How to understand lipid profile results
This analysis is prescribed to check how fat metabolism works and whether there are any cardiovascular risks. Sometimes, as a result, it is recommended to change the lifestyle or start lifelong treatment. To understand why, due to high cholesterol, which does not bother a person and is “not visible on a plate”, you suddenly have to reconsider your habits, you need to figure out what this profile means.
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What it is
A lipid profile is a biochemical blood test that determines the content of cholesterol and its fractions in the blood. It is prescribed during a comprehensive examination, when they want to identify the risks of developing a heart attack or unstable angina, the so-called “pre-infarction state”, which leads to atherosclerosis.
Knowing the lipid profile, the doctor will set goals in the treatment of the patient, prescribe the necessary treatment and be able to control the result. The amount of treatment will depend on which fraction of cholesterol is elevated and the general condition of the patient. The problem with high cholesterol is that you can find out about it only by passing an analysis, there are no symptoms, the patient “does not hurt anything.”
Analysis of patient X. with hypertension, who submitted a lipid profile for the first time. He was put on a diet and rosuvastatin 10 mg/day
Why appoint
According to the medical scale SCORE, cholesterol is one of five indicators (as well as gender, age, smoking, blood glucose) that predicts the risk of an adverse cardiovascular event in the next ten years. Simply put, if cholesterol is elevated, then there is a greater risk that a person will have a heart attack or stroke. Gender and age cannot be changed, but cholesterol, smoking and blood glucose can be affected. To do this, the doctor prescribes a lifestyle change or medication, and the patient follows the recommendations.
“The lipid profile must be assessed,” says Natalya Polenova , Candidate of Medical Sciences, GMS Clinic cardiologist, “if the patient has a cardiovascular disease, arterial hypertension, if coronary heart disease is suspected, and also if there are risk factors: obesity, diabetes mellitus, early cardiovascular disease in parents. In addition, even an absolutely healthy and athletic person should know the level of cholesterol from the age of 20 and control it once every 3-5 years.
Cardiovascular risk assessment scales are modified over time in accordance with new data. For example, new scales have been developed for those who do not suffer from cardiovascular disease and diabetes at the time of the examination: SCORE 2, which predicts not only the risk of death, but also non-fatal cardiovascular events from 40 to 69 years; SCORE2-OP scale designed for patients aged 70–89 years. They do not take into account total cholesterol, but its specific fraction.
What does it include
“It is customary to divide cholesterol into “bad” and “good,” continues Natalya Polenova . – You can check the indicators for one or another parameter yourself. “Bad” cholesterol, low-density lipoprotein cholesterol (LDL-C), is responsible for the deposition of fat in the vessels, which ultimately leads to heart attacks and strokes – these are the main culprits of death worldwide, even in the era of the COVID pandemic. But the “good” cholesterol, high-density lipoprotein cholesterol (HDL cholesterol), ensures the transport of fatty particles from blood vessels to the liver, where they are safely processed. The more HDL cholesterol in the lipid profile, the better for the vessels.”
The standard lipid profile includes:
- total cholesterol, norm < 5.2 mmol/l
- HDL cholesterol, the norm in men > 1.0 and in women > 1.2 mmol / l
- LDL cholesterol, it is calculated by the formula or determined by a direct method, like other lipids. The rate is variable depending on the condition of the patient, for example, with a low cardiovascular risk, the rate is < 2.9 mmol / l
- triglycerides, norm < 1.7 mmol/l
“The perception of cholesterol levels will change depending on the patient,” says Yuri Meshcheryakov, family doctor, GMS Clinic internist. – For persons without vascular pathology (in primary prevention), acceptable cholesterol values \u200b\u200bmay correspond to risk scales: SCORE2, SCORE2-OP, ASCVD and others. If the patient has already had a stroke or heart attack, interventions for critical limb ischemia (in secondary prevention), then the norms will be extremely low.”
The extended lipid profile includes a lipoprotein protein (a, which indicates a hereditary form of cholesterol metabolism disorders. As well as apolipoprotein B and apolipoprotein A1, proteins that are involved in cholesterol transport in LDL and HDL. They are prescribed to more accurately assess the effect of treatment and risks , for example, if there is a clinic of cardiovascular disease, and cholesterol is normal.There are other additional indicators of lipid metabolism.
“The composition of the lipid panel may include lipoproteins of varying degrees of density with triglycerides (including the possibility of electrophoresis of lipid fractions). It all depends on the indications and the need in a particular clinical case, says Yuri Meshcheryakov. “Obviously, the depth of immersion in patients’ problems will be different for a primary care physician and a cardiologist or lipidologist.”
