Low density lipoproteins - LDL: what is it, the norm, how to lower the indicators. Lpvp lowered: what does it mean and what are the rates of the indicator

How does cholesterol work? As we have seen, an objective assessment of the role of cholesterol in life and metabolic processes occurring in our body every minute is such that without it the body simply cannot exist. But in this issue there is one more, no less

What is cholesterol? You need to know your enemy by sight, no matter how many hypostases he has. Therefore, let's take a closer look at the "harmful" fat plaques. And at the same time, we systematize all the knowledge accumulated by science at the time of writing the book about them, their role and purpose.

Cholesterol In short, it's fat. Cholesterol differs from fat in the usual sense (that is, fat) in that it is soluble in water. And for this, it binds to a protein. For the time it takes to transfer it from the intestines after absorption or from the liver after synthesis

Cholesterol The latest studies have shown that food cholesterol is not the main risk factor for atherosclerosis. In addition, its pronounced deficiency caused by appropriate nutrition and the use of drugs (statins, etc.) sharply increases the risk of developing

Cholesterol is believed to be extremely harmful to human health. Is this really so? No, this is a delusion, since it takes part in many important biochemical processes.

What is cholesterol?

This is a substance from the group of lipids that circulates in the bloodstream and is involved in the production of many hormones. It is produced in the liver and also comes from the foods we consume. In addition, it is used as building material for many cells, including the brain. It is needed for the metabolism of bile acids, which are involved in the absorption of fats.

It is its excess level in the blood, and not cholesterol itself as such, that causes the well-known health problems.

Consider harmful effect cholesterol on the body

At wrong ratio low and high density lipoproteins occur in the body pathological changes that provoke the development of atherosclerosis.

Lipoproteins accumulate on the intima of the vessels, deposited in the form of plaques. The longer they form, the denser they become.

The arteries affected by atherosclerotic plaques lose their elasticity, the lumen of the vessels gradually narrows, and the blood begins to circulate poorly. The result of this is the development of the cardio - vascular pathology.

It is also possible for a blood clot to separate from the vessel wall, which is fraught with serious consequences for human body for example, pulmonary embolism may develop, this is a very serious condition that requires urgent medical intervention otherwise, death is possible.

Cholesterol is of two types:

Low-density lipoprotein (LDL)

Their second name is "bad" lipoproteins, it is they who form the atherosclerotic plaque, and contribute to its development and growth.

High-density lipoprotein (HDL)

They are also called "good" lipoproteins, they do not in any way affect the formation of atherosclerotic plaque, on the contrary, to some extent they are able to lyse existing deposits on the intima of the vessels.

Hence, we can conclude that the less LDL in the body, the more chances a person has that such a formidable disease as atherosclerosis will not befall him.

To determine the level of lipoproteins in the human body, you need to know the total cholesterol, the amount of HDL, LDL and triglycerides. Thanks to biochemical analysis blood, these data can be easily found out.

In order for the human body to function normally, it needs to receive at least 2.5 grams of cholesterol daily. Moreover, two grams are synthesized on their own, and the remaining 0.5 we must receive with food. And this is very important, since it is involved in many biochemical processes.

What the doctors call bad cholesterol, in fact, is a product of the combination of vegetable fat with animal fat. As a result of this symbiosis, the human body produces LDL, the so-called "bad" lipoproteins, which are capable of forming "cholesterol accumulations".

If the cholesterol level is high, then they are prescribed pharmacological preparations helping to reduce it:

Statins;

Fibric acids, from which drugs such as clofibrate, fenofibrate, lopid, and others are prepared;

Bile acid-binding drugs include colestipol and cholestyramine.

This treatment is used when cholesterol levels are too high and lifestyle changes alone are not enough to bring them back to normal. But, it is worth remembering that prevention is better than any therapeutic measures.

Accordingly, the correct lifestyle and balanced diet help maintain its level in normal condition.

What substances and products need to be introduced into your diet, to keep cholesterol in the normal range?

Vitamin E;
Omega-3 fatty acids. Their main source is fish fat;
Green tea, due to the polyphenols it contains, normalizes lipid metabolism;
Garlic, it is able to thin the blood, due to alliin, which is included in its composition;
Soy protein;
Nicotinic acid or vitamin B3;
Folic acid;
Vitamin B12;
Vitamin B6.

