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# How To Compute Ldl Cholesterol

## How Does This Cholesterol Calculator Work

Fitness & Health Calculations : How to Calculate LDL Cholesterol

This tool functions as a total cholesterol, HDL, triglycerides and LDL calculator. Do you want to know whether your HDL, LDL levels or the TC/HDL ratio and LDL/ HDL ratio show an increased risk for heart disease?

Use it then to check if your cholesterol levels are in the normal range. All you have to do is input the data from your medical documents.

## More Accurate Results Seen With New Method In Certain Groups

byNicole Lou, Staff Writer, MedPage Today February 26, 2020

A way to calculate LDL cholesterol levels that gives more accurate results than standard equations for people with hypertriglyceridemia or very low LDL has been reported.

The equation, which relies on -quantification of LDL with ultracentrifugation to separate lipoprotein classes in a patient’s serum, topped the Friedewald and for accuracy — especially for people with high triglycerides.

It was as accurate up to 800 mg/dL as the Friedewald equation was for levels under 400 mg/dL, according to Alan Remaley, MD, PhD, of the National Heart, Lung, and Blood Institute in Bethesda, Maryland, and colleagues.

While only slightly more accurate in the normal lipid range, the equation led to 35% fewer misclassifications when patients with hypertriglyceridemia in the 400-800 mg/dL range were categorized into different treatment groups according to LDL cholesterol.

The equation could “be reserved only for patients with hypertriglyceridemia and/or low LDL-C levels,” the researchers suggested in JAMA Cardiology. “From a practical standpoint, however, it may be simpler to use the new equation for all patients rather than use two different equations for calculating LDL-C levels.”

Notably, clinical laboratories that adopt the new equation would not have additional costs compared to the standard lipid panel, because the equation has no intellectual property restrictions, according to the investigators.

Disclosures

## Hdl Vs Ldl Cholesterol

There are two main types of lipoproteins in the bodyLDL and HDL. The difference is in the lipid to protein ratio.

The low-density lipoproteins, LDL cholesterol, contains more cholesterol and less protein. To get rid of their fatty overload, they carry and release cholesterol on the walls of our blood vessels. This leads to the forming of atheromatous plaques that narrow or completely obstruct the lumen of blood vessels. Remember, atherosclerosis is one of the leading causes of CVDs like heart attack and stroke. So, what can be estimated by the cholesterol calculator is the risk of heart disease. This is why LDL is known as bad cholesterol.

The high-density lipoproteins , are produced in the liver. HDL cholesterolcontains more protein and less cholesterol. Their function is entirely opposite from LDLthey take away cholesterol from the walls of the blood vessels and transport it to the liver for processing and removal from the body. In this way, HDL clears excess amounts of total cholesterol, reduces atherosclerosis, and subsequently lowers your risk of developing CVDs. Therefore, HDL is popularly known as good cholesterol.

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## High Ldl Cholesterol Diagnosis

A blood test can check your LDL, HDL, and total cholesterol levels. It also measures triglycerides, a type of fat that stores extra energy from your diet. High triglyceride levels can make you more likely to have heart problems.

Experts recommend testing every 4 to 6 years. YouÃ¢ll probably need it more often if you have heart disease or diabetes, or if high cholesterol runs in your family.

Lower numbers are better when it comes to LDL cholesterol test results. The general guidelines for adults in the United States are:

• Less than 100 milligrams per deciliter : Optimal
• 100-129 mg/dL: Near or above optimal
• 130-159 mg/dL: Borderline high
• 160-189 mg/dL: High
• 190 mg/dL and above: Very high

If you have a condition like heart disease or diabetes, your doctor might recommend an LDL target of 70 mg/dL or below.

## Total Cholesterol To Hdl Ratio

The total cholesterol to HDL ratio calculator is used to determine their proportion in the blood. The total cholesterol/HDL ratio is considered to be the least precise in determining your health risk. So, what should your cholesterol ratio be?

