What Is Remnant Cholesterol
Weve talked about TG, HDL, and a bit about LDL. Theres another thing we ought to coverremnant cholesterol.
Remnant cholesterol is the most dangerous type of cholesterol particle. Its also called triglyceride-rich lipoproteins , which consists primarily of VLDL and IDL .
Image from the Cholesterol Code by Dave Feldman.
Remnant cholesterol is short-lived in the plasma of a healthy person. RC particles appear only briefly after a meal. They are then metabolized into other lipoproteins by the breakdown of triglycerides inside an RC particle. This breakdown is accomplished by lipoprotein lipase lining the luminal surface of capillaries.
RC is also higher in the serum of those with CV disease risk . It is calculated by subtracting LDL and HDL cholesterol levels from total cholesterol number .
Consult A Doctor For Your Triglycerides Problem
High Triglycerides and low LDL HDL ratio can be caused by a lot of reasons. If you take Triglycerides and LDL HDL ratio blood tests and the results are higher than 150 mg/dL for Triglycerides and lower than 0.5 Ratio for LDL HDL ratio, your physician may recommend more tests to figure out the problem. You might also get these tests if your physician thinks you have some other disease.
What Works Better To Lower Cholesterol Statins Or Dietary Supplements
A recent study from the US compared the effects of statins drugs used to lower cholesterol level in the blood and commonly used supplements such as fish oil, cinnamon, garlic and turmeric. It found that statins were 35 per cent more effective in lowering the low density lipoprotein or bad cholesterol whereas none of the supplements demonstrated a significant decline when compared to a placebo.
Diabetologist Dr V Mohan says that the findings arent surprising, considering statins can be more effective than exercise and lifestyle changes when it comes to lowering LDL levels.
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Why are statins the mainstay of treatments for cholesterol control?
When we talk about lipids, there are different categories like cholesterol and triglycerides. Within cholesterol, there are LDL or bad cholesterol and HDL or good cholesterol. Now, several studies, including our own, have shown that LDL is more important than triglycerides when it comes to managing heart diseases triglycerides are important for pancreatitis but that too when the levels are very high.
Having said that, there are some Scandinavian studies that show that even triglycerides are an important factor for heart health. Also, when the triglycerides go very high, the LDL nature changes it becomes small and dense that is more atherogenic . That is when the secondary role of triglycerides becomes important.
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What Can Affect My Ldl Level
Things that can affect your LDL level include:
- Diet. Saturated fat and cholesterol in the food you eat make your blood cholesterol level rise
- Weight. Being overweight tends to raise your LDL level, lower your HDL level, and increase your total cholesterol level
- Physical Activity. A lack of physical activity can lead to weight gain, which can raise your LDL level
- Smoking.Cigarette smoking lowers your HDL cholesterol. Since HDL helps to remove LDL from your arteries, if you have less HDL, that can contribute to you having a higher LDL level.
- Age and Sex. As women and men get older, their cholesterol levels rise. Before the age of menopause, women have lower total cholesterol levels than men of the same age. After the age of menopause, womens LDL levels tend to rise.
- Genetics. Your genes partly determine how much cholesterol your body makes. High cholesterol can run in families. For example, familial hypercholesterolemia is an inherited form of high blood cholesterol.
How To Prepare For The Test
You should not eat for 8 to 12 hours before the test.
Alcohol and some medicines can interfere with blood test results.
- Make sure your health care provider knows what medicines you take, including over-the-counter drugs and supplements.
- Your provider will tell you if you need to stop taking any medicines before you have this test.
- DO NOT stop or change your medicines without talking to your provider first.
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Which Cholesterol Number Is The Most Important
When we measure cholesterol and blood fats, we’re really talking about three different numbers: HDL, LDL, and triglycerides. They combine to give you a “lipid profile” score, but the three individual scores are most important. Here are the numbers to strive for: Total cholesterol of 200 mg/dL or lower.
Metabolic Syndrome Risk Factors
High triglyceride levels are associated with a collection of disorders known as metabolic syndrome. A person with metabolic syndrome has an increased risk of developing diabetes, stroke or heart disease.A person is classed as having metabolic syndrome when they have any three of the following factors:
- Central obesity excess fat in and around the stomach
- High blood pressure
- High blood triglycerides.
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How The Hdl Cholesterol And Triglycerides Tests Are Done :
If your doctor wants HDL cholesterol and Triglycerides tests on you, you may need to go through these tests. During the HDL cholesterol and Triglycerides blood tests, a pathologist will put a needle into your veins and take out a small quantity of blood. A pathologist is a physician in the medical field who thoroughly studies the causes and effects of disease. Within a few hours you will get your HDL cholesterol and Triglycerides Test reports by your pathologist.
