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The remainder of the serum cholesterol after subtracting the HDL is the non-HDL cholesterol. The concentration of these other components, which may cause atheroma, is known as the non-HDL-C. This is now preferred to LDL-C as a secondary marker as it has been shown to be a better predictor and it is more easily calculated. [10]
These groups, from least dense to most dense, are chylomicrons (aka ULDL by the overall density naming convention), very low-density lipoprotein (VLDL), intermediate-density lipoprotein (IDL), low-density lipoprotein (LDL) and high-density lipoprotein (HDL). LDL delivers fat molecules to cells.
Reference ranges for blood tests, showing usual, as well as optimal, levels of HDL, LDL, and total cholesterol in mass and molar concentrations, is found in orange color at right, that is, among the blood constituents with the highest concentration. Total cholesterol is defined as the sum of HDL, LDL, and VLDL.
LDL contains apolipoprotein B (apoB), which allows LDL to bind to different tissues, such as the artery wall if the glycocalyx has been damaged by high blood sugar levels. [8] If oxidised, the LDL can become trapped in the proteoglycans, preventing its removal by HDL cholesterol efflux. [8]
Hyperlipidemia is abnormally high levels of any or all lipids (e.g. fats, triglycerides, cholesterol, phospholipids) or lipoproteins in the blood. [2] The term hyperlipidemia refers to the laboratory finding itself and is also used as an umbrella term covering any of various acquired or genetic disorders that result in that finding. [3]
Level of the good cholesterol HDL is also increased. Fibrates may decrease LDL, though generally to a lesser degree than statins. Similar to statins, the risk of muscle damage exists. Nicotinic acid, like fibrates, is also well suited for lowering triglycerides by 20–50%. It may also lower LDL by 5–25% and increase HDL by 15–35%.
The idea that HDL cholesterol is good for you stems from a study conducted in the 1970s that determined high levels of HDL were linked with a low heart disease risk, explains Alfonso Waller, M.D ...
Levels of LDL or non-HDL cholesterol both predict future coronary heart disease; which is the better predictor is disputed. [39] High levels of small dense LDL may be particularly adverse, although measurement of small dense LDL is not advocated for risk prediction. [39] In the past, LDL and VLDL levels were rarely measured directly due to cost.