Risk factors that lead to high cholesterol levels

Physical inactivity, or a sedentary lifestyle, leads to the accumulation of LDL in the blood;
Obesity;
Smoking;
Eating fatty foods in a large number;
Heredity.

Sports helps in the fight against high cholesterol, plus proper nutrition, fat should enter the body, in total, no more than thirty percent of the total calories consumed. Moreover, animal lipids should be only eight percent.

Principles to keep cholesterol level is normal:

Introduction to the diet of a large amount of soluble fiber, due to the use of oatmeal, apples, beans, peas and barley;
Eating foods containing lean protein, such as skinless chicken
Reducing the consumption of butter, cheese, cream;
To give up smoking;
Active lifestyle.

Conclusion

So, cholesterol is an important substance for our body, which is responsible for the implementation of a wide range of biochemical processes. Accordingly, in order for its content to be normal, you do not need to "go all out" and be zealous in absorbing fatty foods in large quantities. Remember - everything is good in moderation!

We will learn about the risks associated with low HDL cholesterol levels. We investigate the symptoms and causes of low cholesterol values ​​well, and we see how to return the values ​​to the level of the physiological diet.

What is HDL cholesterol

Low HDL levels are spoken of when concentration v peripheral blood turns out below 40 mg / dL for men and 50 mg / dL for women.

Seemingly, low level cholesterol can be interpreted as a symptom good health however, in the case of HDL, the opposite is true.

Why Low Good Cholesterol Values ​​Are Bad

Surely You Know That High Cholesterol Levels Are Enemies To Health of cardio-vascular system... But this axiom does not apply to all types of cholesterol. In fact, in the case of HDL, the higher the concentration, the lower the risk of developing atherosclerotic changes and, as a result, heart disease.

Cholesterol is essential component proper functioning of the body (component of cell membranes, precursor important hormones, for example, steroid). To move freely with the bloodstream, cholesterol is packed into special proteins that increase its solubility.

High HDL values ​​not only prevent plaque deposition by inhibiting LDL oxidation, but also help remove existing plaque by preventing monocyte adhesion to the vessel wall and, as a result, prevent possible obstruction of blood vessels.

Optimal levels HDL concentration are:

• Men: 60 mg / dL or more
• Women: 60 mg / dL or more

What are the symptoms of a decrease in HDL

A decrease in HDL values ​​occurs asymptomatic and few people notice it, only with the usual periodic medical supervision.

Symptoms occur when health has already been damaged and diseases develop.

Reasons for lowering cholesterol values

But what are the reasons that can lead to decrease in HDL values?

There are many of them, and they are not always associated with diseases:

• Pregnancy and menopause are the most common causes of physiological lowering of HDL cholesterol values. The reason is to be found in hormonal changes... Recent studies have shown that a noticeable decrease in cholesterol is observed within two years after pregnancy.
• During menopause lowering cholesterol is associated with a lack of estrogen, which regulates cholesterol synthesis.
• Birth control pills can reduce the level of HDL cholesterol, as they contain a progestin, which leads to an increase in the level of LDL cholesterol, thus increasing the value of total cholesterol.
• Improper nutrition: rich in fatty foods and poor content vegetables, fiber and monounsaturated fats, which leads to an increase in the proportion of LDL cholesterol and a decrease in the proportion of HDL.
• Wrong behavior: sedentary image life leads to an increase in the level of "bad" cholesterol and reduces the "good".
• Smoking The mechanism that links smoking to HDL cholesterol is not entirely clear, but quitting smoking has been shown to significantly increase good cholesterol.
• Obesity: in obesity, an excess of triglycerides occurs, which leads to an increase in the concentration of very low density lipoproteins and a number of changes in the cholesterol chain: high density lipoproteins become smaller and lose their atherogenic functions.

Diseases leading to a decrease in the level of good cholesterol:

• celiac disease or food allergy lower cholesterol because the body does not absorb food and therefore does not get HDL from the diet.
• hypothyroidism and liver disease such as hepatitis and cirrhosis of the liver; excess hormones thyroid gland leads to an increase in metabolism.
• Medications such as beta blockers, diuretics, interferon, or statins used to lower cholesterol.

