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The causes of increase and decrease in low density lipoproteins
Last reviewed: 19.10.2021
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LDL-cholesterol more closely correlates with the risk of developing atherosclerosis and ischemic heart disease than the concentration of total cholesterol. Low risk is noted at the concentration of LDL-C, less than 3.37 mmol / l, moderate - at 3.37-4.27 mmol / l, high - at a value exceeding 4.27 mmol / l. LDL-XC can be determined by the calculation method according to the Friedwald formula: LDL-XC (mmol / L) = Total HD-HDL-XC-TG / 2.18. This method can not be used for triglyceride concentrations above 4.52 mmol / L and for patients with type III HLP.
Atherogenic cholesterol is primarily determined by its belonging to a particular class of LP. In this regard, especially should be allocated to LDL, which are the most atherogenic for a number of reasons.
LDL transport two-thirds of the total plasma cholesterol and the richest (the cholesterol content in them can reach 45-50%). Particle size (diameter 21-25 nm) allows LDL, along with HDL, to penetrate into the wall of the vessel through the endothelial barrier, but unlike HDL, which are easily removed from the wall, contributing to the elimination of excess lipids, LDL are retained in it, because they have selective affinity to glucosaminoglycans and smooth muscle cells. The latter is due to the presence of apo-B in the LDL, and on the surface of the cells the walls of the receptor receptor to the latter. Due to these reasons, LDL is the main transport form of cholesterol for the needs of vascular wall cells, and under pathological conditions - the source of its accumulation in the vessel wall. That is why in case of type II HLP, characterized by a high concentration of LDL-cholesterol, an early and severe atherosclerosis and coronary artery disease are often observed. The definition of LDL-cholesterol is very informative, and the deviation of this indicator from the norm can with a high degree of probability indicate what the danger with respect to the development of atherosclerosis and coronary artery disease.
Lipid parameters in adults and their relationship with the risk of developing diseases
|
Index |
Reference Values |
Boundary values of high-risk CHD |
High risk of ischemic heart disease |
High risk of pancreatitis |
|
Cholesterol, mmol / l |
<5.2 |
5.2-6.2 |
> 6.2 |
- |
|
LDL-C, mmol / L |
<3.4 |
3.4-4.1 |
> 4.1 |
- |
|
HDL-C, mmol / L |
> 1.6 |
- |
<0.9 |
- |
|
Triglycerides, mmol / l |
<2.3 |
2.3-4.5 |
> 4.5 |
> 11.3 |
|
Cholesterol / HDL-XC |
<5.0 |
5.0-6.0 |
> 6.0 |
- |