LDL, HDL and triglycerides

regedit

Hi there, I have a fair good understanding of triglycerides and cholesterol but I can't make up this result:
Total Cholesterol: 6.5 (normal less than 5)
Triglycerides: 0.54 (normal, less than 1.7)
HDL: 2.08 (normal if less than 2.08)
LDL (direct): 4.1 (normal, less than 3)

Can someone interpret the results please. If triglycerides and LDL were high and HDL low, I would know what to make out of the results but the way they are, they are confusing me.

Edwardius

You should probably talk to a doctor anyway

Well according to the interwebz conventional wisdom low trigs+high LDL signifies the presence of the larger "fluffy" LDL particles. You can't really tell from those readings because I think the LDL is computed from the total-HDL (I haven't read up on this stuff in a while). Basically if you get a particle size analysis it should make the picture clearer. You probably won't die of a stroke in the meantime :P. Low trigs are likely to be a pretty good sign though

I had similar readings a few years back and the doc was tripping over himself to prescribe statins (same fella offered beta blockers to a buddy of mine who was nervous about an important talk).

Maybe ask on the nutrition forum too?

siochain

what bug's me about the ranges is the normal range is given as the bench mark to be at. The normal Irish person dies of from a heart attack, stroke or cancer. GP’s in general haven’t a clue what their talking about when it comes to talking about the above. Everyone should invest time in understand their health and be well prepared for your doctor’s visit, challenge everything if the don’t like or don’t have the answers change your GP.

Reyman

regedit wrote: »

Hi there, I have a fair good understanding of triglycerides and cholesterol but I can't make up this result:
Total Cholesterol: 6.5 (normal less than 5)
Triglycerides: 0.54 (normal, less than 1.7)
HDL: 2.08 (normal if less than 2.08)
LDL (direct): 4.1 (normal, less than 3)

Can someone interpret the results please. If triglycerides and LDL were high and HDL low, I would know what to make out of the results but the way they are, they are confusing me.

Total cholesterol is worked out as follows:
TC = HDL+LDL+(0.45xTriglyicerides). I think you'll find this works for your readings.

Check with your doctor but I'd say he'll tell you your HDL levels are superb! (you're probably very fit) but you need to get your LDLs down by changing your diet. I.E. stop eating saturated fatty foods and/or lose weight!

DrIndy

In general terms:

HDL = good cholesterol
LDL = bad cholesterol

Cholesterol itself isn't a bad thing - its is in fact a vital component of cell membranes and for the formation of hormones. The trouble is abnormal deposition of cholesterol inside arteries which make unstable plaques which can rupture and cause a heart attack, stroke or cut off circulation to your legs or gut.

In simple terms. HDL mops up cholesterol and reduces deposition and LDL deposits it.

Thus you want a high HDL and a low LDL or a positive ratio favouring HDL. This is in many ways more important than the actual total.

I have had a patient with a cholesterol level of less than 5 who had a heart attack before the age of 30 - but his HDL was less than 0.5.

I have also heard of patients with huge total cholesterol - but HDLs were also really high which was protective.

Triglycerides matter but they can fluctuate a lot - after a fatty meal your serum will actually go so cloudy for a while lab machines can't analyse the blood. So its about the baseline measurement.

This is helpful. The numbers are american though where they use different units

http://www.nhlbi.nih.gov/health/public/heart/chol/wyntk.htm

Lifestyle changes do make a difference. Exercise alters the HDL/LDL balance and smoking encourages deposition. Its not all about diet.

Finally though - the commonest inherited disease in the world is family hypercholesterolaemia which is the tendency for cholesterol to be raised by genetics. There are about 18 different forms (maybe more identified now) and if you have this then the odds are stacked against you that exercise, diet and not smoking will actually help and often the only options is tablets.

regedit

DrIndy wrote: »

In general terms:

HDL = good cholesterol
LDL = bad cholesterol

Cholesterol itself isn't a bad thing - its is in fact a vital component of cell membranes and for the formation of hormones. The trouble is abnormal deposition of cholesterol inside arteries which make unstable plaques which can rupture and cause a heart attack, stroke or cut off circulation to your legs or gut.

In simple terms. HDL mops up cholesterol and reduces deposition and LDL deposits it.

Thus you want a high HDL and a low LDL or a positive ratio favouring HDL. This is in many ways more important than the actual total.

I have had a patient with a cholesterol level of less than 5 who had a heart attack before the age of 30 - but his HDL was less than 0.5.

I have also heard of patients with huge total cholesterol - but HDLs were also really high which was protective.

Triglycerides matter but they can fluctuate a lot - after a fatty meal your serum will actually go so cloudy for a while lab machines can't analyse the blood. So its about the baseline measurement.

This is helpful. The numbers are american though where they use different units

http://www.nhlbi.nih.gov/health/public/heart/chol/wyntk.htm

Lifestyle changes do make a difference. Exercise alters the HDL/LDL balance and smoking encourages deposition. Its not all about diet.

Finally though - the commonest inherited disease in the world is family hypercholesterolaemia which is the tendency for cholesterol to be raised by genetics. There are about 18 different forms (maybe more identified now) and if you have this then the odds are stacked against you that exercise, diet and not smoking will actually help and often the only options is tablets.

Hi Indy,
Than ks for that.
Because of my background I understand the concept of dislipidemias but I am puzzled with high the scenario of a high HDL (great to have), somewhat elevated direct LDL (not that good) and then excellent values of triglycerides in a fasting patient. I suppose, the test could be repeated fora better understanding.
Something ceiculated on the net from support groups:

So from this, you don’t know if you are predominately LDL pattern A (no big deal) or predominately LDL pattern B (much more risk). Some labs do have the capability to measure the LDL gradient and can determine your predominate LDL pattern type. However, there is another way. Studies have shown that there is a strong correlation between a low triglyceride/high HDL level and LDL pattern A (the non risky kind), and conversely, a high triglyceride/low HDL level is strongly associated with LDL pattern B (the harmful kind). This is one reason that high triglycerides alone are an independent risk factor for heart diease.
Ok, where am I going with this with respect to your situation. Other studies have shown that a high triglyceride/HDL ratio is the best indicator for heart disease risk (approximately 8x better at predicting heart disease risk than high total cholesterol alone). A triglyeride/HDL ratio of 5.0 is moderate risk and the higher the number, the higher the risk, while a ratio of <2.0 is very low risk.
From what I have just described, you can see that with your very low triglyceride level (<100) and moderately high HDL level (>50) you are at very low risk of heart disease. Also, your very low triglyceride level indicates that your LDL is predominately pattern A, the harmless kind. If you are still concerned, you can have your LDL gradient measured to determine your LDL pattern type.
I wouldn’t even remotely consider cholesterol lowering medications without knowing your LDL pattern type to see if there is any risk associated with your lipid levels because there are potential significant side effects (muscle damage, neurological damage, liver damage, even death – i.e. the Baycol recall) associated with many cholesterol lowering medications (statins in particular).
Oh, and I think that your low sugar, lower carbohydrate diet is the way to go to lower your risk of heart disease because of the positive effects it has on triglycerides and HDL.

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