Cholesterol

Cholesterol (from gr. chole (bile) and stereos (solid) – discovered in the form of gallstones) is a lipid molecule (C27H45OH) found in animal cells.

The importance of cholesterol:

  • part of the cell membrane and nerve structure
  • necessary for the production of some (steroid) hormones
  • bile acids are formed by oxidation of cholesterol

How it gets into the body:

  • diet (exogenous) – up to 300mg daily (athletes a little more)
  • liver synthesis (endogenous – about 75%) – the liver also ensures (if possible) the balance between income and synthesis of cholesterol

In the body, cholesterol binds to various so-called apolipoproteins (special proteins) and creates lipoproteins (fat transporters) that are divided into several classes, the most important of which are:

  • Good HDL (high density L. – about 10nm) – particle (and bound cholesterol) is directed from peripheral tissues (ie from the body) to the liver, ie it removes excess cholesterol from the body as well as plaque from the arteries (the main protein component: apolipoprotein A1)
  • Bad LDL (low density L. – about 20nm) – travels from the liver to the peripheral tissues – ie it distributes cholesterol throughout the body, where it unloads (and also upon malfunction it causes arterial clogging), the main protein component: apolipoprotein B

For the sake of completeness: lipoproteins transports, in addition to cholesterol, also other lipids (triglycerides), and there are also other lipoprotein classes such as IDL, VLDL and chylomicrons. Put simply, from these lipoproteins, triglycerides (derived from food, i.e., from the intestine) are gradually released until only cholesterol is left in them, and then LDL is formed.

LDL is then divided into large lbLDL and small sdLDL (which are the most dangerous). Another subclass of lipoproteins is lipoprotein (a) or shortly LP (a). This is the same as LDL, but in addition to apolipoprotein B, it contains also other apolipoprotein (a). Elevated levels of LP (a) also indicate problems.

We can measure the following parameters in the blood (in all cases the lower value is better, except of HDL):

  • total cholesterol (less indicative, but if it is high, it is also associated with high LDL at the expense of HDL)
  • HDL (the more is better – blood vessels cleaning)
  • LDL (ideally if lbLDL and sdLDL levels could also be measured)
  • triglycerides (higher triglycerides indicate more small sdLDL)
  • total cholesterol / HDL (total to “cleaners” ratio)
  • LDL / HDL (the ratio between lipoproteins that “clog” and those that “clean”)
  • triglycerides / HDL (better indication of problem than triglycerides alone)

More recently, these markers are considered to be the most relevant (in all cases the lower value is better):

  • LP (a) – lipoprotein (a), indicates a problem
  • LDL-P (number of LDL particles, not their total volume)
  • apo-B (apolipoprotein B), or B to A1 apolipoprotein ratio (apo-B is a component of particles carrying cholesterol by potentially undesirable way)

Poor values ​​of these parameters, which indicate a health problem, are called dyslipidemia.

Since we do not feel plaque deposition, these cholesterol markers can be an early warning of the risk of atherosclerosis (vascular plugging) and metabolic syndrome, with the recommendation to adjust the diet and overall lifestyle.

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