FAT METABOLISM (CHOLESTEROL, TRIGLYCERIDES, LIPOPROTEIN A)

LDL cholesterol | Triglycerides | Lipoprotein | PDF Fat metabolism (cholesterol)

People in different regions of the world have different concentrations of blood lipids. These differences are partly due to nutrition. A diet high in fat causes higher average cholesterol concentrations in the blood. However, a large proportion of the differences in cholesterol concentrations in our population are also genetically determined. Twin studies have shown that one third of the cholesterol concentration measurable in the blood is food-related. Two thirds of cholesterol is produced by the body itself and cannot be influenced by changes in diet.

Cholesterol is a substance produced naturally in the body and is primarily produced in the liver. We need cholesterol e.g. B. for the production of bile acids, hormones and cell structure. However, there are various diseases that can lead to an increase in cholesterol in the blood. This increases our risk of developing atherosclerosis (deposits in the vessels) at an early stage, which in turn can lead to cardiovascular diseases such as heart attacks and strokes.

If several people in the family suffered from coronary heart disease at an early age or even died (heart attack or stroke), all family members, including children, should be examined to see whether they have a lipid metabolism disorder.

LDL cholesterol

In the blood, we divide cholesterol into two main components. We then speak of the so-called bad LDL cholesterol (low-density lipoprotein) and the good HDL cholesterol (high-density lipoprotein). LDL carries cholesterol from the liver to all cells in the body, but also to the wall of the arteries, where it can be deposited. HDL, on the other hand, brings the cholesterol from the body's cells back to the liver and can also absorb the LDL deposited in the vessel walls. In this respect it has a protective function.

For this reason, it is not enough to just know the value for total cholesterol, which should not be more than 200 mg/dl (5,6 mmol/l). The target value for LDL cholesterol is determined individually. As a rule of thumb, however, you can remember the following: If you have no or only one risk factor, you should aim for an LDL of less than 150 mg/dl (3,9 mmol/l). If there are two or more risk factors, the LDL should not be more than 135 mg/dl (3,5 mmol/l). However, if atherosclerosis or even heart disease has already occurred, then an LDL of less than 100 mg/dl (2,6 mmol/l) should be aimed for. This target value also applies to diabetics.

To Lowering LDL cholesterol The diet must first be changed. A consultation with a nutritionist can therefore be very useful in some cases. This alone can reduce LDL cholesterol by ten to 20 percent. In the case of the inherited form, however, this measure is often not sufficient and medication must be administered. In order to have a positive influence on the “good” HDL cholesterol, you should exercise a lot and regularly. Endurance sports such as jogging, swimming and cycling are best.

Triglycerides

Most people only talk about cholesterol. However, there are other blood fats that can pose a risk for cardiovascular disease. These primarily include triglycerides. Triglycerides are the visible white fat we all know and are needed by muscles for energy. Triglycerides should not be higher than 180 mg/dl on an empty stomach. Since food contains a lot of triglycerides, this leads to an increase of about twice as much 3-6 hours after eating. You can therefore also imagine that triglycerides can fluctuate significantly from day to day. But triglycerides in the blood can increase not only through high-fat foods. All sweet things (sugar, chocolate) and alcoholic drinks that contain a lot of carbohydrates also lead to increased values. This is because the body can produce triglycerides from carbohydrates.

Since triglycerides are highly dependent on food, a low-fat and high-fiber mixed diet is the top priority to reduce blood lipid levels. Quickly metabolized carbohydrates and alcohol should be largely avoided. If this measure is not sufficient, administering medication may make sense.

lipoprotein(a)

The lipoprotein(a), also short Lp(a) called, is a blood fat similar to LDL cholesterol, whose physiological role is not known. However, Lp(a) plays a major role in the development of atherosclerosis. We know from research that Lp(a) is a leading risk factor for the development and progression of coronary heart disease. However, unlike cholesterol, it cannot be influenced by changes in diet or medication. The level of Lp(a) in the blood is innate and remains relatively constant until old age.

People who suffer from coronary heart disease or have relatives who have developed cardiovascular disease prematurely should have their lipoprotein(a) tested. Since blood levels fluctuate only slightly, a single laboratory determination is generally sufficient. Repeat measurements are not necessary. Normally a value below 30 mg/dl is considered normal, although this can vary from laboratory to laboratory.

As one Direct influence on Lp(a) is not possible is, all other risk factors should be well treated. The target value for LDL cholesterol should be a maximum level of 115 mg/dl.