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Note On Existing Studies
More research is needed to fully understand whether very high HDL levels increase the risk of death.
The authors of a 2019 study suggest that genetic mutations linked to very high HDL levels, impaired HDL function at high levels, and potential bias in research due to flaws in study design may contribute to the potential link found in some studies.
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How Often Should I Get A Cholesterol Test
When and how often you should get a cholesterol test depends on your age, risk factors, and family history. The general recommendations are:
For people who are age 19 or younger::
- The first test should be between ages 9 to 11
- Children should have the test again every 5 years
- Some children may have this test starting at age 2 if there is a family history of high blood cholesterol, heart attack, or stroke
For people who are age 20 or older::
- Younger adults should have the test every 5 years
- Men ages 45 to 65 and women ages 55 to 65 should have it every 1 to 2 years
When To Seek Medical Advice
A high triglyceride level often does not produce any symptoms, so this condition is usually diagnosed during routine blood tests including a lipid panel.
If the patient does not have any medical conditions or bad lifestyle choices, then the doctor usually orders a lipid panel to be done every few years to assess the triglyceride and cholesterol levels.
If the triglyceride levels are detected above the normal range in the lipid panel, then the doctor will usually recommend lifestyle changes, such as exercise and diet as the first line of treatment for hypertriglyceridemia. If diet and exercise are not effective in lowering the high triglycerides, then medications, such as fibrates or statins are prescribed.
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Diagnosis Of High Triglycerides
A blood test can reveal whether or not you have high triglycerides. You may need to have two blood tests for accurate results. Dont eat anything for at least 12 hours before each blood test because food particularly fatty food can temporarily boost triglyceride levels in the blood and skew your test results.Triglycerides are measured in mmol/L. The range includes:
- Very high over 6 mmol/L
- High between2 and 6 mmol/L
- Borderline high between 1.7 and 2 mmol/L
- Normal below 1.7 mmol/L
The doctor may also test your cholesterol levels. In many cases, high triglycerides and high cholesterol go hand in hand. This condition is sometimes known as combined hyperlipidemia.
Study Design And Participants
We performed a nested casecontrol study among subjects participating in the PREVEND cohort. This study investigates vascular and renal damage in a predominantly Caucasian population. Details of the study have been described elsewhere. In summary, in 199798, all inhabitants of the city of Groningen, aged 2875 years, were sent a short questionnaire on demographics and cardiovascular morbidity and a vial to collect an early morning urine sample. Altogether, 40 856 subjects responded . Pregnant women and diabetic subjects using insulin were excluded. All participants with urinary albumin concentration > 10 mg/L were invited to our clinic together with randomly selected subjects with a urinary albumin concentration < 10 mg/L. So, the PREVEND Study consists of a population enriched with subjects with microalbuminuria. The study population comprised 8592 subjects who completed the total screening programme. The study was approved by the local medical Ethics Committee. All participants gave written informed consent.
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What Would Cause Low Triglycerides
There is no specific value that defines a low triglyceride level. However, it is still possible to identify individuals with dangerously low triglyceride levels via blood tests called lipid profile tests.
The following factors can lead to low triglycerides. These factors, combined with lipid profile test results, can help health professionals decide if medical intervention to increase triglycerides would benefit a patients health.
Normal Range Of Ldl Hdl Ratio : 05
Ideal values of LDL HDL ratio depending on age :
| Age | Ideal LDL HDL ratio value |
|---|---|
| < 5 years | |
| > 100 years | 0.62696 |
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What Causes Levels To Fluctuate
Triglyceride levels fluctuate naturally in response to many factors, including calorie intake and time of day. Eating a meal can cause an increase in triglycerides, which the body may store to use later when it needs energy.
These fluctuations are typically short-lived, but they are part of the reason why doctors may ask a person to fast before getting a lipid profile blood test.
Some health conditions may increase the risk of higher triglyceride levels. According to the
- hormone medications
- immunosuppressant drugs
Anyone who is uncertain about the side effects of their specific medication should speak with their doctor.
A person can use a few treatments to help lower their triglyceride levels.
High Total Cholesterol Normal Ldl High Hdl Normal Triglycerides
In this case, the high total cholesterol is less troublesome since its largely due to elevated HDL . The fact that HDL is high and LDL is normal also makes for a favorable HDL:LDL ratio. Although, extremely high levels of HDL cholesterol can be due to genetics. Generally, HDL levels shouldnt exceed 116 mg/dL for men and 135 mg/dL for women.2
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Preventive Steps For High Cholesterol And Heart Health
When you have high cholesterol, staying heart-healthy requires more than a regimen of statins. Even if youre on medication, it is absolutely essential to make lifestyle changes: Stop smoking , drink alcohol only in moderation, eat well, build exercise into your life, and get to a healthy weight, Dr. Rocco says. Smoking cessation alone can boost HDL 5 percent, while for every 7 pounds you lose, youll see a 1 mg increase in HDL. Regular moderate-intensity exercise raises HDL as much as 6 percent, he adds.