• The optimum ratio is below 3.5.
• An average total cholesterol/HDL ratio is considered below 5.0.
• And an elevated ratio is above 5.0.

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## What Happens If High Cholesterol Goes Untreated

High blood levels of LDL cholesterol and triglycerides have been linked to the development of CVDs, along with other factors such as hypertension and diabetes mellitus. The risk of damage to the vascular walls and the formation of deposits and blockages increases when there is more bad and less good cholesterol in our blood. The good news is that the reduction in total cholesterol by 1% leads to a 2% reduction in the risk of developing cardiovascular disease.

Increased cholesterol levels may be caused by a familial predisposition as well, as is the case in about 3% of people. Usually, blood cholesterol is high from an early age and is unaffected by the diet. In these cases, specialists recommend taking lipid-lowering agents such as statins from a younger age. These drugs are prescribed and taken under medical supervision.

However, it is a myth that lipid-lowering medication can be stopped as soon as your results are within the cholesterol and triglycerides normal range. The levels may be lowered, but if you stop taking the drug, the cholesterol, and especially LDL, will rise again. You should consult your doctor about any change in your treatment.

In about 20% of the population, high LDL cholesterol levels are associated with another underlying condition such as:

• obesity
• hypothyroidism

## Triglycerides To Hdl Ratio

The triglycerides/HDL proportion is calculated by dividing the triglycerides by the HDL levels. A cholesterol risk calculator for this ratio is also used to identify the likelihood of a heart attack, though not as often as the previous ratio.

• The normal ratio is 2.0 or less.
• Values between 4.06.0 are considered to be high.
• A triglycerides/HDL ratio of 6.0 or more is considered very high.

## How Does A Cholesterol Calculator Work

Friedewald Equation for Calculation of LDL Cholesterol

Some LDL calculators operate using the Friedewald equation from 1972, while others use the Iranian lipid profile calculation formula from 2008. Based on the blood sample results for total cholesterol, triglycerides, and HDL, it calculates LDL cholesterol levels. The second equation is often suggested for those with a small carbohydrate intake when the triglyceride content is smaller than the mean value required.

You can choose to type the three values into the cholesterol calculator as mmol/L or mg/dL according to the obtained results from the lab.

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## How To Maintain Healthy Cholesterol Levels

Only foods of animal origin contain cholesterol. The richest sources are:

• fatty meats
• animal organs
• shrimp
• egg yolks
• high-fat dairy products

You should also note that if you decide to cut fat from your diet completely, cholesterol will not normalize by itself.

There are some tips on how to maintain a normal cholesterol level:

• Eat foods rich in soluble fiber.
• Include the recommended number of servings of fruits and vegetables in your diet.
• Quit smoking and excessive drinking, as alcohol and cholesterol levels are interrelated.
• Restrict high-calorie sweet and fatty foods.
• Engage in regular physical activity.
• Lose excess weight and maintain a normal BMI.

Even people with high LDL levels can eat eggs and dairy products in moderation. However, it is recommended to restrict the number of egg yolks to up to three per week. For dairy products, it is advisable to choose low-fat or non-fat cheeses, yogurts, cottage cheese, and sour cream in order to have normal total cholesterol levels.

Interestingly, garlic has been shown to reduce liver cholesterol production. And oatmeal has a similar effect. Moreover, research relates the ketogenic diet and cholesterol levels. In fact, it has confirmed that this diet can help lower total cholesterol and LDL while increasing HDL levels.

A healthy diet is crucial, but it must be a lifelong change to ensure good results. Crash diets wont result in normal cholesterol levels for adults.

