A Specific Plasma Lipid Signature Associated With High Triglycerides And Low Hdl Cholesterol Identifies Residual Cad Risk In Patients With Chronic Coronary Syndrome
Residual coronary artery disease risk is a relevant clinical unmet need.
Residual risk is associated with specific cardiometabolic profiles.
We analyzed plasma of 193 patients at baseline and follow-up.
A common panel of lipid biomarkers identifies patients with cardiometabolic risk.
These 13 lipids associated together with TG/HDL-C ratio and prognostic risk score.
Normal Cholesterol High Triglycerides
Even though your latest physical may have shown that your cholesterol levels are normal, you may still be at risk for heart disease if your triglycerides level is high.
A 20-year study conducted by the University of Washington School of Public Health and Community Medicine found that a pattern of elevated levels of triglycerides, the main form of fats circulating in the bloodstream, even when cholesterol levels are normal, can mean a two- to three-fold increase of deaths by cardiovascular disease.
Blood triglycerides come from two main sources: the food you eat-especially sugar, animal products and saturated fats-and from your liver. Although its not exactly clear how, high triglyceride levels can result in hardening of the arteries or thickening of the artery walls , which can raise your risk for stroke, heart attack, and heart disease.
- Normal triglyceride levels are less than 150 milligrams per deciliter
- Borderline high is 150-199 mg/dl high is 200-499 mg/dl
- Very high 500 mg/dl. A triglyceride level of 150 mg/dl or above is considered a risk for metabolic syndrome-a constellation of conditions resulting from too much fat around the waist-which in addition to raising your risk for heart disease, it can also increase your risk for diabetes.
Low Levels May Be Associated With Worse Outcomes In Some Conditions
In one study, people with heart failure and lower levels were more likely to die from heart complications. The levels associated with risk were around 120 mg/dL on average, while levels of 130-149 mg/dL were considered protective .
Upon further analysis, the researchers concluded that only women with heart failure and low triglycerides may be at an increased risk of dying. According to them, low triglyceride levels may point to more advanced stages of heart failure .
In another study, people with lung scarring had triglycerides under 57 mg/dL, which was about 60% lower than the values of healthy controls .
Similarly, people with autoimmune disease had 50-70% reduced triglyceride levels compared to healthy people in a different study. Researchers suggested that low triglyceride levels might actually be a marker of autoimmunity and an overactive immune response .
Its important to note here that low triglycerides in all of these cases are not causing any of these conditions. They are the effect of these conditions. For example, in heart failure, low triglycerides may be due to liver damage due to diminished oxygen supply or increased levels of inflammation.
There is no proof that low triglyceride levels are harmful in and of themselves.
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Does Your Total Cholesterol Number Even Matter
As one of the most ordered lab tests, total cholesterol can provide a high level glance at how your body is handling lipids, or fats. According to the CDC, roughly nine percent of all doctors visits include a cholesterol test.1 So, how should you interpret your total cholesterol value? Is the whole greater than the sum of its parts?
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Know Your Triglyceride Numbers
A blood test called a lipid panel checks both your triglyceride and cholesterol levels. Usually, your doctor will ask that you fast, or not eat or drink anything other than water, for 9-12 hours before the test. Youâll get blood taken from a vein in your arm. Some labs offer non-fasting lipid panels, or they may prick your finger for blood.
Here are the levels, based on a fastingblood test.
- Normal: Less than 150 mg/dL
- Borderline: 150 to 199 mg/dL
- High: 200 to 499 mg/dL
- Very High: 500 mg/dL or above
Anyone over age 20 needs to get regular tests to track their cholesterol and triglyceride levels, according to the American Heart Association.
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Normal Range Of Ldl Hdl Ratio : 05
Ideal values of LDL HDL ratio depending on age :
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If you want your blood test report to be interpreted by LDL HDL ratio specialist, then you can upload your report. Our LDL HDL ratio expert will provide you with the most accurate interpretation of your blood test results and treatment within 12 hours. Upload blood test report now
Do High Tg Levels Affect Hdl And Ldl Cholesterol Levels
The image below shows how LDLs and HDLs transport TG. It is from the National Lipid Associations website, used with permission from Tom Dayspring .
Here, an enzyme called CETP facilitates the exchange of cholesterol in large HDL and large LDL with TG. What CETP does is it takes cholesterol out of large HDL and LDL particles and then transfers TG into these particles. In turn, hepatic lipase metabolizes TG-rich HDLs and LDLs, leading to smaller HDLs and LDLs.
In a nutshell, high TG levels affect HDL and LDL levels. And prediabetes leads to high TG levels.
Look at the image below showing what a lipid profile would look like in a patient with prediabetes.
Aside from prediabetes, this patient actually has another problemfamilial hypercholesterolemia . Neither condition was noticed before the patient came to us.
To make matters worse, the patient also has an elevated TG/HDL216/34 or 6.4! I recommend a goal of 1.5 or less.