Risks of low HDL levels

Considering protective function HDL against arteries, low HDL cholesterol, exposes the body high risk cardiovascular disease.

When HDL cholesterol levels fall well below optimal levels, the total cholesterol ratio is above 5, then damage to the arteries can lead to:

• Atherosclerosis: fatty deposits in the arteries that reduce blood flow.
• Stroke: obstruction or rupture of an artery in the brain, which leads to the death of brain tissue.
• Heart attack: Reduction or cessation of blood flow, which leads to the death of the heart muscle.
• Cardiac ischemia: complete or partial stop of the flow of blood to the heart.

What to do to increase your HDL levels

Quit smoking... Quitting smoking leads to an increase in HDL levels by about 10%. Especially if you add to this physical activity(at least 5 days a week for 30 minutes): Swimming, cycling, running, brisk walking, gardening, anything that increases your heart rate.

Lose overweight ... Losing 3 kg increases your HDL cholesterol level by 1 mg / dl blood.

Follow the rules rational nutrition ... The basis of such a diet should be the consumption of healthy fats. In particular, monounsaturated and polyunsaturated, in the latter case it is omega 3, found in fruits with a hard shell and oily fish.

Drinking one or two glasses of red wine a day... Not everyone agrees with this recommendation, but wine certainly helps maintain high values HDL. Perhaps this is the reason that explains the French paradox. The French, being active consumers of saturated fat ( butter, fatty meat) have a low prevalence of cardiovascular disease.

Taking drugs that increase HDL cholesterol the most common is niacin. There are also additives based on this ingredient. It should not be used without the advice of a doctor, because side effects on liver function.

Diet to increase cholesterol values

To reduce the risk of cardiovascular disease, you need to eat foods that help raise HDL cholesterol and lower LDL cholesterol.

In particular:

• Fishes rich in omega-3s (fats) such as salmon or swordfish.
• Cereals especially whole grains such as bread and pasta.
• Non-greasy boiled sausage or low fat ham.
• Low fat cheese such as mozzarella, ricotta, goat cheese.
• Milk and yoghurt.
• Lean meat such as turkey, chicken and rabbit.
• Dried fruits such as hazelnuts, walnuts and almonds because they contain omega-3s.
• Antioxidant-rich foods such as vitamin C, which is abundant in kiwi, broccoli, oranges and lemons.
• Some legumes, such as the soya beans which contain phytoestrogens, substances that can mimic the effects of estrogen and lower cholesterol levels.

A diet that can help you keep your bad cholesterol low - vegetarian diet because it eliminates the consumption of animal fats and involves the consumption of large amounts of fruits and vegetables rich in vegetable fats containing sterols, which have a structure similar to cholesterol and stimulate the reduction of total cholesterol.

Cholesterol is one of essential substances for any living creature belonging to the animal kingdom. This fatty monohydric alcohol is one of the natural intermediate products of metabolic processes.

At the same time, it is cholesterol that is considered one of the "culprits" of atherosclerosis and some other diseases. After the discovery of the role of this substance in pathophysiological processes, cardiologists, nutritionists, and doctors of some other specialties took up arms against it. In fact, everything is not so simple and unambiguous, the problem is not in cholesterol, as such, but in its quantity and the body's ability to absorb this substance properly.

The body provides about 80% of the need for this substance on its own, cholesterol is synthesized in the liver. The rest of the body gets from food of animal origin. It enters the bloodstream in the form of complex complex compounds and is included in a number of processes, in particular:

• Cell growth and reproduction, as one of the components of cell membranes and intracellular structures;
• Synthesis of hormones;
• Transport of substances from antioxidant activity and fat-soluble vitamins;
• Synthesis of bile acids.

What is "bad" and "good" cholesterol

Cholesterol is insoluble in water, therefore, for transportation to target organs, it forms complex lipoprotein complexes. The complex has a spherical shape and consists of esters of cholesterol and triglycerides, coated with a shell of protein molecules.

