How Blood Lipids Different from Each Other

How Blood Lipids Different from Each Other, Dyslipidemia or Hyperlipidemia is a silent threat that can lead to atherosclerosis causing coronary heart disease, cerebrovascular disease, and peripheral arterial disease.

Normally, there are 2 types of blood lipids:

1. Cholesterol which can be further classified into 2 types.
   • Low-density lipoprotein (LDL-C) or bad cholesterol is harmful because it can accumulate in the wall of arteries and cause atherosclerosis.
   • High-density lipoprotein (HDL-C) or good cholesterol helps remove bad cholesterol from blood vessel wall reducing the risk of atherosclerosis.
2. Triglycerides are lipids which are absorbed from ingested food or synthesized by our body after excessive carbohydrate intake which is converted into triglycerides and stored in fat cells.

The normal lipids level of an adult is:

• Cholesterol lower than 200 mg/dL
• Triglycerides lower than 150 mg/dL
• LDL-C lower than 130 mg/dL
• HDL-C higher than 40 mg/dL in male and 50 mg/dL in female

Causes

• Genetic factors and family history of dyslipidemia
• Secondary condition of diabetes, chronic kidney disease, endocrine disorders, and obesity
• Medications such as hormones, steroids, and diuretics drugs
• Excessive intake of foods high in saturated fats and trans fat leading to high blood cholesterol; foods containing carbohydrate, sugar, and alcohols, causing high level of triglycerides
• Lack of exercise or being sedentary

Signs and Symptoms

Usually, there are no signs and symptoms. High lipid level can be diagnosed with blood testing. If left untreated, it can lead to other complications or disorders such as acute pancreatitis when the level of triglyceride is extremely high, causing abdominal pain.  Very high cholesterol can lead to yellow lumps on eyelid and palm due to cholesterol deposit in the skin.

Patients with long-standing high cholesterol are at risk of developing atherosclerosis. When there is blockage of an artery, resulting clinical symptoms will be specific to the artery involved such as coronary heart disease, paralysis and stroke, and peripheral artery disease.

When to see the doctor

Those at risk should have an annual medical checkup. Doctor will order a lipid profile blood test to measure the levels of each type of blood lipids.

An annual health screening is recommended for:

1. Men and women 40 years old and above
2. Patients at risk for atherosclerosis, including those with smoking history, diabetes, hypertension, kidney disease, obesity, or chronic inflammatory diseases such as arthritis, and SLE
3. Patients with first degree relative having coronary heart disease before age 55 in male and 65 in female.
4. Patients with signs of high cholesterol or established evidence of atherosclerosis.

Before the blood test, patients should refrain from eating or drinking for at least 12 hours. Total cholesterol, triglycerides, HDL-C and LDL-C will be measured. The LDL-C level can either be determined directly or derive from Friedewald’s formula as follows:

Calculated LDL-C mg/dL = Total cholesterol – HDL-C – (Triglycerides/5)         

However, there is limitation of this formula in patients with high triglycerides, particularly when higher than 400 mg/dL which will give a falsely low LDL-C level. This formula is also not reliable if patients have not fast before the blood lipids testing.

Treatments

The first step is to alter your lifestyle.

1. Exercise regularly for 30 minutes, 3-4 times a week aiming to maintain weight and BMI in healthy range.
2. Watch your diet. Eat just enough to meet the body’s dietary and nutritional need, avoiding foods high in saturated or trans-fats.
   • Saturated fatty acids are fats that cannot take in more hydrogen atoms. They are found in fats and meat from animal source such as lard, beef tallow, pork, beef, coconut milk, coconut oil, butter, and egg yolk. When saturated fats are over consumed, the excess is stored in fat cells leading to obesity, coronary heart disease and cerebrovascular disease. Nonetheless, saturated fats are necessary to our body, they should be consumed in moderation.
   • Unsaturated fatty acids are healthier. Found in plants (except coconut and palm trees which produce saturated fatty acids) and marine fishes, they contribute less to obesity and cardiovascular disease. Unsaturated fats can be classified based on the degree of unsaturation into 2 types:
     • Monounsaturated fats found in plant-based oils such as olive oil, sesame oil, safflower oil, avocado oil, nuts and grains.
     • Polyunsaturated fats can be found in soybeans, corn, sunflower oils, and deep-sea fish including salmon and tuna.
3. Avoid alcohol consumption.
4. Avoid smoking as it reduces HDL-C
5. Refrain from eating starchy, sugary foods, and sweetened beverages as they raise triglycerides level.
6. Consult your doctor whether lipids lowering medications are appropriate.
7. Have annual health checkup to evaluate for joint risk factors and follow up on blood lipids level.