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Why Is Tg/hdl Important
TG/HDL is important because it is an important predictor of risk for heart disease. It is also a marker of insulin resistance, and insulin resistance is the major cause of prediabetes, metabolic syndrome, and type 2 diabetes.
The Womens Ischemia Syndrome Evaluation study studied 544 women referred for CV disease evaluation . The TG/HDL ranged from 0.3 to 18.4. It was a powerful predictor of all mortality and cardiovascular events.
This chart shows the WISE study range of TG/HDL. Individuals with lower TG/HDL had lower CV disease risk.
High Cholesterol High Hdl Low Triglycerides
There are 2 kinds of LDL cholesterol, A and B, of which B is associated with heart disease.Most labs calculate LDL as follows:
LDL = Total Cholesterol HDL triglycerides/5.
This doesnt explain the difference between LDL A or B .
Studies have shown that there is a strong correlation between a low triglyceride/high HDL level and LDL pattern A .
On the other hand, a high triglyceride/low HDL level is strongly associated with LDL pattern B . Thus high triglycerides are an independent risk factor for heart disease.
From this you can calculate that in your situation a high LDL is mostly Type A , confirmed by a high HDL and low triglyrerides and that therefore there a very low risk of heart disease.
Having high cholesterol may still be healthy if good cholesterol levels, triglycerides, and other markers of cardiovascular health are good. You can calculate this here. People with high good cholesterol levels and low levels of triglycerides may actually be at a lower risk for heart disease than people with normal cholesterol levels who have lower levels of good cholesterol and higher levels of bad cholesterol.
Hope this helps,
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What Is High Cholesterol Symptoms Causes Diagnosis Treatment And Prevention
High cholesterol is a condition that occurs when levels of cholesterol in your blood are elevated enough to cause health problems, including heart disease and stroke. Sometimes known as hyperlipidemia, high cholesterol is painless and doesnt cause any symptoms until a person develops severe heart disease.
According to the Centers for Disease Control and Prevention , heart disease is the leading cause of death in the United States, and stroke is the fifth leading cause.
Produced by your liver, cholesterol is a dense, fatty substance thats found in every cell of your body, and it is considered essential to many life-sustaining functions. It helps your body make hormones and vitamin D, and its also found in compounds that your body creates to help you digest food, such as bile.
Circulating in the bloodstream in small bundles of fat and protein called lipoproteins, cholesterol comes in two primary types: low-density lipoprotein , which contributes to the buildup of fatty plaques, and high-density lipoprotein , which is thought to protect from heart disease and stroke. A blood test known as a lipid panel can measure both LDL and HDL cholesterol, as well as triglycerides, the most common type of fat in the blood.
What Can Raise Your Triglycerides
Triglycerides can be raised due to what doctors refer to as ‘primary’ and ‘secondary’ causes, explained below. Some people have a combination of both.
It is very important that your doctors investigates all these potential causes so that you can start treatment.
Primary causes of raised triglycerides
‘Primary’ refers to inherited conditions which cause raised triglyceride levels.
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Why Cholesterol Matters For Women
Ah, cholesterol and triglycerides. We hear about them all the time. Even foods that might seem good for you on the surface, like fruit-filled yogurt or bran muffins, can contribute to abnormal levels if they contain too much saturated fat or refined sugar, says Erin Michos, M.D., associate director of preventive cardiology at the Ciccarone Center for the Prevention of Heart Disease.
Whats more, many women are at risk for high cholesterol and dont realize it. Approximately 45 percent of women over the age of 20 have a total cholesterol of 200 mg/dl and above, which is considered elevated but a survey by the American Heart Association found that 76 percent of women say they dont even know what their cholesterol values are, Michos says.
Scarier still: Triglycerides, a type of blood fat typically measured alongside cholesterol, are even more risky in women compared with men. This is a problem because womens cholesterol levels can fluctuate quite a bit after menopause and tend to increase with age, putting us at greater risk of heart disease and stroke. Knowing your cholesterol numbers and how to control them is a big step toward staying healthy.
My Cholesterol Is Normal But My Triglycerides Are High: Why Is That
So both your HDL and LDL levels are where they should be, but your triglycerides are still high why is that?
Triglycerides become elevated due to excess calories that do not get burned off, and in turned get stored in fat cells. Statins are medications that primarily lower LDL cholesterol, but depending on the medication dose, can lower Triglycerides from 20 to 40 percent, Sai Hanumanthu MD, with the TriHealth Heart Institute explains.
There are steps you can take to lower your triglyceride levels while promoting good cardiovascular health, including:
- Losing 5 to 10 pounds if overweight
- Avoiding alcohol
- Avoiding foods high in saturated fats
- Limiting simple carbs that have high processed sugars .
- Participating in 30 minutes of exercise per day
All these suggestions and routine follow up with a medical professional will lower you triglyceride level, even despite a low total cholesterol, Dr. Hanumanthu says.