Contrary to prior nutritional information, there is not a clear link between dietary intake of cholesterol and increased cardiovascular risk the focus is on lowering saturated fat and trans fat in the diet. The new 2015 dietary guidelines by the U.S. government removed the limitation on cholesterol in the diet.
Features of a Mediterranean diet include:
- Eating primarily plant-based foods
- Using olive oil in place of butter
- Enjoying fish and poultry at least twice a week
Adopting this kind of diet, along with exercise, pays off not just in terms of heart disease, but overall, Andersen says. Its really an anti-aging plan.
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Consequences Of Low Hdl High Triglycerides
Cholesterol gets deposited easily in the blood vessels of these patients and the build-up of cholesterol cannot be cleansed out efficiently due to low level of HDL cholesterol. Consequently, these patients are at very high risk for narrowing of the blood vessels.
HDL cholesterol and triglyceride level serves as an extremely useful test to diagnose Insulin Resistance Syndrome. If your HDL is low and/or your triglyceride level is high, you have Insulin Resistance Syndrome.
Low HDL cholesterol has been known to be a strong risk factor for coronary artery disease for a long time. In 1977, the results of the famous Framingham Heart Study were published in the American Journal of Medicine. In this study, HDL cholesterol was found to be the most potent lipid predictor of coronary heart disease.
Several other studies including the Coronary Primary Prevention Trial , the Multiple Risk Factor Intervention Trial , and the Lipid Research Clinics Follow-up Study further confirmed the strong relationship between low HDL cholesterol and coronary artery disease.
Raising HDL cholesterol reduces the risk for heart attack. A 1% increase in HDL cholesterol is associated with a 3% decrease in risk of heart disease. This impressive role of HDL cholesterol in preventing heart attack was shown in the famous Veterans Affairs HDL Intervention Trial . The results of this study were published in the New England Journal of Medicine in 1999.
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What Is Considered Low Triglycerides
There isnt an official cutoff for low triglycerides. Most labs will consider any value below 150 mg/dL normal and values below 90 mg/dL as optimal.
If you are healthy and your values are lower than normal, you probably have nothing to worry about on the contrary.
But based on the studies above, in certain conditions, levels that are 50-70% lower than the average healthy persons might signal a more serious course of disease or higher levels of inflammation .
How Can You Naturally Lower Tg And Increase Hdl Levels
The most effective ways to improve your TG/HDL are:
- Lose weight. Body fat used to be considered as an inert energy storage tissue. Now we know it is an endocrine tissue that releases chemicals that cause insulin resistance, prediabetes, and CV risk .
- Eat fewer carbs. Get into a lower carbohydrate diet .
- Exercise. Exercise increases HDL levels and lowers TG levels .
- Take niacin. It is one of the few supplements that lowers TG , increases HDL cholesterol levels , and lowers LDL cholesterol levels .
- Get dietary and supplemental omega-3s .
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Cholesterol Tests And Their Results
The United Stated Preventive Services Task Force , which makes healthcare screening recommendations for Americans, suggests that men 35 and older, and women 45 and older, have their lipids screened at least once. It also recommends that both men and women at increased risk for coronary heart disease with a history of heart disease in the family, for example be screened for lipid disorders starting at age 20. Other medical societies recommend testing cholesterol more aggressively, including the AHA, which advises having your cholesterol checked every four to six years starting at age 20 .
Until very recently, patients had been told to fast for 9 to 12 hours before being tested. Now, new research involving more than 300,000 people, published in April 2016 in the European Heart Journal, says its not necessary to do a cholesterol test on an empty stomach, though some doctors still recommend it.
A cholesterol test measures HDL, LDL, and triglycerides other lipoproteins may be tested by a lipid specialist. A lab report may list your results for each of these, with additional information showing desirable targets in milligrams per deciliter :
Total Cholesterol
- Above 500: very high
Cholesterol Ratio
This measures your level of HDL cholesterol in relation to your total. An optimal ratio is less than 3.5 to 1. A higher ratio means youre more at risk for heart disease.
How To Raise Hdl Cholesterol And Lower Triglycerides
What I have found really works is a simple change in your diet: Lower carbohydrates and increase monounsaturated fats found in nuts, especially almonds, walnuts, pecan, macadamia and pistachios. Increasing the intake olive oil, avocados and fatty fish such as salmon also helps somewhat. Compared to popular belief, exercise does not help to raise your HDL cholesterol or lower triglycerides.
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