What Are The Two Types Of Cholesterol Called

Can I Take The Test At Home

At-home cholesterol testing is available to measure calculated levels of LDL cholesterol. At-home testing for cholesterol uses a blood sample taken by a device that pricks your finger to obtain a small drop of blood that can be tested.

There are two types of at-home LDL tests that use a fingerstick blood sample:

• Self-tests: In this kind of test, the analysis of your blood happens at home. This can be done by applying a drop of blood on paper that is then placed into a small device that determines the cholesterol levels. Another type of self-test uses chemically treated paper that indicates the levels of cholesterol in your blood.
• Self-collection: For this kind of test, your blood sample is taken at home but is then sent to a laboratory for analysis.

For help deciding whether an at-home cholesterol test kit is right for you, it may be helpful to talk to your primary care doctor or cardiologist. It is common to have a follow-up cholesterol test performed by a doctor if an at-home cholesterol test kit finds abnormal results.

How Do You Prepare For A Cholesterol Test

In most cases, youll need to fast for nine to 12 hours before the test. Make sure you tell the person drawing your blood how long it has been since you ate or drank anything that wasnt water.

There are some cases when a cholesterol test is done without fasting. This is true for tests done at health screenings and may be true for people younger than 20 or for people who are unable to fast.

Some medical societies believe that fasting is not necessary to get a true picture of lipid levels in the blood, while other associations stand by the belief that fasting gives a better idea of a persons heart disease risk. You should be clear on whether or not you need to fast, and for how long, before you go for the blood test.

Learn The Warning Signs Of Serious Complications And Have A Plan

High blood cholesterol can lead to serious cardiovascular complications, such as heart attack or stroke. If you think that you are or someone else is having the following symptoms, Every minute matters.

Heart attack

Heart attack symptoms include mild or severe chest pain or discomfort in the center of the chest or upper abdomen that lasts for more than a few minutes or goes away and comes back. This discomfort can feel like pressure, squeezing, fullness, heartburn, or indigestion. There also may be pain down the left arm or in the neck. Although both men and women can experience these symptoms, women are more likely to have other, less typical symptoms, such as shortness of breath, nausea, vomiting, unusual tiredness, and pain in the back, shoulders, or jaw. Read more about the signs and symptoms of a heart attack.

Stroke

If you think someone may be having a stroke, act F.A.S.T. and perform the following simple test.

FFace: Ask the person to smile. Does one side of the face droop?

AArms: Ask the person to raise both arms. Does one arm drift downward?

SSpeech: Ask the person to repeat a simple phrase. Is their speech slurred or strange?

TTime: If you observe any of these signs, . Early treatment is essential.

Read more about the signs and symptoms of a stroke.

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When Should I Get Ldl Cholesterol Testing

LDL cholesterol testing may be used to assess your risk of cardiovascular disease or monitor changes in cholesterol over time.

Doctors will take factors such as age, family history, and other medical conditions when determining how often you should check your levels of LDL cholesterol. Examples of common screening recommendations are outlined below:

Demographic Group
With or without risk factors	Annually

Having your cholesterol levels checked at regular intervals gives doctors a chance to notice any changes that could become harmful to your health. High or increasing cholesterol levels are a risk factor for heart disease, diabetes, or stroke, among other conditions.

Doctors may want to test your cholesterol levels more regularly if you or your family have a history of heart disease, smoking, high blood pressure, type 2 diabetes, obesity, a sedentary lifestyle, or a diet high in saturated fat.

How Is The Total Cholesterol Or Blood Cholesterol Test Done

A blood test is a routine test. A phlebotomist is a person whose job is to draw blood. Blood is usually drawn from the vein in your arm. You will sit down and the phlebotomist will wrap a rubber band around your upper arm so that the vein in your elbow sticks out. Then they will use a needle to puncture the vein and remove blood. The blood is sent to the lab to be examined.

