Lipid profile.pptx and chlestrol hdl vldl

lipid profil

1. Lipid profile By hanan omar

2. Introduction The major lipids present in the plasma are: fatty acids, Triglycerides, cholesterol and phospholipids. Other lipid-soluble substances, present in much smaller amounts (e.g. steroid hormones ). Elevated plasma concentrations of lipids, particularly cholesterol, are related to the pathogenesis of atherosclerosis.

3. Lipids transport Lipids are carried in the bloodstream by complexes known as lipoproteins. This is because these lipids are not soluble in the plasma water. Thus they travel in micelle -like complexes composed of phospholipids, cholesterol and protein on the outside with cholesteryl esters, and triglycerides on the inside. The four main types of lipoproteins are chylomicrons, VLDL, LDL, and HDL

4. The story of lipids Chylomicrons transport fats from the intestinal mucosa to the liver In the liver, the chylomicrons release triglycerides and some cholesterol and become low-density lipoproteins (LDL). LDL then carries fat and cholesterol to the body’s cells. High-density lipoproteins (HDL) carry fat and cholesterol back to the liver for excretion.

5. The story of lipids When oxidized LDL cholesterol gets high, atheroma formation in the walls of arteries occurs, which causes atherosclerosis. HDL cholesterol is able to go and remove cholesterol from the atheroma. Atherogenic cholesterol → LDL, VLDL, IDL

6. Clinical Significance Cholesterol and triglycerides, like many other essential components of the body, attract clinical attention when present in abnormal concentrations. Increased or decreased levels usually occur because of abnormalities in the synthesis, degradation, and transport of their associated lipoprotein particles. Increased or decreased plasma lipoproteins are named hyperlipoproteinemia & hypolipoproteinemia respectively.

7. 8 Lipid Profile Report PP Fasting

8. 9 www.drsarma.in Normal Lipid Profile Total Cholesterol < 200 TG ‘Ugly’ Lipid < 150 ‘Bad’ Cholesterols LDL < 100 HDL ‘Good’ cholesterol > 50 VLDL is Ugly TG ÷ 5 < 30 Lp (a) ‘Deadly’ cholesterol < 20

9. Triglycerides 10 Glycerol backbone with FA attached by ester bonds Sources of Triglycerides: Exogenous source: Dietary Endogenous : Liver and tissue storage Glycerol Triglyceride

10. Triglycerides Triglycerides ( triacylglycerides ) contain: Three fatty acid molecules One glycerol molecule

11. Triglycerides Serum triglycerides measurements are done for the following clinical reasons: • Hypertriglyceridemia increases the risk for pancreatitis. • Hypertriglyceridemia is associated with the following clinical findings: eruptive xanthoma , lipemia retinalis , hepatomegaly , splenomegaly , depressed HDL-cholesterol . in characterizing risk of CVDs • For the estimation of LDL-cholesterol, using the Friedewald equation

12. TG levels: TG test needs 12 hrs fasting because its level is effected by meal (fatty meal, high carbohydrates meal) Level should be: Less than 150 mg/dl High TG leads to fatty liver

13. Cholesterol Cholesterol is a sterol compound that is found in all animal tissues Serves many important physiological functions including: synthesis of bile acids, steroid hormones, and cell membranes. Cholesterol also appears to be involved in atherosclerosis; thus cholesterol measurement is one of the most common laboratory tests used today.

14. Cholesterol levels: -High level associated with heart disease -Good level: below 200 mg/dl (low risk of heart disease). -Border line: 240mg/dl (if higher at high risk) -Notes : -Measuring blood cholesterol level not need fasting? Cholesterol level is not affected by single meal but affected by long term pattern of eating (change from high fat diet to low fat diet for several weeks) -Cholesterol level is elevated during pregnancy (till 6 weeks after delivery) -Some drugs are known to increase cholesterol levels as anabolic steroids, beta blockers, epinephrine, oral contraceptives and vitamin D.

15. High denisty lipoprotien (HDL) HDL is a fraction of plasma lipoproteins It is composed of: 50% protein, 25% phospholipid, 20% cholesterol, and 5% triglycerides Evidence suggests that high-density lipoprotein (HDL) cholesterol is a primary coronary heart disease (CHD) risk factor.

16. Low Density Lipoprotein (LDL) Where all concentrations are given in mmol /L (note that if calculated using all concentrations in mg/ dL then the equation is: [LDL- chol ] = [Total chol ] - [HDL- chol ] - ([TG]/5) The ([TG]/5) is used as an estimate of VLDL-cholesterol concentration. It assumes, first, that virtually all of the plasma TG is carried on VLDL, and second, that the TG:cholesterol ratio of VLDL is constant at about 5:1

17. Limitations of the Friedewald equation The Friedewald equation should not be used under the following circumstances: when chylomicrons are present when plasma triglyceride concentration exceeds 400 mg/dL in patients with dysbetalipoproteinemia (type III hyperlipoproteinemia

18. Thank you