There are several types of lipoprotein complexes in the blood, differing in composition and other physical and chemical properties... One of the key characteristics of the lipoprotein complex is density. On this basis, the complexes are just subdivided into "bad" and "good" cholesterol.

Low-density lipoprotein complexes are abbreviated as LDL and are conventionally called "bad" cholesterol. High density lipoproteins, or HDL, are called "good".

In fact, LDL and HDL cholesterol are vital to keep the body functioning.

"Bad" cholesterol

As part of LDL, this compound comes from the liver to target organs, where it is included in the synthesis processes. LDL is a precursor to many hormones, including sex hormones. The body's need for readily available cholesterol is higher, so LDL accounts for over 60% of all cholesterol present in the blood. The content of cholesterol derivatives in them reaches 50%. When moving in the bloodstream, loose complexes can be damaged and cholesterol esters, which are outside the protein membrane, settle on the walls of blood vessels.

With an excessive intake of LDL into the blood, the cells do not have time to assimilate it completely and the process of formation of deposits on the walls of blood vessels is accelerated. Atherosclerotic plaques are formed. The narrowing of the vascular lumen over time manifests itself in vascular insufficiency, ischemia in the affected area. With the destruction of the plaque, it is possible to completely overlap the lumen of the vessel - thrombosis or thromboembolism.

"Good" cholesterol

High-density cholesterol complexes, HDL, are popularly called "good". These compounds carry cholesterol to the liver, where it is used to synthesize bile acids and excreted from the body. The cholesterol content in the complexes is up to 30%. In people with normal levels of this fraction of lipids in the blood, the risk of myocardial infarction is reduced to almost zero. When moving along the bloodstream, HDLs capture excess cholesterol from the walls, according to some reports, even from the formed plaques. If HDL cholesterol is lowered, the body cannot cope with cleansing the walls of blood vessels, cholesterol continues to accumulate and atherosclerosis develops.

At the same time, it should be understood that the names "bad" and "good" cholesterol are more than arbitrary. What is HDL cholesterol? In fact, it is one of the final stages of lipid metabolism, "construction waste", which must do good service to the body before being disposed of. Replacing all the "bad" cholesterol with good cholesterol is both impossible and unsafe. The main thing is not so much the absolute indicators of the content of LDL and HDL cholesterol, but their balance.

The rate of cholesterol in the blood

"Bad" and "good" cholesterol - compounds are not interchangeable, they must be present in the body always, simultaneously and in a certain ratio. A deviation from the norm in the direction of increasing or decreasing the content of any of the cholesterol fractions or any of its fractions indicates the presence serious problems in the body or the potential threat of their occurrence in the foreseeable future.

Indicative norms for cholesterol content:

• Total - less than 5.2 mmol / L
• Triglycerides - no more than 2 mmol / l;
• LDL - up to 3.5 mmol / l
• HDL - more than 1.0 mmol / l

The concept of a norm is rather arbitrary. Cholesterol level depends on gender, age, presence of endocrine and other chronic disease, hereditary features of lipid metabolism. This indicator is influenced by stress, physiological changes seasonal in nature. The individual norm may differ slightly from the average values; in the presence of certain diseases and other risk factors, the cholesterol level should be controlled more stringently.

The attending physician will tell you about the individual rate and permissible limits for each patient. He will give advice on how to effectively lower cholesterol levels and, if necessary, prescribe treatment.

How to normalize cholesterol

First of all, doctors recommend adhering to special diet... Products containing trans fats are excluded from the diet, the consumption of animal fats and sweets is limited. It is better to replace fatty meat with fatty sea fish, which contains omega-3 and omega-6 polyunsaturated fatty acids.

If necessary, the doctor will prescribe drug treatment... The course of treatment includes:

• Statins;
• Bile acid binders;
• Fibric acids;
• B vitamins, vitamin E, omega-3 fatty acids, folic acid.

Not everyone knows how dangerous the condition is, when the LDL level is elevated, what it means and how to cure the pathology. Cholesterol is present in the blood. It is a lipid that plays an important role in metabolic processes. It has structural, digestive and hormonal functions. In the human body, cholesterol is bound to proteins. These compounds are called lipoproteins. An increase in LDL content is the main reason atherosclerosis.

