Cholesterolemia

The content of cholesterol (CS) in the blood can be elevated, normal or decreased. The term "cholesterolemia" can refer to both normal and elevated cholesterol levels, although it would be more appropriate to use the term "hypercholesterolemia". Accordingly, low cholesterol in the blood called hypocholesterolemia.

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

According to the ICD 10 - the universally recognized medical list of diseases - the increased content of cholesterol is assigned the code E 78.0, which relates this pathology to the diseases of the endocrine system and metabolism.

[1], [2], [3], [4], [5], [6], [7], [8]

Causes of cholesterolemia

Cholesterinemia does not in all cases signify a separate pathology. More often this term is characterized only by a sign of a possible development of the disease - the appearance in the blood of an excessive amount of lipids. Let's list the main causes of the appearance of cholesterolemia:

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

Among the diseases that can cause an increase in the level of cholesterol, we can note:

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

Also, risk factors that create favorable conditions for cholesterolemia in the body are announced:

• increased blood pressure;
• excessive body weight associated with excessive intake of food, improper diet or metabolic disorders;
• sedentary lifestyle;
• frequent stress;
• age after 60 years;
• features of nutrition, for example, frequent consumption of fried and fatty foods;
• regular intake of alcohol.

These factors can cause not only an increase in the number of lipids, but also cause serious diseases.

[9], [10], [11], [12], [13], [14], [15],

Cholesterolemia after cholecystectomy

Often you can hear the question: is it possible to raise the level of cholesterol after removing the gallbladder?

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

• First, it's overweight. The weight gain of each additional extra kilogram contributes to the biological process inside the body, which affects the metabolism to some extent.
• Secondly, it's food. The food we eat is able not only to deliver excess cholesterol into our body, but also to contribute to the increased production of its own cholesterol in the body.
• Thirdly, it is the abuse of carbohydrate foods (simple fast carbohydrates, for example, white wheat flour and sugar).

Removal of the gallbladder has little effect on the amount of lipids in the bloodstream, because cholesterol is successfully transformed and in the biliary tract of the liver.

[16], [17], [18], [19]

Symptoms of cholesterolemia

As a rule, cholesterolemia is detected using laboratory diagnostic methods (lipidogram). However, many experts consider this method of diagnosis to be of little informative, since the overall total lipid profile does not reflect the real picture, because the blood contains not just cholesterol, but high and low-density lipoproteins, as well as triglycerides. It is possible to suspect cholesterolemia if you divide the total cholesterol level into components and recalculate the effect that lipoproteins have on the vascular walls.

Only in neglected cases with persistent elevated cholesterol content in the bloodstream, one can observe external signs of pathology, according to which it is possible to judge the presence of cholesterolemia:

• the appearance of the lipoidal arch of the cornea (senile arch) at the age of up to sixty years - is the appearance on the cornea of rings of a gray hue;
• the appearance of xanthelasma - grayish-yellowish nodular formations under the surface epithelium of the eyelids;
• the appearance of xanthom - cholesterol formations located near the tendons, more 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 thing as "malignant cholesterolemia". This is a separate pathology, which refers to diseases caused by impaired functional production of proteins. The disease is due to the lack of a full-length receptor protein in the membrane cytoplasmic cell membrane, which recognizes the transport form of the protein transporting cholesterol molecules.

In patients with malignant course of cholesterolemia, the cholesterol required for cells can not enter the cells. Instead, it accumulates in large amounts in the bloodstream. There is a deposition of lipids on the vascular walls of the circulatory system, which inevitably leads to a narrowing of their lumen and the rapid emergence of hypertension in a relatively young age. A sharp progression of the disease can lead even to an early lethal outcome.

Diagnosis of cholesterolemia

The formulation of a competent and correct diagnosis is possible after the analysis determining the lipid spectrum, with a chrosterelic separation of cholesterol and with the calculation of the atherogenicity index.

