The lipid function test is done on a fasting blood sample to identify various lipid abnormalities and includes the estimate of total cholesterol, triglycerides, HDL cholesterol, LDL cholesterol.
The most important lipids present in the blood are cholesterol and Triglycerideswhich, when incorporated into lipoproteins such as chylomicrons, transports very low density lipoproteins (VLDL), medium density lipoproteins (IDL), low density lipoproteins (LDL) and high density lipoproteins (HDL) in the blood become.
Disorders of lipoprotein metabolism (dyslipidemia) include primary and secondary conditions that increase circulating lipids.
HDL is considered to be good cholesterol as it carries cholesterol to the liver where it can be removed from the bloodstream before it builds up in the arteries. LDL, on the other hand, carries the cholesterol directly into the arteries, which can lead to the formation of plaque and atherosclerosis, which can ultimately lead to heart attacks. Hence, LDL is called bad cholesterol.
Hypercholesterolemia (increased total cholesterol level in the blood) is a well treatable cause of heart disease and should therefore be actively investigated. It is recommended by the National Cholesterol Education Program that a fasting lipid profiling be performed every 5 years from the age of 20.
Preparation for the lipid profile test:
- Sample for lipid analysis requires 12 hours of fasting.
- Triglycerides and LDL are affected by recent food intake. Patients should follow a routine diet for 2-3 weeks prior to analysis.
- Lipid analysis should not be performed during acute illness and should be postponed for 3 months after severe illness.
- Drugs that affect lipid levels, such as steroids, oral contraceptives, should be avoided.
Possible causes of lipid profile abnormalities:
- Patients with high serum triglycerides> 200 mg / dl are at risk of arteriosclerosis, and patients with> 1000 mg / dl have an increased risk of acute pancreatitis.
- An increase in triglycerides is associated with low HDL. Low HDL cholesterol is a risk factor for coronary disease even when total cholesterol levels are normal.
- High LDL cholesterol is a strong risk factor for atherosclerotic heart disease and has been linked to obesity, high carbohydrate intake, diabetes mellitus, sedentary lifestyle, and smoking.
- Secondary lipoprotein disorders arise from underlying causes such as diabetes mellitus, alcohol abuse, hypothyroidism.
Treatment of dyslipidemia:
- In overweight patients, weight loss can help lower triglyceride levels.
- Taking care of obesity or overweight involves three essential elements of lifestyle: eating habits, physical activity, and behavior changes.
- Lifestyle changes are the first thing you need to address to reduce your risk of heart disease.
- Patients should receive nutritional advice to reduce the amount of saturated fats, artificial trans fats, and cholesterol in their diet.
- The main focus of diet therapy is on reducing total calorie consumption. This reduction is consistent with the goal of losing 0.5-1 kg / week. Examples include:
- Choose smaller, frequent meals at regular intervals.
- Eat more fruits and vegetables.
- Increase your fiber intake.
- Consume more whole grains, beans, peas.
- Choose leaner cuts of meat and skimmed milk and dairy products.
- Reduce your consumption of fried foods and foods with added fats and oils.
- Drink water instead of sugar-sweetened drinks, cut down on sugar and sweets.
- Decrease your sodium intake.
- Reduce your saturated fat intake, which you can find in animal products.
- Foods with low energy density are soups, fruits, vegetables, oatmeal and lean meats should be preferred.
- High energy density foods like dry food and high fat foods like cheese, egg yolks, potato chips, and red meat are high energy dense foods and should be avoided.
- The purpose of a Very Low Calorie Diet (VLCD) is to achieve rapid and significant short-term weight loss over a period of 3 to 6 months.
- A combination of diet and exercise is the most effective behavioral approach to treating obesity.
- Adults should exercise 150 minutes of moderate intensity or 75 minutes of vigorous aerobic exercise during the week.
- Regular Aerobic exercise can lower bad cholesterol (LDL) and raise good cholesterol (HDL). Make sure you weigh the correct weight for your height.
- Eat foods with unsaturated fats like nuts, fish, vegetable oil, olive oil, canola and sunflower oils.
- Patients who drink alcohol should be encouraged to reduce their alcohol consumption or, if possible, to eliminate it altogether.
If Diet and exercise not lower Cholesterol levels, then your doctor will prescribe medications or a combination of treatments after secondary causes are ruled out.
-DR. Pedurthy Anoosha
References:
- Jameson, Fauci, Kasper, Hauser, Longo, Loscalzo: Harrison’s Principle of Internal Medicine, 20th ed., Ch 400, pp. 2889-2902.
- Shirish M. Kawthalkar: Essentials of Clinical Pathology, 7th ed., Chapter 5, pp. 69-74.
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