Cholesterolemia

The cholesterol (CH) content in the blood can be elevated, normal or reduced. The term "cholesterolemia" can refer to both normal and elevated cholesterol levels, although in the case of elevated levels it would be more correct to use the term "hypercholesterolemia". Accordingly, reduced cholesterol content in the blood is called hypocholesterolemia.

Today we will look at the increased content of lipids in the bloodstream, which can be observed in diseases of the gallbladder, kidneys, atherosclerosis and metabolic disorders.

According to ICD 10, a generally recognized medical list of diseases, elevated cholesterol levels are assigned code E 78.0, which classifies this pathology as a disease of the endocrine system and metabolism.

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Causes of cholesterolemia

Cholesterolemia does not always mean a separate pathology. More often, this term is used to characterize only a sign of possible disease development – the appearance of excess lipids in the blood. Let us list the main causes of cholesterolemia:

• hereditary predisposition (homozygous type of familial disease);
• metabolic and metabolic disorders;
• unhealthy diet, unhealthy lifestyle.

Among the diseases that can provoke an increase in cholesterol levels, one can note:

• diabetes mellitus;
• liver and kidney diseases;
• thyroid disease;
• long-term treatment with certain medications.

Risk factors that create favorable conditions for cholesterolemia in the body are also mentioned:

• increased blood pressure;
• excess body weight associated with excess food intake, poor nutrition or metabolic disorders;
• sedentary lifestyle;
• frequent stress;
• age after 60 years;
• dietary habits, such as frequent consumption of fried and fatty foods;
• regular alcohol consumption.

The listed factors can not only cause an increase in the amount of lipids, but also cause serious diseases.

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Cholesterolemia after cholecystectomy

One often hears the question: is it possible for cholesterol levels to increase after gallbladder removal?

To answer this question, let's go back to the reasons for elevated lipid levels.

• Firstly, it is excess weight. Each additional kilogram of weight gain contributes to the disruption of the biological process within the body, which to one degree or another affects metabolism.
• Secondly, it is nutrition. The food we eat can not only supply our body with excess cholesterol, but also contribute to the increased production of our own cholesterol in the body.
• Thirdly, it is the abuse of carbohydrate foods (meaning simple fast carbohydrates, such as white wheat flour and sugar).

Removal of the gallbladder has little effect on the amount of lipids in the bloodstream, since cholesterol is successfully transformed in the bile ducts of the liver.

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Symptoms of Cholesterolemia

As a rule, cholesterolemia is detected using laboratory diagnostic methods (lipidogram). However, many specialists consider this diagnostic method to be uninformative, since the resulting general lipid level indicator does not reflect the real picture, because the blood contains not just cholesterol, but high- and low-density lipoproteins, as well as triglycerides. You can suspect cholesterolemia if you divide the total cholesterol level into components and recalculate what effect lipoproteins have on the vascular walls.

Only in advanced cases with persistently elevated cholesterol levels in the bloodstream can external signs of pathology be observed, by which one can judge the presence of cholesterolemia:

• the appearance of a lipoid arcus of the cornea (senile arcus) before the age of sixty years - is the appearance of gray rings on the cornea;
• the appearance of xanthelasma - grayish-yellowish nodular formations under the superficial epithelium of the eyelids;
• the appearance of xanthomas – cholesterol formations located near tendons, most often on the surface of the skin above the knee and elbow joints.

The main clinical manifestations appear only as a result of the progression of the disease in the absence of proper treatment.

There is also such a concept as "malignant cholesterolemia". This is a separate pathology that refers to diseases caused by impaired functional production of proteins. The disease is explained by the absence in the membrane cytoplasmic cell membrane of a full-fledged receptor protein that recognizes the transport form of the protein that transports cholesterol molecules.

In patients with malignant cholesterolemia, the cholesterol necessary for cells cannot enter the cells. Instead, it accumulates in large quantities in the bloodstream. Lipids are deposited on the vascular walls of the circulatory system, which inevitably leads to narrowing of their lumen and the rapid development of hypertension at a relatively young age. Rapid progression of the disease can even lead to early death.

Diagnosis of cholesterolemia

A competent and correct diagnosis can be made after an analysis that determines the lipid spectrum, with fractional separation of cholesterol and calculation of the atherogenicity index.