Youve probably been at health fairs where testing is offered. In that case, the person performing the test takes a drop of blood from your finger. The finger-stick test uses a small blade to poke a hole in the tip of your finger to get the blood.

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Estimation Of Ldl Particles Via Cholesterol Content

Chemical measures of lipid concentration have long been the most-used clinical measurement, not because they have the best correlation with individual outcome, but because these lab methods are less expensive and more widely available.

The lipid profile does not measure LDL particles. It only estimates them using the Friedewald equationby subtracting the amount of cholesterol associated with other particles, such as HDL and VLDL, assuming a prolonged fasting state, etc.:

L T

where H is HDL cholesterol, L is LDL cholesterol, C is total cholesterol, T are triglycerides, and k is 0.20 if the quantities are measured in mg/dl and 0.45 if in mmol/l.

There are limitations to this method, most notably that samples must be obtained after a 12 to 14 h fast and that LDL-C cannot be calculated if plasma triglyceride is > 4.52 mmol/L . Even at triglyceride levels 2.5 to 4.5 mmol/L, this formula is considered inaccurate. If both total cholesterol and triglyceride levels are elevated then a modified formula, with quantities in mg/dl, may be used

L T

This formula provides an approximation with fair accuracy for most people, assuming the blood was drawn after fasting for about 14 hours or longer, but does not reveal the actual LDL particle concentration because the percentage of fat molecules within the LDL particles which are cholesterol varies, as much as 8:1 variation.

Normal ranges

Can You Get Rid Of Cholesterol Deposits

Researchers are working on ways to eliminate plaque from coronary arteries. One method that has been proposed involves using combinations of medicines in healthy people aged 25 to 55 years. It is suggested that getting the levels of cholesterol down very low will allow arteries to clear up and heal up.

Several researchers believe that the way to reverse heart disease and prevent it in the first place is found in a whole-food, plant-based diet. Studies have been done that have shown that limiting nutrition to whole foods that are plant-based have been successful in reducing blood cholesterol and even, in some cases, lessening plaque buildup.

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Proteolytic Cleavage In The Golgi Releases Srebp

Once SREBP reaches the Golgi, it is ambushed and cleaved by two specific proteases . Cleavage releases the DNA-binding domain of the protein from the membrane. This fragment then moves across the cytosol and enters the nucleus, where it binds to SRE sequence elements that increase the expression of HMG-CoA reductase and also of various other enzymes from the cholesterol synthesis pathway .

Another protein that is upregulated by SREBP and SRE is the LDL receptor, a membrane protein that mediates endocytosis of low density lipoprotein . In cells that do not synthesize cholesterol themselves, SREBP upregulates transcription of the LDL receptor,

Like SREBP and SCAP, HMG-CoA reductase is anchored in the ER membrane. This does not seem necessary for the chemistry it performs. Instead, this location facilitates the negative feedback regulation imposed on it by cholesterol. Indeed, the enzyme contains a sterol-sensing domain that is homologous to the one found in SCAP .

11.4

Medications To Treat High Cholesterol

For most people who need medication to manage high cholesterol, doctors will prescribe statins. Statins, also known as HMG CoA reductase inhibitors, are a class of drugs that prevent cholesterol from forming in the liver, where both LDL and HDL cholesterol are made. This lowers the amount of cholesterol circulating in the blood. They are most effective at lowering LDL cholesterol but can also lower triglycerides and HDL cholesterol.

If you have certain conditions, or if statins arent working to decrease your high cholesterol sufficiently, your doctor may prescribe one of these other cholesterol-lowering medications:

• PCSK9 Inhibitors A newer type of medicine, PCSK9 inhibitors bind to and inactivate a protein on certain liver cells, which then lowers LDL cholesterol. Administered by injection, they are often used in patients with high cholesterol that doesnt respond to statins or people with familial hypercholesterolemia.
• Selective Cholesterol Absorption Inhibitors The most commonly used nonstatin agent, according to the AHA, selective cholesterol absorption inhibitors prevent cholesterol from being absorbed in the intestine. This means less cholesterol is delivered to the liver and, ultimately, the blood.
• Bile Acid Sequestrants Also known as bile-acid-binding agents, these drugs work by removing bile acids from the liver. Since LDL cholesterol is needed to make bile acids, the body then breaks down more LDL cholesterol particles.