## Validation Of The Friedewald Formula In Patients With Metabolic Syndrome

#### Abstract

Currently, the Friedewald formula is the main method for evaluating low-density lipoprotein cholesterol . Recently, many limitations have emerged regarding its use, including patients with triglyceride levels 400mg/dL, diabetes mellitus, and kidney or hepatic chronic diseases. We analyzed the use of the FF in patients with metabolic syndrome. We selected patients with known metabolic syndrome that fulfilled the National Cholesterol Education Program Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults Final Report and excluded patients with triglyceride levels 400mg/dL and chronic liver and/or kidney disease. Using direct assays, we measured total cholesterol, high-density lipoprotein cholesterol, triglycerides, and LDL-c. Then, LDL-c was estimated using the FF and compared with the LDL-c by direct assay. The sample size was 135 patients. Using the FF, the mean LDL-c value was mg/dL it was mg/dL by direct assay. The correlation coefficient between these two methods was 0.89, with statistical significance . There were no significant differences between the patients with triglyceride levels > 150mg/dL . In conclusion, FF is a good method for estimating LDL-c in patients with metabolic syndrome.

#### 5. Conclusion

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## What Is Cholesterol Ratio And Why Does It Matter

Working out the cholesterol ratio is essential to prevent the risk of coronary artery diseases and strokes. It also allows for a quick diagnosis based on the blood test results, making it easy to assess the general health condition of an individual and heart health.

The American Heart Association recommends that all adults older than 20 have a lipid profile once every four to six years .

The optimal ratio is 3.5:1, and higher values indicate an increased risk of heart diseases .

## Question 8 Does Quest Offer Advanced Lipid Testing Options To Assess Ascvd Risk

Yes. Aside from standard lipid profile tests, Quest offers several advanced lipid testing options, including measurement of LDL particle number and size. In a number of retrospective analyses, lipoprotein subfractions have been found to be associated with CVD events.9,10 Additionally, particle numbers as determined by ion mobility were found to be a significant determinant in defining residual risk.11 Quest uses ion mobility separation of subfractions for these measurements. The ion mobility method directly measures particle size and concentration, unlike other approaches that use algorithms to indirectly calculate lipid subfractions.12 And, unlike some methods, ion mobility separation of subfractions does not cause lipoprotein modification that could potentially affect the accuracy of the assay.10,13 Ion mobility has been used in multiple lipoprotein studies9,10,14 and is the method used in the Cardio IQ Lipoprotein Fractionation, Ion Mobility test .

References

• Stone NJ, Robinson JG, Lichtenstein AH, et al. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014 129:S1-45.
• Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem. 1972 18:499-502.
• Recommended Reading: Is Tuna Good For High Cholesterol

## How To Calculate Ldl Cholesterol

After having the lipid profile measured, you can start the calculation. Check what units are your lab test results expressed in – it’s important for the calculation.

• Insert the total cholesterol level.
• Enter the High-Density Lipoprotein level.
• Fill in the third field with your triglyceride level.
• The calculated LDL cholesterol is presented in the last line.
• ## Technical Definition Of Remnant Cholesterol

Remnant cholesterol is everything that is not LDL or HDL cholesterol. There are 5 main types of cholesterol: chylomicrons, VLDL, IDL, LDL, and HDL. When you go get a lipid panel, they measure your total cholesterol. That is everything and anything included in the list above. Typically you will be fasting for a lipid panel, so that means your chylomicrons will not be a part of that. They have a very short half life of only about 10-20 minutes..

Yep it is pretty much everything that is involved in the energy delivery part of the job. If they are supposed to be delivering energy and then moving on to the other stages of cholesterol, but cant, that means there is a problem. VLDL & IDL are only supposed to hang around for a few hours and then transform into LDL.

• VLDL has a half life ranging from 30 minutes to 4 hours.
• IDL has a half life of 1-2 hours.

In a healthy person, there shouldnt be much of the remnants hanging around. It means they werent able to drop off their energy. Once they drop off the fat, they eventually get to LDL, which has a much longer lifespan. LDL has a half life of about 3 days! That is much longer than the other kinds of cholesterol so it should make up a very large portion of your total cholesterol.

