low-density lipoprotein cholesterol


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Related to low-density lipoprotein cholesterol: LDL-C

cholesterol

(ko-les'te-rol?) [ chole- + sterol]
C27H45OH, a monohydric alcohol; a sterol widely distributed in animal tissues and occurring in egg yolks, various oils, fats, myelin in brain, spinal cord and axons, liver, kidneys, and adrenal glands. It is synthesized in the liver and is a normal constituent of bile. It is the principal constituent of most gallstones and of atherosclerotic plaques found in arteries. It is important in metabolism, serving as a precursor to various steroid hormones (e.g., sex hormones, adrenal corticoids).

An elevated blood level of cholesterol increases a person's risks of developing coronary heart disease (CHD). Lowering elevated total blood cholesterol levels and the levels of low-density lipoprotein cholesterol reduces the risk of heart attacks both in persons with a prior history of coronary disease and in asymptomatic individuals. Risk categories and recommended actions are included in the accompanying table. See: table

Cholesterol levels may be decreased by eating a diet that is low in cholesterol and fat and high in fiber; exercising regularly; and taking medications. Drugs used to control cholesterol levels include lovastatin (and other statins); niacin; and bile-acid resins, e.g., cholestyramine.

high-density lipoprotein cholesterol

See: high-density lipoprotein under lipoprotein.

low-density lipoprotein cholesterol

See: low-density lipoprotein under lipoprotein.

non-HDL cholesterol

The total cholesterol minus the HDL cholesterol. It is a risk factor, independent of other cholesterol measurements, for atherosclerotic vascular disease, esp. in patients with diabetes mellitus, triglyceride levels > 200 mg/dL, or people with the metabolic syndrome.

total cholesterol

The sum of low- and high-density lipoproteins.
*N/A = not applicable. SOURCE: http://www.nhlbi.nih.gov/guidelines/cholesterol/atp3full.pdf, from the Third Report of the Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III); National Cholesterol Education Program; National Heart, Lung, and Blood Institute; National Institutes of Health, NIH Pub. No. 02-5215, September 2002.
Suggested Management of Patients with Raised Lipid Levels
• LDL cholesterol is the primary key to treatment. Diet is first-line therapy and drug intervention is reserved for patients considered to be at a higher risk. Continue diet for at least 6 months before initiating drug therapy; use drug therapy in conjunction with diet, not in place of diet. The greater the risk the more aggressive the intervention.
• If there is evidence of coronary heart disease (CHD), do lipoprotein analysis.
• Initially measure total cholesterol and HDL cholesterol levels; based on these results and the presence or absence of other risk factors, determine course of action or proceed to lipoprotein analysis.
• See American Heart Association (AHA) diet, Step I, and AHA diet, Step II.
• Risk factors for atherosclerosis: advanced age, diabetes mellitus, family history, hypertension, male gender, obesity, sedentary lifestyle, tobacco use.
TOTAL AND HDL CHOLESTEROL
Status and Total CholesterolHDL Cholesterol=2 Positive Risk FactorsRecommendations
Desirable (200 mg/dL)=35 mg/dLN/A*• Reassess total and HDL levels in 5 yr.
• Provide information on diet, physical activity, and risk factor reduction.
=35 mg/dLN/A• Do lipoprotein analysis (see below).
Borderline high (200–239 mg/dL)=35 mg/dLNo• Reassess total and HDL levels in 1–2 yr.
• Reinforce diet, physical activity, and other risk factor reduction activities.
=35 mg/dLYes• Do lipoprotein analysis (see below).
High (=240 mg/dL)• Do lipoprotein analysis (see below).
LIPOPROTEIN ANALYSIS
LDL cholesterol = (total cholesterol - HDL) - (triglycerides ÷ 5)
Status and LDL Cholesterol=2 Positive Risk FactorsRecommendations
Desirable (130 mg/dL)N/A• Reassess total and HDL in 5 yr.
• Provide information on diet, physical activity, and risk factor reduction.
Borderline high-risk (130–159 mg/dL)No• Reassess total, HDL, and LDL annually.
• Provide information on Step I diet and physical activity.
High-risk (=160 mg/dL)Yes• Clinical workup (history, physical exam, and lab tests) to check for secondary causes or familial disorders.
• Consider risk factors that can be changed.
• Initiate Step I diet; if diet fails, proceed to Step II diet.
• Consider drug therapy if diet fails to obtain desired levels.
Goal for borderline high-risk patients with =2 negative risk factors is LDL 130 mg/dL.
Goal for high-risk patients with no other risk factors is LDL 160 mg/dL.
• When there is evidence of CHD, the goal of therapy is to reduce LDL to =100 mg/dL.
• LDL > 100—Do clinical workup and initiate diet or drug therapy.
• LDL =100—Individualize instruction on diet and physical activity and repeat lipoprotein analysis annually.
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References in periodicals archive ?
Effect of serum lipoprotein(a) on estimation of low-density lipoprotein cholesterol by the Friedewald formula.
Comparison of modified Friedewald's formula with direct measurement of low-density lipoprotein cholesterol in Bangladeshi population.
Subjects were considered to have dyslipidemia if they had fasting levels of triglycerides (TG) [greater than or equal to] 1.7 mmol/l (150 mg/dL) and/or fasting levels of high-density lipoprotein cholesterol (HDL-C) < 1.03 mmol/l (40 mg/dL) in men and <1.30 mmol/l (50 mg/dL) in women and/or fasting level of total cholesterol (TC) [greater than or equal to] 5.2 mmol/l (200 mg/dL) and/or fasting level of low-density lipoprotein cholesterol (LDL-C) [greater than or equal to] 4.10 mmol/l (160 mg/dL) and/or used medications for this abnormality.
A 12 hours fasting blood sample was collected from each patient for serum total cholesterol, triglycerides, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and glucose as well as glycosylated hemoglobin (HbA1c) by using standard methods at Biochemistry laboratory of the research centre.
Study leader Dr Zhen-Yu Chen, from the Chinese University of Hong Kong, said: "Total cholesterol, low-density lipoprotein cholesterol (LDL), and the heart-healthy high-density lipoprotein cholesterol (HDL) are still important health issues.
Intensive treatment to lower low-density lipoprotein cholesterol (LDL-C) reduces carotid intima-media thickness (CIMT) in patients with type 2 diabetes, according to a secondary analysis from the Stop Atherosclerosis in Native Diabetics Study (SANDS) trial.
Far too many clinicians focus solely on low-density lipoprotein cholesterol (LDL-C) and ignore the rest of the profile.
Developed from plant sterols, a plant-based compound which helps to lower low-density lipoprotein cholesterol, the all-natural ingredients have been proven to lower cholesterol by up to 15%.
The Healthy Heart diet with macadamia nuts did reduce total cholesterol, low-density lipoprotein cholesterol and triglyceride levels compared with the standard American diet.
It's likely to result in greater improvements in total and low-density lipoprotein cholesterol (LDL, the "bad" cholesterol) than turning to reduced-fat foods like low-fat cheeses and low-fat frozen entrees.
The observed rise in cholesterol has been found to be due to an increase in serum low-density lipoprotein cholesterol (LDL-C) (5).
When drugs become necessary, we recommend as initial therapy pravastatin or atorvastatin for elevated low-density lipoprotein cholesterol levels and gemfibrozil or fenofibrate when triglyceride concentrations exceed 500 mg/dL."

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