Distinguish between useful and bad cholesterol... The latter is represented by low and very low density lipoproteins. Elevated level of these compounds indicates a metabolic disorder. This leads to the development of systemic atherosclerosis. This state is a risk factor for other diseases (coronary artery disease, hypertension).

Normally, the concentration of low-density lipoproteins in men ranges from 2.02-4.79 mmol / l, and in women - 1.92-4.51 mmol / l. An LDL content of less than 3.9 mmol / L is normal. The amount of total cholesterol in a healthy person ranges from 3.6 to 7 mmol / L. The most optimal content of this lipid is less than 5 mmol / l. This indicator reflects the state of metabolism.

The concentration of total cholesterol is maintained by food and the synthesis of this substance in the body. is the most atherogenic. This means that it negatively affects blood vessels and leads to the appearance of atherosclerotic plaques. Arteries are predominantly affected. The higher the LDL concentration, the greater the risk of developing coronary artery disease.

Important etiological factors

If low density lipoproteins are elevated, then the reasons are: metabolic disorders, unhealthy diet or hereditary (genetic) predisposition. There are several groups of dyslipidemias. Each of them is characterized by an increase in the level of certain fats. If the concentration of LDL in the blood is increased, then the cause may be hereditary hypercholesterolemia (type 2a dyslipidemia).

It is due to both external and internal factors... Type 2b dyslipidemia is common. Its difference is that LDL and VLDL are increased. 4 type of dyslipidemia is characterized by high content in the bloodstream only low density lipoproteins. Distinguish between primary and secondary form this pathology.

The main risk factors are:

• inherited genes responsible for the formation of cholesterol;
• endocrine diseases (hypothyroidism, diabetes mellitus);
• stagnation of bile;
• liver disease;
• cholelithiasis;
• long-term or uncontrolled use of drugs (diuretics, immunosuppressants);
• wrong lifestyle;
• excess in the diet of fatty foods.

High cholesterol and LDL cholesterol is more common in people who smoke, abuse alcohol, are more stressed and have little exercise. An increased level of fat is a consequence of dietary inaccuracies. LDL is elevated in people who consistently consume foods rich in animal fats.

Plant lipids contained in olive oil, nuts and other products are useful.

Animal fats are found in large quantities in eggs, mayonnaise, pork, beef, lamb, offal, sour cream, liver, sausage. These foods should not be eaten daily. Such a diet contributes not only to an increase in LDL, but also to a decrease in healthy fats (HDL). The fatal risk factors for the development of dyslipidemia and atherosclerosis include: male gender, elderly age, burdened family history ( cases of ischemic heart disease from relatives). Alimentary obesity, etc., negatively affect the metabolism.

Clinical manifestations of dyslipidemia

If LDL cholesterol is elevated, symptoms may not be present. This is a laboratory sign. If blood cholesterol is significantly higher normal performance, then the following symptoms are possible:

• the appearance of xanthomas on the body;
• deposition of fat in the eye area;
• overweight.

With hyperlipoproteinemia, the first signs appear most often after 30 years. Xanthomas are a typical sign of a violation of fat metabolism. They are localized in the tendon area. Feet or hands may be affected. V severe cases periorbital xanthelasms are formed. These are small formations of a round shape and yellow color.

In some patients, on examination, a change in the cornea is found. A white or yellowish rim may appear. If this symptom originated in young age(up to 50 years), this indicates hereditary dyslipidemia. High cholesterol in the blood may indicate the appearance of atherosclerotic plaques.

Atherosclerosis as a consequence of dyslipidemia

Elevated cholesterol is a sign of atherosclerosis. With this disease on inner surface arteries (endothelium) are deposited low density lipoproteins. Over time, this ailment leads to the formation of plaques. Over the years, the lumen of the vessels decreases, which contributes to the violation of the blood supply to the organs.

There are 3 phases of atherosclerosis development. At stage 1, cholesterol in the blood is deposited on the walls of blood vessels. This most often occurs in the area of ​​the forks. Complexes are formed, which include proteins and cholesterol. Lipid spots are formed. They are very small but grow larger over time.

