HDL cholesterol, commonly known as good cholesterol, is the smallest and at the same time the most diverse molecule from the lipoprotein group. HDL cholesterol has for many years been considered a molecule that protects us against heart attacks and other cardiovascular diseases. However, recent studies have shown that this compound is much more complex and that defective HDL cholesterol particles with atherosclerotic properties may be formed in our body.

HDL cholesterol(Eng.high density lipoprotein ), commonly referred to as good cholesterol, is actually a high-density lipoprotein in which consists of triglycerides, cholesterol esters, free cholesterol and proteins, e.g. apoliprotein A-II. HDL cholesterol isthe smallestlipoprotein, but it has the highest protein content (even up to 70%) compared to other chemical components. HDL particles are also considered to be the most diverse class of lipoproteins in terms of size, shape, and composition.

HDL cholesterol - functions in the body

HDL cholesterol is produced in the liver and small intestine. The main function of HDL molecules in the body is the reverse transport of free cholesterol, which consists in collecting its excess from various tissues. The cholesterol is then transported and stored in the liver. It is a very important function from the point of view of protection against heart attack and stroke, as too high a level of cholesterol in the blood may cause its accumulation in the blood vessels and participate in the atherosclerotic process. The resulting atherosclerotic plaque causes stiffness and narrowing of the blood vessel.

In addition, HDL cholesterol has a number of other functions:

  • reduces the number of adhesive proteins on the surface of the vascular endothelium
  • inhibits the oxidation of "bad" LDL cholesterol
  • has an anti-inflammatory effect by inhibiting the adhesion and mixing of leukocytes and the secretion of pro-inflammatory cytokines
  • protects the vascular endothelium by activating the production of nitric oxide
  • has an antithrombotic effect by inhibiting tissue factor in plaque macrophages
  • has antibacterial effect

Research has shown that HDL cholesterol can have both effects pro-inflammatory and anti-inflammatory . Under physiological conditions, HDL cholesterol is beneficial for its anti-inflammatory properties. However, in people with chronic inflammation (e.g. obesity, diabetes, chronic kidney disease), HDL cholesterol may be subject to oxidative damage (oxidation). This results in the formation ofdefective HDL particles , which incorrectly act as cholesterol reverse transport. Consequently, they exhibit pro-inflammatory and pro-atherosclerotic properties.

HDL cholesterol - what is the test?

HDL cholesterol testing is performed withvenous bloodtaken from the elbow flexion. The test should be performedon an empty stomach , approximately 12 hours after the last meal. A few days before the test, you should not radically change your eating habits.

HDL cholesterol - when to do?

HDL cholesterol testing is commissioned as part of a lipid profile that includes triglyceride, total cholesterol, and LDL cholesterol tests in addition to HDL cholesterol.

HDL cholesterol testing should be ordered from:

  • men over 40
  • women over 50
  • people on an incorrect diet
  • smokers
  • chronically stressed people
  • alcohol abusers
  • physically inactive people
  • people with hypertension
  • obese people
  • person with metabolic syndrome
  • people with thyroid diseases
  • people with kidney problems
  • people with inflammatory diseases, e.g. rheumatoid arthritis, diabetes
  • people with a genetic predisposition to high cholesterol

HDL cholesterol - norms

  • men: equal to or greater than40 mg / dl
  • women: equal to or greater than45 mg / dl

HDL cholesterol - how to interpret the test result?

Epidemiological studies have shown the protective effect of HDL cholesterol against the atherosclerotic process, therefore its high level protects us from heart attack and stroke. However, it is worth knowing that increasing its concentration in the blood with drugs does not reduce the risk of these diseases. Hence, HDL cholesterol testing is not the most important parameter of the lipid profile and in practice it is not used as a marker of the effectiveness of lipid disorders therapy.

The reason for too low HDL cholesterol may be:

  • genetic diseases, e.g. familial hyperlipidemia, Tangier disease
  • high levels of triglycerides and LDL cholesterol
  • obesity
  • metabolic syndrome
  • diabetes
  • hormonal disorders
  • drugs, e.g. steroids
  • liver and intestine diseases
  • smoking
  • alcohol abuse

HDL cholesterol - how to increase its level?

HDL cholesterol levels can be increased through the use of statin drugs that block the action of the enzyme 3-hydroxy-3-methylglutaryl coenzyme A (in the HMG-CoA skin) regulating cholesterol metabolism. In addition, the increase in "good" cholesterol can be influenced by a number of nutritional and lifestyle factors, including:

  • eliminate trans fats from processed foods and fast food from the diet
  • use a Mediterranean diet rich in products such as: fish and seafood, fresh vegetables and fruits, olive oil and herbs

Additionally, shedding excess kilograms and physical activity may have a beneficial effect. It is estimated that each kilogram lost translates into an increase in HDL cholesterol by about 0.4 mg / dL. On the other hand, each 1000 kcal burned during exercise physical activity translates into an increase in HDL cholesterol by about 3 mg / dl.

Interestingly, research has shown thatred fermented rice , common in Asian cuisine, contains a substance called monacolin K, which is produced by fermentation of thefungus Monascus purpureus . It turns out thatmonacolin Khas a chemical structure similar to that of a statin drug (lovastatin). Another source of "natural" statins is the oyster mushroom.

Good to know …

An example of the lack of correlation between low HDL cholesterol and the risk of cardiovascular disease is the case of people who carry a mutation in the gene encoding the apo A-I protein, which affects its structure. The mutant protein is called apo A-I Milano. People with the mutation have very low HDL cholesterol and high blood triglycerides, yet do not develop atherosclerotic disease.

  • Cholesterol lowering diet - what you can eat, menu
  • Ways to raise cholesterol. How to lower cholesterol without drugs?
Probe

Category:

Research