Triglycerides (80% in VLDL 15% in LDL)

1.      Triglycerides (80% in VLDL 15% in LDL)

Introduction

Triglyceride levels are not strong predictors of atherosclerosis or CAD and may not be an independent risk factor. Triglyceride levels are inversely related to HDL cholesterol levels.

Normal Range
20 –170mg/dL
Classification
Normal Range	Borderline	High	Very high
< 150mg/dL	150 – 199mg/dL	200 – 499mg/dL	> 500mg/dL

 

Increased in

Genetic hyperlipidemias (e.g. Lipoprotein lipase deficiency, apo C..II deficiency, familial Triglyceridemia, dysbetalipoproteinemia); secondary hyperlipidemias (gout, pancreatitis, acute illness (e.g. in AMI rises to peak in 3 weeks and increase may persist for 1 year); drug use (e.g. thiazides, steroids, amiodarone, interferon).

Decreased in

Abetalipoproteinemia; malnutrition; vigorous exercise; drugs (e.g. ascorbic acid, clofibrate, phenformin, metformin, progestins).  

LDL (Low Density Lipoprotein) cholesterol (Lipid Profile)

1.      LDL (Low Density Lipoprotein) cholesterol

Introduction

LDL levels are directly related to risk fill CAD

 

Indication

Assess risk and decide treatment for CAD

 

Normal Levels

 

      No coronary heart disease (CHD) and < 2 risk factors < 160mg/dL

 

No CHD but > 2 risk factors < 130mg/dL

 

Presence of CHD < 100mg/dL

Increased in

Familial hypercholesterolemia and combined hyperlipidemia; diabetes mellitus (DM) and hypothyroidism; chronic renal failure; diet high in cholesterol and total and saturated fat;

Pregnancy; cholesteryl ester storage disease; drug use (e.g. anabolic, steroids, beta – blockers, progestins, carbamazepine).

Decreased in

Severe illness; abetalipoproteinemia; some laboratories also various ratios; total cholestero/HDL ratio – low risk: 3.3 – 4.4, average risk: 4.4 – 7.1, moderate risk: 7.1 – 11.0, high risk > 11.0.

High Density Lipoprotein (HDL) Cholesterol (Lipid Profile)

1.      High Density Lipoprotein (HDL) Cholesterol

Introduction

Levels of HDL are inversely related to risk of CAD. For every mg/dL decreased in HDL, risk of CAD increase by 2 -3%

 

Indications

Assessment of risk of CAD

 

Diagnosis of various lipoproteinemia

 

Normal Levels
Men	Women
> 40mg/dL	> 50mg/dL

 

Increased in (60mg/Dl is negative risk factor for CAD)

 

Vigorous exercise; moderate consumption of alcohol; Increased clearance of triglyceride (VLDL), Familial lipid disorders with protection against atherosclerosis (illustrates importance of measuring HDL to evaluate hypercholesterolemia); 1 in 20 adults with mild increased total cholesterol levels (240 – 300mg/dL) secondary to increased HDL ( > 70mg/dL); Hypobetalipoproteinemia.

 

Decreased in (< 32mg/dL in men, < 38mg/dL in women)

Stress and recent illness (e.g. acute myocardial infarction [AMI], stroke, surgery, trauma); starvation, non fasting sample; obesity and lack of exercise; cigarette smoking; DM, hypo – and hyper – thyroidism; acute and chronic liver disease; genetic disorders; familial hypoalphalipoproteinemia.