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## A More Accurate Measurement Tool

The traditional Friedewald equation estimates LDL cholesterol this way: total cholesterol minus HDL cholesterol minus triglycerides divided by five. For simplicitys sake, the formula applies a one-size-fits-all factor of five to everyone. But Johns Hopkins researchers found that this often makes LDL cholesterol appear lower than it really is for some high-risk patients. The researchers sought a more accurate formula that would take into account specific details about a persons cholesterol and triglyceride levels.

Using a database of blood lipid samples from more than 1.3 million Americansalmost 3,000 times larger than the one used to develop the Friedewald equation Johns Hopkins researchers developed a more accurate system for calculating LDL cholesterol. It can be used to make more precise decisions about treatment to prevent heart attack and stroke.

This newer LDL cholesterol formula is being adopted by U.S. laboratories as well as others around the world. The best implementation is direct coding the LDL cholesterol estimation in the lab IT system, which automates the process and saves clinicians time. The formula is also available as a mobile device app called the LDL Cholesterol Calculator. It is available on the iTunes App Store and on Google Play, for those whose lab hasnt adopted it.

Researchers hope the new formula will one day be adopted by all labs that process lipid panels, as it can improve patient care.

## Problems With The Research

LDL calculation

The first problem is that all of the research on remnant cholesterol has been from observational and epidemiological studies. These were not randomized controlled trials, which is the standard for medicine. We do not want to say that causes the research to be meaningless. In fact, that is a very important part of understanding disease.

Also, the people who tend to have high cholesterol are not doing it because they are purposefully following a strict high fat ketogenic diet . They most likely are also eating a whole bunch of junk food that happen to use fats. The other parts of the junk food cause problems around the cholesterol, and then the cholesterol comes to help and sticks.

People who follow a high fat diet on purpose have improved markers of heart disease, like triglycerides. That shows it is not a rise in cholesterol alone that is a problem. It is probably from the other parts of the diet that cause inflammation and such.

There isnt a whole ton of research on people actually following a ketogenic diet, so it is hard to pull conclusions. But the research that does exist suggests that rising cholesterol levels from a ketogenic diet are not harmful. Most studies on cholesterol do not look at people who are low-carb. So if somebody has a whole bunch of cholesterol with their inflammatory carbohydrates, then that makes sense it is problematic!

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## Recommendations For Analytical Performance

A NCEP expert laboratory panel in 1995 issued recommendations for measurement of LDL-C, emphasizing the importance of accuracy and providing analytical performance goals similar to those for TC, TGs, and HDL-C . The panel recommended standardization of the measurements, i.e., achieving traceability of all results to accepted Reference Methods . The CDC uses an RM, based on the Lipid Research Clinics -quantification procedure . The CDC BQ method subjects serum to ultracentrifugation at density 1.006 kg/L for at least 18 h at 105 000g to float VLDL and any chylomicrons present. A tube-slicing technique removes VLDL and the bottom fraction, which are recovered quantitatively by pipetting and reconstituted to the original volume. HDL-C is obtained according to the HDL RM using heparin-Mn2+ to precipitate LDL, including IDL and Lp, from the BQ infranate . Cholesterol is measured in the fractions by the Abell-Kendall RM . LDL-C is calculated by difference as the 1.006 kg/L bottom cholesterol minus HDL-C.

The current primary goal for analytical performance in LDL-C is that total error be within 12% of the true value. The total error term, combining the contributions of imprecision and inaccuracy or bias , represents the maximum tolerable error in measurement of a single specimen to 95% tolerance limits, i.e., in 19 of every 20 measurements. Imprecision, in proportional units, or CV 4% and bias 4% from the RM allow a method to meet the current total-error goal.

## How To Calculate Cholesterol Ratios

There are three indicators that describe your heart disease risk with high accuracy. They are all built as ratios of the aforementioned blood results, and are therefore called cholesterol ratios.

Are you wondering what a good cholesterol ratio is? You can use this total cholesterol calculator to find the following values:

• LDL HDL ratio is simply the LDL level divided by the HDL level. LDL HDL ratio is one of the most popular measures of a heart disease risk.
• ideal: below 2.0

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