms or signs. No treatment required.

Currently, serum HDL-C concentrations below 0.91 mmol/L are considered an indicator of high risk of CAD, while levels above 1.56 mmol/L play a protective role. To determine treatment tactics, simultaneous assessment of serum concentrations of total cholesterol and HDL-C is important. If the patient's HDL-C concentration is reduced (less than 0.91 mmol/l) and total cholesterol is normal, the most effective measures for the prevention of CHD are: physical exercise, smoking cessation and weight loss. When total cholesterol concentrations increase and HDL-C levels decrease (less than 0.91 mmol/l), medical intervention programs should be aimed at reducing total cholesterol levels with special diets or, if necessary, with drug therapy.

Having determined the content of HDL-C in the blood, it is possible to calculate cholesterol ratio atherogenicity (K xc): K xc = (Total cholesterol-HDL-cholesterol) / HDL-cholesterol. Khc actually reflects the ratio of the content of atherogenic to antiatherogenic drugs in the blood. This coefficient is no more than 1 in newborns, in healthy men 20-30 years old it reaches 2.5, in healthy women of the same age - 2.2. In men 40-60 years old without clinical manifestations atherosclerosis K hc is from 3 to 3.5. In people with coronary artery disease it is more than 4, often reaching 5-6. It is noteworthy that Khc is relatively low in long-livers: in people over 90 years of age it does not exceed 3. Khc more accurately reflects the favorable and unfavorable combination of drugs in terms of the risk of developing coronary artery disease and atherosclerosis.

When analyzing the results of the study, it should be taken into account that an increase or decrease in HDL-C levels is possible in a number of diseases or conditions.

Diseases and conditions in which the concentration of HDL-C in the blood may change

However, using only HDL-C levels to assess the risk of atherosclerosis may provide potentially incorrect diagnostic information, so its values ​​should be assessed in comparison with the concentration of total cholesterol and LDL-C.