What is a Good LDL Cholesterol Score

cholesterol (Cholesterol, CHOL)

Cholesterol is a type of blood fat from the sterol group and an essential component of all human cell membranes. Cholesterol is also needed to make bile acids, sex hormones and vitamin D. However, packed in malignant droplets of fat in the blood, it leads to heart attacks and strokes.

Short version:

  • Cholesterol is an important building block for many metabolic processes.
  • It is partly produced by the body itself, the rest is ingested through food.
  • Cholesterol is transported in the blood with the help of lipoproteins.
  • These are divided into VLDL, IDL, LDL and HDL according to their density.
  • High LDL values ​​lead to vascular calcification, whereas HDL has a protective effect.
  • Especially people with cardiovascular problems should have their fat levels checked regularly.

 


What is cholesterol

Cholesterol is found in almost all tissues in our body and is an important building block for numerous metabolic processes. In order to ensure that this vital substance is available in sufficient quantities, our body produces cholesterol itself. Normally around 60% of the cholesterol it needs is made in the body - mainly in the liver. The rest is ingested through food.

Cholesterol that is no longer required is excreted in the bile, reaches the intestine and can be reabsorbed from there. This makes it clear why special diets are often only of limited effectiveness in the case of hypercholesterolemia (high cholesterol levels in the blood).

Similar to fat, cholesterol is not soluble in aqueous media (blood). In order for it to be able to get from the liver to the tissues via the blood, cholesterol needs a transport medium - the so-called lipoproteins. Lipoproteins are made up of cholesterol and other fats (lipids) as well as protein molecules (proteins) and can be divided into different classes depending on their density.

+++ More on the topic: blood lipids +++

VLDL, IDL, LDL and HDL

Lipoproteins are divided into 4 categories according to their density:

  • VLDL (very low density lipoprotein)
  • IDL (intermediate density lipoprotein)
  • LDL (low density lipoprotein)
  • HDL (high density lipoprotein)

The different densities arise from the fact that the lipoproteins gradually release fatty acids to the fat and muscle tissue over the course of their lifetime. The fewer fatty acids, the higher the protein content in the respective lipoprotein, and thus the density also increases.

While high LDL concentrations can lead to vascular calcification (arteriosclerosis), high HDL concentrations have a protective effect on the vessel walls to a certain extent.

+++ More on the topic: Cholesterol - the underestimated danger +++

Why does the body need cholesterol?

Cholesterol has vital tasks and functions in our body:

  • Cholesterol is a necessary component of body cells.
  • Cholesterol is an essential repair molecule for damaged cell walls.
  • Cholesterol is needed to produce bile acids.
  • Cholesterol is important for the production of certain hormones (e.g. cortisol, estrogen or testosterone).
  • Cholesterol is the starting material for the body's own production of vitamin D.

When is the cholesterol level determined?

Since cholesterol leads to cardiovascular diseases such as heart attacks and strokes via arteriosclerosis, it is routinely determined during a "complete blood count" and as part of annual preventive examinations.

The cholesterol level in the blood serum is measured. It is important that there should not be too much cholesterol in the blood and that the HDL cholesterol is not too low.

Cholesterol should also be measured regularly in people with:

+++ More on the subject: vascular calcification +++

Which cholesterol levels are normal?

In addition to the (total) cholesterol level in the blood serum, the LDL and HDL cholesterol as well as the triglycerides (free fatty acids that are not bound to transport proteins) are always measured in order to obtain a meaningful picture. How high the respective cholesterol value should be depends on age, gender and other individual risk factors such as diet or existing cardiovascular diseases.

Basically a Total cholesterol below 200 mg / dL and an HDL value of over 40 mg / dl or over 50 mg / dl for men and women is desirable. However, the LDL cholesterol level is much more important in relation to cardiovascular diseases. Depending on the calculated risk, the following LDL cholesterol target values ​​result:

  • at very high risk: <55 mg / dl
  • at high risk: <70 mg / dl
  • with moderate risk: <100 mg / dl
  • at low risk: <115 mg / dl

+++ More on the topic: lowering cholesterol +++

Who should pay special attention to their cholesterol levels?

Too high a cholesterol level is a health hazard, especially for people at a very high risk of a cardiovascular event. Which includes:

High-risk patients include those with:

  • familial hypercholesterolaemia (inherited high levels of LDL cholesterol)
  • Type 1 or Type 2 diabetes
  • severe high blood pressure
  • high 10-year risk score

Moderate risk patients include those with:

  • an age of: men> 45 years, women> 55 years
  • Positive family history for early onset cardiovascular diseases (1st degree male relatives under 55 years of age; 1st degree female relatives under 65 years of age)
  • Diabetes and a duration of diabetes of less than ten years
  • Smoke
  • high blood pressure
  • low HDL cholesterol
  • moderate 10-year risk score

A low risk have people with a maximum of one classic risk factor.

Causes of high cholesterol levels:

  • frequent consumption of red meat, sausages and saturated fat
  • genetic predisposition
  • Obesity
  • Nephrotic syndrome (complex of symptoms consisting of increased protein in the urine, increased blood lipid levels and peripheral edema)
  • Hypothyroidism
  • Biliary obstruction
  • diabetes
  • pregnancy
  • Taking certain medications (including cortisone and progestins)

Causes of Low Cholesterol:

  • Malnutrition
  • Cirrhosis of the liver
  • rare genetic diseases of lipid metabolism
  • Manganese deficiency
  • Hyperthyroidism (overactive thyroid)

treatment

In the treatment of excessively high cholesterol levels, drugs from the group of statins are primarily used after all non-drug measures (diet, exercise, change in lifestyle) have been exhausted. If necessary, these can also be combined with other active ingredients or, in the case of statin intolerance, replaced by others in order to achieve the target values.

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Authors:
Mag. Rer. nat. Ulrike Keller (first author), Tanja Unterberger (2016), Christopher Waxenegger (2020)
Medical review:
Univ.Prof. Dr. Thomas Stulnig
Editorial editing:
Mag. (FH) Silvia Hecher, MSc, Mag. Astrid Leitner (2020)

Status of medical information:
swell

Mach F, Baigent C, Catapano AL et al., 2019 ESC / EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk. Eur Heart J 2020 Jan 1; 41 (1): 111-188 (last accessed on November 2nd, 2020)

Karow T, Lang-Roth R: General and special pharmacology and toxicology. 25th edition, 2017

Geisslinger G, Menzel S, Gudermann T, Hinz B, Ruth P: Mutschler drug effects - pharmacology, clinical pharmacology, toxicology. Scientific publishing company, Stuttgart, 11th edition, 2020

Austrian Lipid Consensus 2016. http://www.oedg.org/pdf/Diabetes-mellitus-Anleitungen-fuer-die-Praxis-2016.pdf (Online, last accessed: May 12, 2016)

T. Stulnig, S. Moosheer: Diet in the case of elevated blood lipid levels: Cholesterol and triglycerides, Maudrich, 1st edition 2013.

Claus Luley in Walter G. Guder & Jürgen Nolte: The laboratory book for clinic and practice. Urban & Fischer, Munich 2009.

A. Dormann, C. Luley and C. Heer: Laborwerte. Urban & Fischer, Munich 2009.

Markus Vieten: Understanding laboratory values ​​made easy. Trias, Stuttgart 2009.
 
B. Neumeister et al. Clinical guidelines for laboratory diagnostics, Urban & Fischer Verlag, 4th edition 2009.

M. Vieten: Understanding laboratory values ​​made easy, Trias Verlag, 2009.

 

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