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How Can I Lower My Cholesterol Level

The first step in reducing your cholesterol is to maintain a healthy, balanced diet. It’s important to keep your diet low in fatty food.

You can swap food containing saturated fat for fruit, vegetables and wholegrain cereals. This will also help prevent high cholesterol returning.

Other lifestyle changes, such as taking regular exercise and giving up smoking, can also make a big difference in helping to lower your cholesterol.

If these measures don’t reduce your cholesterol and you continue to have a high risk of developing heart disease, your GP may prescribe a cholesterol-lowering medication, such as statins.

Your GP will take into account the risk of any side effects from statins. The benefit of lowering your cholesterol must outweigh any risks.

Read more about how high cholesterol is treated

Abc Transporters Induce Substrate Flip

One feature that is shared by many ABC transporter substrates is their amphiphilic nature. Most ABC transporters expel their substrates from the cytosol to the extracellular space. In this case, the substrate initially resides within the inner leaflet of the cytoplasmic membrane. Once it enters the inward-open conformation of the transporter, the latter undergoes a transition to the outward-open conformation, which is powered by the hydrolysis of ATP. The substrate then leaves the transporter and diffuses into the outer membrane leaflet, from where it may distribute to other extracellular reservoirs.

11.4.7

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Signs Symptoms And Complications

High bad LDL cholesterol usually does not cause symptoms, so most people do not know they have it until they are tested during a routine doctors visit. Very high levels may cause symptoms such as fatty bumps on your skin, called xanthomas, or grayish-white rings around the corneas in your eye, called corneal arcus. These mostly develop in people who have familial hypercholesterolemia.

Undiagnosed or untreated high blood cholesterol can lead to serious problems, such as heart attack and stroke.

How Can I Prevent High Cholesterol

Here are a few things you can do to keep your cholesterol under control:

• Eat a healthy diet that includes lots of fruit, vegetables and whole grains.
• Limit drinks and foods that have a lot of fat or sugar, like sugary drinks, treats, and fried foods.
• Get plenty of exercise. Experts recommend at least 60 minutes every day!

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Learn About Other Precautions To Help You Stay Safe While Taking Statins

Statins are the most common medicine used to treat high blood cholesterol. Learn some tips to stay safe if your doctor gives you statins.

• Keep taking your statin medicine as prescribed. If you started taking a statin after you recently had a heart attack, a stroke, or another complication, you should not stop taking this medicine on your own, because that can increase your risk for a repeat event or even death. Ask your doctor if you have any concerns about your medication or if you would like to stop or change to a different treatment.
• Ask your doctor what medicines, nutritional supplements, or foods you should avoid. Some of these can interact with statins to cause serious side effects or make them less effective. For example, grapefruit affects how your liver breaks down some statins.
• Tell your doctor about any symptoms or side effects. Sometimes, people report muscle problems while taking statins. If you start having muscle pain, your doctor may order a blood test to look for muscle damage. The pain may go away if you switch to a different statin. Muscle damage with statins is rare, and your muscles may heal when you switch to a different medicine.
• If you are a woman who is planning to become pregnant, talk to your doctor about your options. You should stop taking statins about three months before getting pregnant. Also, you should not take statins if you are breastfeeding.

Confirming Unhealthy Cholesterol Levels

A lipid panel usually measures total cholesterol, LDL cholesterol, and HDL cholesterol. Your test may also show the level of non-HDL cholesterol, which includes LDL and all other types of bad cholesterol that raise your risk of atherosclerosisand complications.

