DIAGNOSIS UNDER THE MICROSCOPE | health & wellness || 9
IS NOT SO GOOD
NOT SO BAD
By “ good ” cholesterol , health professionals mean high-density lipoprotein cholesterol ( HDL-C ); “ bad ” cholesterol is low-density lipoprotein cholesterol ( LDL-C ). Scientists also refer to “ bad ” cholesterol as “ non-HDL cholesterol ” to include other types of cholesterol besides LDL-C .
As for “ bad ” cholesterol , it is generally understood that high levels of LDL-C result in atherosclerosis — also called arteriosclerosis or hardening of the arteries — by forming deposits , or plaques , in the interior walls of the arteries , causing inflammation , narrowing the blood vessels , and decreasing their elasticity . Plaques in coronary arteries increase the risk of ischemic heart disease , angina , and heart attack . In their article about atherosclerosis and coronary artery disease ( CAD ), WebMD . com says that atherosclerosis kills half a million Americans a year from CAD alone . Moreover , atherosclerosis can also interfere with circulation to other organs , and high levels of LDL-C in the blood are associated with impaired kidney function , fatty liver , erectile dysfunction , and Alzheimer ' s disease .
Nevertheless , despite its being “ bad ,” we need some LDL- C ; it provides structural integrity to cell membranes , protects nerve fibers , facilitates digestion , and plays a positive role in metabolism and immune function . Additionally , along with HDL-C , it is a component of steroid hormones , including adrenalin , testosterone , estrogen , and progesterone . In its article , “ Cholesterol level : Can it be too low ?” the Mayo Clinic says that very low levels of LDL-C — less than 40 milligrams per deciliter of blood — put us at increased risk of cancer and stroke , among other illnesses .
The risks of heart disease related to low levels of HDL-C are well known . Among other beneficial actions , good cholesterol removes cholesterol and fat , or lipids , from cells and transports them to the liver , where they are converted to bile acids that are excreted with bile into the intestine . It is especially important to note that HDL-C also removes cholesterol and fat from atherosclerotic plaques , which has the potential to actually reverse atherosclerosis . HDL-C also helps safeguard heart muscle against damage caused by the hypoxia of ischemic events . Thus , doctors can congratulate their patients on having a high level of good cholesterol — but not too high , if the results of the aforementioned Danish study are confirmed . To observe whether there was an association between extremely high levels of HDL-C and death from all causes , Doctors Madsen , Varbo , and Nordestgaard of the University of Copenhagen analyzed data from over 116,500 people being followed in the Copenhagen General Population Study and the Copenhagen City Heart Study . They established that mortality from all causes was lowest among men with an HDL-C of 73 mg / dL and women with 93 mg / dL . Mortality was 106 % higher among men with the most extremely high levels of HDL-C — 116 mg / dL — and 68 % higher among women with 135 mg / dL — than for people with the optimal HDL-C levels . Moreover , mortality among men with very high levels — between 97 and 115 mg / dL — was 36 % higher than for those with the lowest risk , and 10 % higher for women with levels between 116 and 134 mg / dL . At the same time , it was confirmed that low levels of HDL-C — lower than 39 mg / dL — were also associated with serious risks to health and greater mortality .
Statistics indicate that people who are overweight , men over forty , and women after menopause are particularly at risk if they have high levels of non-HDL-C and / or low HDL-C . They are urged to monitor cholesterol levels regularly and to strive through diet and , if necessary , with medication , for a total-cholesterol-to-HDL- C ratio of 3.5 to 1 .
Various theories about what causes atherosclerosis include one that sugar is the villain rather than fat . Some studies find no correlation between fat intake and heart disease . One well-based scientific opinion is that development of atherosclerosis is connected to a low level of lipid transport proteins that help move cholesterol to the liver for excretion in the bile . It is also known that inherited genetic abnormalities cause malfunctions in LDL receptors on the surface of cells and in the liver , resulting in very high levels of LDL-C . This familial hypercholesterolemia is not rare — it may affect as many as 1 in 200 people — but most are never diagnosed with the disorder . Whatever the process , exces-
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