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Low Triglycerides But High Ldl
Triglycerides and low-density lipoproteins are both found in your bloodstream. Along with high-density lipoproteins, these particles make up your cholesterol profile. According to the American Heart Association, high levels of triglycerides and LDL cholesterol are associated with an increased risk of coronary diseases. Optimally, triglyceride levels should be below 150 mg/dl, and LDL should be below 100 mg/dl.
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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.
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Diets High In Calories Carbs And Fats
Triglyceride levels increase with a positive energy-intake balance . In other words, when you eat more than your body needs, the surplus is transformed into fat, including triglycerides. Its easier to overeat when your diet is high in calories and contains lots of carbs and saturated fats .
Low-fat, high-carbohydrate diets are among the most common causes of high triglycerides. But wait we said that high-fat diets are bad, so doesnt that mean a low-fat diet should be beneficial? Not quite .
Saturated, unhealthy fats are bad. But your body needs healthy fats such as those found in olive oil and fish oil to keep your triglyceride levels normal and to maintain your overall health. If you dont get enough dietary fats, your body will revert to transforming the sugars you consume into fats .
This goes against the popular but unfounded belief that your body wont store fat as long as you dont eat fats. In truth, high-carbohydrate diets can be much worse than high-fat diets for your triglyceride levels. Many scientists advocate that high-carb, low-fat diets likely also contributed to the obesity epidemic in America over the past few decades .
What Are Risk Factors For High Triglycerides
Factors that may raise triglyceride levels include:
- Excessive alcohol use.
- American Academy of Family Physicians. High Cholesterol. Accessed 11/182/2021.
- American Heart Association. Cholesterol. Accessed 11/18/2021.
- Centers for Disease Control and Prevention. Getting Your Cholesterol Checked. Accessed 11/18/2021.
- Hormone Health Network. Triglycerides. Accessed 11/18/2021.
- MedlinePlus. Triglycerides Test. Accessed 11/18/2021.
- Merck Manual Consumer Version. Overview of Cholesterol and Lipid Fats. Accessed 11/18/2021.
- National Heart, Lung and Blood Institute. High Blood Triglycerides. Accessed 11/18/2021.
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High Triglycerides And Low Hdl Cholesterol Can Be Caused By Many Reasons
If your Triglycerides is in between 0 mg/dL and 150 mg/dL and your HDL cholesterol is in between 40 mg/dL and 60 mg/dL then you need not worry as these are the normal ranges for Triglycerides and HDL cholesterol respectively. But if your levels are lesser or greater than the above values, then there may be some problem in your body.
Understanding Cholesterol: Hdl Ldl And Triglycerides
There are two types of grocery shoppersthose who race in with a list in hand and meticulously grab every item on the list before checking out and leaving, and those who meander up and down every aisle, not sure what they want until they see it on the shelf.
But within those two types, theres another shopper you may have seenthe label-reader. This person is health-conscious and examines the nutrition labels of food items before placing them in the cart.
One of the most important categories to check for on a food label is cholesterol.
Cholesterol is a waxy, fat-like substance found in your blood. Your body needs some cholesterol, but too much can build up on the walls of your arteries and can lead to heart disease and stroke. Checking your risk for heart disease and stroke is as simple as getting a lipidpanel, which tests your blood cholesterol.
There are four important things checked in a lipid panel:
- Total cholesterol
- Low-density lipoproteins
HDL is known as the good cholesterol because it helps remove cholesterol by carrying it back to the liver where it can be eliminated from the body. Its good to have a high HDL number. LDL is known as the bad cholesterol because having too much LDL may cause a buildup of plaque in your blood vessels. Triglycerides are also a type of fat found in your blood. High triglycerides, low HDL, and/or high LDL numbers can increase your risk for heart attack and stroke.
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What Are Triglycerides
Lipids, also referred to as fats, are one of the three macronutrients that are an essential part of the diet. There are various types of lipids, including steroids, phospholipids, and triglycerides. Triglycerides are a type of lipid that the body can use for both immediate and stored energy.
When you eat a meal, your body uses the nutrients from that meal as energy or fuel. However, if you eat a meal with too much energy , this excess energy gets converted into triglycerides. These triglycerides are stored in fat cells for use at a later time.
The most common concern about triglycerides is high triglyceride levels. High levels of triglycerides in the blood may contribute to atherosclerosis, the clogging and hardening of the arteries. Because of this, high triglyceride levels may increase your risk of heart disease, heart attack, or stroke.
Low triglyceride levels may be a health concern as well. Lets look at how low triglycerides may affect your health and how to prevent and treat related problems.
The most common blood test used to check your triglyceride levels is called a lipid panel. A standard lipid panel will test for the following:
- total cholesterol
- cholesterol/HDL ratio
- non-HDL cholesterol
Your doctor will use a lipid panel to determine if your triglyceride levels are within normal range.
There is no current range for low triglyceride levels. However, if your triglyceride levels are very low, this may indicate an underlying condition or disease.