Stage 2 is called liposclerosis. During this period, connective tissue... Blood clots often form. Calcification develops at 3 stages. The plaque hardens and narrows the arteries. With atherosclerosis against the background of an increase in the level of LDL cholesterol, the following symptoms are possible:

• chest pain;
• dizziness;
• high blood pressure;
• abdominal pain;
• violation of the stool;
• lameness;
• violation of sensitivity;
• difficulty breathing;
• dyspnea.

High blood cholesterol may mean that a person has coronary heart disease. This diagnosis confirmed by instrumental studies and functional tests.

Patient examination plan

You need to know not only the reasons for the increase in LDL, but also the methods of researching patients. Before lowering cholesterol, you need to:

• general blood analysis;
• biochemical research;
• lipid profile;
• electrocardiography;
• arteriography.

The Friedwald formula is used to calculate the lipoprotein content. Cholesterol, HDL, and triglyceride values ​​are used. Reduced level high density lipoprotein also indicates pathology. Normal values depend on the person's age. In children, this indicator is always lower. On the early stages no complaints.

If symptoms occur from the organs, then a comprehensive examination is required.

The reasons may lie in the blockage of the arteries. In this case, instrumental research is organized.

How to normalize lipid composition

If untreated, the concentration of LDL cholesterol may rise. To reduce the content of atherogenic lipoproteins in the blood, it is necessary:

• follow a strict diet;
• give up smoking and alcohol;
• accept medications(statins);
• dose physical activity;
• move more;
• take vitamins and dietary supplements.

Most effective drugs are statins. This group includes: Atherostat, Simvor, Mevakor, Liprimar, Torvakard, Atoris, etc. The main active ingredients they are: atorvastatin, lovastatin and simvastatin. These medications are able to reduce the level of atherogenic lipoproteins by decreasing their production in the body.

It is recommended to take them at night, since cholesterol synthesis increases during this period. It is possible to lower the level of lipids in the body with the help of fibrates, derivatives nicotinic acid and sequestrates fatty acids... When treating, it is important to eliminate the causes of the violation of fat metabolism. There are drugs that can increase the level of beneficial (antiatherogenic) lipoproteins.

Additionally, Omega-3 polyunsaturated acids may be prescribed. Reducing LDL is possible by extracorporeal methods. Used: hemosorption, plasma filtration and immunosorption. Not everyone knows how to lower cholesterol in the body.

At hereditary form dyslipidemia, genetic engineering methods are effective.

In the case of developed atherosclerosis and symptoms of circulatory disorders, it may be necessary radical methods treatment (shunting, stenting, endarterectomy). With proper treatment, the concentration of cholesterol and LDL decreases. An important aspect of therapy is the normalization of a person's weight.

Compliance with a cholesterol diet

Poor lifestyle and poor nutrition are the main reasons for an increase in LDL and VLDL levels. Diet is the main treatment for lowering fat in the body. When beta-cholesterol in the form of LDL is raised, the following recommendations must be adhered to:

• exclude from the diet foods rich in animal fats (meat, butter, sour cream, fatty cottage cheese, mayonnaise, bacon);
• take food 4-6 times a day in small portions;
• drink more fluids;
• enrich the diet with herbs, sea fish, mussels, squid, shrimp, vegetables and fruits;
• have a full breakfast;
• reduce salt intake;
• steam or boil food;
• do not eat dry food.

With obesity, you need to eat 5-6 times a day, but little by little. If LDL (cholesterol) is elevated, but body weight is normal, then four meals a day are observed. With hyperlipoproteinemia, alcohol should not be consumed. You can eat vegetables, fruits, low-fat cottage cheese, kefir, light cheese, sea ​​fish, olive or vegetable oil, soup, walnuts, almonds, lean meat (chicken, rabbit), ice cream, jelly.

It is recommended to give up sweets and pastries. Need to drink mineral water, jelly and unsweetened tea. Proper nutrition- the main method that increases the proportion of beneficial high-density lipoproteins in the blood. You need to stick to the diet for life. If this is not done, then it is possible highest level LDL. Thus, the work of the whole organism depends on the lipid composition of the blood. The higher the content of LDL, VLDL and triglycerides, the worse.

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