To clarify the diagnosis, additional types of research may be prescribed:

• a complete assessment of the anamnestic data, which includes the detection of characteristic symptoms of the disease and questioning the patient about his well-being;
• determination of hereditary predisposition, as well as revision of previously existing diseases;
• visual examination, listening to respiratory movements and heart rate, measuring blood pressure;
• general blood and urine tests to rule out the possibility of an inflammatory process in the body;
• blood biochemistry with assessment of creatinine, glucose and urea levels;
• lipidogram, which determines the amount of lipoproteins;
• immunological studies;
• genetic testing of the blood of close relatives to detect genetic defects.

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Treatment of cholesterolemia

Treatment of elevated cholesterol levels can be conservative and non-drug.

The following treatment methods can be used without the use of drugs:

• bringing weight back to normal;
• measured physical activity according to an individually designed program;
• revision of the diet, elimination of fatty and fried foods, reduction of daily caloric intake, prescription of a diet with increased consumption of fruits and vegetables;
• exclusion of alcohol consumption in any form;
• smoking restrictions.

Conservative treatment involves the administration of the following medications:

• Statins are drugs that block the synthesis of enzymes that support the body's production of cholesterol. Statins lower lipid levels (including in hereditary cholesterolemia), and reduce the risk of developing ischemia and angina. The most well-known statin drugs are: Rosuvastatin, Lovastatin, Atorvastatin, Fluvastatin, Simvastatin.
• Hypolipidemic drugs: Ezetimibe and products based on it inhibit the absorption of cholesterol in the intestinal cavity, blocking its entry into the blood with food.
• Bile acid sequestrants - Cholestyramine and Colestipol - bind lipids in the intestine, inhibiting its absorption and accelerating its excretion in feces.
• Fibrates are drugs based on fibric acid, capable of reducing cholesterol production in the liver. Such drugs include Tycolor, Lipantil, Exlip.
• Omega-3 polyunsaturated fatty acids – alpha-linolenic acid, docosahexaenoic acid and eicosapentaenoic acid, affect the level of triglycerides in the bloodstream.
• Biologically active supplements – Omega Forte, Doppelherz Omega-3, Tykveol, Lipoic acid, Sitopren, help maintain normal lipid levels.

Treatment with drugs can only be prescribed by a doctor, according to an individually selected scheme. Independent use of drugs is highly discouraged, because a reduced amount of cholesterol is no less, and even more dangerous for the body than its increased level.

Prevention of cholesterolemia

Nutrition is of no small importance in preventing high cholesterol. General principles of dietary changes involve stabilizing metabolic processes in the body and normalizing the blood picture.

What are the main aspects of a healthy diet?

• Reduced consumption of animal fats (but not their exclusion).
• Severe restriction of lipid-rich foods.
• Limit consumption of sweets, fast carbohydrates, and baked goods.
• Including complex carbohydrates and plant fiber in your diet.
• Limit salt intake to 3 grams per day.
• Preferential use of raw vegetable oil instead of butter and animal fat.

Completely excluded are products such as offal (especially liver and brains), chicken yolk, fish roe, crab and shrimp meat, hard and processed cheeses, fatty meats, and alcohol.

The main part of the diet should be bran, cereals and porridges, vegetables and fruits, fish. Dishes are cooked in a steamer, boiled, stewed or baked.

The best products for stabilizing cholesterol are:

• almonds - rich in unsaturated fatty acids;
• orange juice – contains phytosterol;
• olive oil is a storehouse of antioxidants and monounsaturated fatty acids;
• asparagus – removes bile acids and cholesterol from the body;
• blueberry – normalizes liver function;
• avocado – contains a large amount of monounsaturated fats;
• Tomatoes are rich in lycopene, which reduces the amount of lipids;
• beans are a source of healthy soluble fiber;
• oatmeal – stabilizes cholesterol levels.

It is also important to monitor your weight, lead a physically active lifestyle, and avoid stress and bad habits.

Prognosis of cholesterolemia

If a blood test reveals a high cholesterol level (with the norm being less than 5.2 mmol/liter, or up to 200 mg/dl), then a full lipid spectrum analysis is recommended. If the prevalence of low-density lipoproteins is proven, then further adjustments should be made to the diet and daily routine.

The prognosis of the disease can depend only on timely measures and the patient's desire to change their health for the better. A competent approach, physical activity, a healthy lifestyle and proper nutrition are the main conditions for stabilizing lipids in the bloodstream.

Possible complications of cholesterolemia include the appearance of atherosclerotic plaques in the vessels (which, in turn, can lead to heart attack or stroke), vascular insufficiency, and vascular spasm.

Stable cholesterolemia is a relatively unfavorable condition of the body. However, self-treatment is unacceptable, since strict control of the cholesterol level in the blood is necessary against the background of the therapy. Remember: low cholesterol is no less dangerous than its high level.