To clarify the diagnosis, auxiliary types of research can be assigned:

• a complete assessment of the anamnestic data, which includes the detection of characteristic symptoms of the disease and a questioning of the patient about his well-being;
• the definition of hereditary predisposition, as well as the revision of pre-existing diseases;
• visual inspection, listening to respiratory movements and heart rhythm, measurement of blood pressure;
• a general study of blood and urine to exclude the possibility of an inflammatory process in the body;
• biochemistry of blood with an estimate of the amount of creatinine, glucose and urea;
• Lipidogram, by which the amount of lipoproteins is determined;
• immunological studies;
• a genetic study of the blood of the next of kin in order to detect genetic defects.

[20], [21], [22], [23], [24], [25], [26]

Treatment of cholesterolemia

Treatment of increased amounts of cholesterol may be conservative and non-medicamentous.

Without the use of drugs, the following treatment methods can be used:

• bringing the weight back to normal;
• dosed physical exercises according to an individually designed program;
• revision of the diet, the exclusion of fatty and fried foods, a decrease in daily calories, the appointment of a diet with increased consumption of fruits and vegetables;
• Exclusion of alcohol in any form;
• smoking restriction.

Conservative treatment involves the appointment of the following drugs:

• Statins are medicines that block the synthesis of enzymes that support the production of cholesterol by the body. Statins lower the level of lipids (including in hereditary cholesterolemia), reduce the risk of developing ischemia and angina. The most famous statin drugs are rosuvastatin, lovastatin, atorvastatin, fluvastatin, simvastatin.
• Lipid-lowering drugs: Ezetimibe and drugs based on it, inhibit the absorption of cholesterol in the intestinal cavity, blocking its entry into the blood with food.
• Sequestants of bile acids - Kolestyramin and Kolestipol - bind lipids in the intestines, inhibiting its assimilation and speeding up its excretion with feces.
• Fibrates - drugs based on fibroic acid, are able to lower the production of cholesterol in the liver. These medications include Taykolor, Lipantil, and Exilip.
• Omega-3-polyunsaturated fatty acids - alpha-linolenic acid, docosahexaenone and eicosapentaenoic acid, affect the level of triglycerides in the bloodstream.
• Biologically active additives - Omega Forte, Doppelherz Omega-3, Tyqveol, Lipoic acid, Sitoprene, help maintain a normal level of lipids.

Treatment with drugs can be prescribed only by a doctor, according to an individually selected scheme. Independent use of drugs is highly discouraged, since a reduced amount of cholesterol represents not less, or even more, a threat to the body than its elevated level.

Prevention of cholesterolemia

An important role in the prevention of high cholesterol is nutrition. General principles of changes in the diet suggest stabilization of metabolic processes in the body and normalization of the blood picture.

What are the main aspects of a proper diet?

• Low consumption of animal fats (but not their exception).
• Strong restriction of foods rich in lipids.
• Restriction of the use of sweets, fast carbohydrates, baking.
• Inclusion in the diet of complex carbohydrates and vegetable fiber.
• Limitation of salt intake up to 3 grams per day.
• The primary use of raw vegetable oil instead of butter and animal fat.

Completely excluded products such as liver (especially liver and brain), chicken yolk, fish caviar, crab and shrimp meat, hard and processed cheeses, fatty meat, alcohol.

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

The best products for stabilizing cholesterol are:

• Almond nut - rich in unsaturated fatty acids;
• orange juice - contains phytosterol;
• olive oil - a storehouse of antioxidants and monounsaturated fatty acids;
• asparagus - removes bile acids and cholesterol from the body;
• blueberries - normalizes the function of the liver;
• avocado - contains a large amount of monounsaturated fats;
• tomatoes - rich in lycopene, lowering the amount of lipids;
• beans - a source of useful soluble fiber;
• oatmeal - stabilizes the level of cholesterol.

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

Prognosis of cholesterolemia

If a high level of cholesterol is detected in the blood test (at a rate of less than 5.2 mmol / liter or 200 mg / dL), a complete lipid spectrum assay is recommended. If the predominance of low-density lipoproteins is proven, then in the future it is necessary to make adjustments to the diet and daily regimen.

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

Of the possible complications of cholesterolemia can be called the appearance of atherosclerotic plaques in the vessels (which, in turn, is fraught with a heart attack or stroke), vascular insufficiency and spasm of blood vessels.

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