Your doctor may diagnose you with high blood cholesterol if your total or non-HDL cholesterol level is higher than what is healthy for you. Your doctor might also find that your level of good HDL cholesterol is too low.

Your doctor may ask that you fast before a lipid panel. This means you do not eat or drink anything except water for 9 to 12 hours before your blood is drawn. Ask you whether you should take your usual medicines before the test and if there are any other special instructions.

Your doctor may order other tests to help decide whether medicines are needed to lower your risk of heart and blood vessel diseases. These may include a coronary calcium scan, and blood tests for levels of C-reactive protein and lipoprotein-a.

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Hdl Versus Ldl Cholesterol

There are two main types of cholesterol: high-density lipoprotein and low-density lipoprotein . Lipoproteins are made of fat and proteins. Cholesterol moves through your body while inside lipoproteins.

HDL is known as good cholesterol because it transports cholesterol to your liver to be expelled from your body. HDL helps rid your body of excess cholesterol so its less likely to end up in your arteries.

LDL is called bad cholesterol because it takes cholesterol to your arteries, where it may collect in artery walls. Too much cholesterol in your arteries may lead to a buildup of plaque known as atherosclerosis. This can increase the risk of blood clots in your arteries. If a blood clot breaks away and blocks an artery in your heart or brain, you may have a stroke or heart attack.

Plaque buildup may also reduce blood flow and oxygen to major organs. Oxygen deprivation to your organs or arteries may lead to kidney disease or peripheral arterial disease, in addition to a heart attack or stroke.

Centers for Disease Control , over 31 percent of Americans have high LDL cholesterol. You may not even know it because high cholesterol doesnt cause noticeable symptoms.

The only way to find out if your cholesterol is high is through a blood test that measures cholesterol in milligrams per deciliter of blood . When you get your cholesterol numbers checked, youll receive results for:

To treat high cholesterol, doctors often recommend these lifestyle changes:

What Do Hdl And Ldl Mean

LDL and HDL are the two main types of cholesterol that make up your total cholesterol.

• HDL , or good cholesterol, may protect the body against narrowing blood vessels
• LDL , or bad cholesterol, may make arterial narrowing worse

There is a third type of cholesterol called VLDL , which is another type of bad cholesterol produced in the liver, and contains a high amount of triglycerides.

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Transport Of Cholesterol Between The Liver And Peripheral Tissues

The liver synthesizes cholesterol from acetyl-CoA . The cholesterol pool in liver cells also receives the dietary cholesterol, which is contained in the chylomicron remnants that are formed through the extraction of triacylglycerol from chylomicrons by lipoprotein lipase .

Liver cells package esterified cholesterol, together with triacylglycerol, into particles of very low density lipoprotein . Like chylomicrons, VLDL interacts with lipoprotein lipase and thereby turns into intermediate and then low density lipoprotein .

LDL is taken up by cells in the periphery through endocytosis, which is mediated by the LDL receptor.71 Excess cholesterol is exported from the cell by an active transporter and delivered to high density lipoprotein , which then carries it back to the liver. Cholesterol transport by HDL is facilitated by lecithin-cholesterol acyltransferase .

11.4.8

Family History And Genetics

Family members usually have similar cholesterol levels. This suggests that your genes can raise your risk of having unhealthy cholesterol levels.

In addition, your genes may raise your risk for another type of bad cholesterol. High levels of lipoprotein-a, also called Lp, may mean you are at high risk of heart or blood vessel diseases, even if your other cholesterol levels are healthy. Genes determine how much Lp you have. Your Lp level is unlikely to change much from childhood to old age.

Lp is not usually part of a routine lipid panel. Your doctor may order an Lp test if you have a family history of early heart or blood vessel disease, such as heart attack, or do not know your family medical history. If you have a high Lp level, your doctor may prescribe a statin to prevent heart and blood vessel disease, even if your other cholesterol levels are in the healthy range.

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