VERIFIED CONTENTAuthor: lek. Patryk Jasielski
High cholesterol, or hypercholesterolemia, is one of the more common diseases in developed countries. It is usually associated with people suffering from hypertension, overweight and obesity. However, can high cholesterol occur only in people with excess kilograms?
In the human body, cholesterol metabolism depends on complex regulatory mechanisms. The main molecules that transport it are lipoproteins, i.e. combinations of proteins with fats. There are three types of lipoproteins:
- VLDL,
- LDL
- and HDL.
VLDL and LDL, or very low-density (VLDL) and low-density (LDL) lipoproteins, are considered "bad cholesterol" that is responsible for the formation of atherosclerosis and the development of cardiovascular diseases. HDL, or high-density lipoprotein, is the "good cholesterol" because it removes cholesterol from the blood and reduces the risk of atherosclerosis. The collected cholesterol is metabolized in the liver and eliminated in the bile.
According to current guidelines, hypercholesterolaemia is diagnosed in people without cardiovascular disease when LDL levels are greater than or equal to 115 mg / dL. HDL concentration, in turn, should be higher than 40 mg / dL in men and 50 mg / dL in women.
Causes of high cholesterol
Hypercholesterolemia is divided into several subtypes due to causes:
- Primary - high cholesterol is the primary symptom and is not associated with other diseases. Here, familial hypercholesterolemia is distinguished, resulting from the mutation of single genes. There is also polygenic hypercholesterolaemia, the most common in society. In this case, high cholesterol is caused by the coexistence of a genetic predisposition with an improper diet and overweight.
- Secondary - the increase in cholesterol is a consequence of other diseases.
Primary hypercholesterolemia
Familial hypercholesterolaemia
It is a rare cause of high cholesterol and is associated with mutations in the LDL receptor genes that render it inactive. So LDL cannot be metabolized and its excess remains in the blood.
A homozygous form is distinguished (approx. 1 case per millionpeople) and heterozygous (1 in 250 people).
In the first form, the course of the disease is very severe. Already in early childhood, LDL levels are extremely high. Atherosclerosis develops very quickly and such people often die from a heart attack at a young age. The diet here does not improve the condition and lean people also have very high cholesterol.
In the heterozygous form, LDL is also elevated, but not as much as in the first form. Atherosclerosis develops earlier and around the age of 40, ischemic heart disease is diagnosed. The risk of a heart attack is also increased.
Poligenic hypercholesterolaemia
It is the most common cause of high cholesterol in the population. It is related to the genetic predisposition to atherosclerosis. Here, however, the way of life also plays a role. Improper diet, high in cholesterol, saturated fatty acids and trans isomers of unsaturated fatty acids, and lack of physical activity lead to hypercholesterolaemia.
This type of disease usually occurs in overweight people. This is because overweight leads to disorders of fat metabolism and the so-called metabolic syndrome.
It lowers the level of HDL lipoproteins, which have a positive effect on cholesterol, and increases the level of VLDL and LDL, i.e. bad particles.
Obesity weakens the action of insulin (that is, it leads to a state of insulin resistance), a hormone that regulates blood sugar levels and fat metabolism.
Additionally, the adipose tissue itself is hormonally active, i.e. it secretes various hormones. They negatively affect the level of cholesterol in the blood, leading to its increase. All this means that overweight and obese people are more likely to have high cholesterol, especially with a genetic predisposition.
Secondary hypercholesterolemia
Secondary high cholesterol is when the condition is caused by another disease and is one of its symptoms. The main causes of high cholesterol are:
- hypothyroidism (thyroid hormones stimulate the metabolism of cholesterol, so their deficiency increases its level),
- liver disease (cholesterol is metabolized here),
- some medications, incl. steroids, diuretics, beta-blockers.
Other causes include Cushing's syndrome and nephrotic syndrome.
Some people with these conditions are thin, but will still have high cholesterol levels.
How to treat and prevent high cholesterol?
High cholesterol often causes no symptoms for a long time. Maybe thisdiscourage treatment and lifestyle changes. However, it should be remembered that hypercholesterolaemia significantly contributes to the development of atherosclerosis.
This, in turn, leads to ischemic heart disease, heart attack or stroke. Untreated hypercholesterolaemia can lead to serious he alth consequences.
Some people can cure high cholesterol with lifestyle changes. It is important to follow a proper diet here. Currently, the so-called Mediterranean diet. It is a diet based on foods that contain mainly polyunsaturated fatty acids, i.e. vegetable fats, complex carbohydrates and lean meats.
Animal fats and simple sugars (such as sweets and sweetened drinks) should be avoided. It is also important to play sports. A 30-minute walk at least 5 times a week will help keep your cholesterol levels normal.
If this does not help, the doctor may prescribe medication. The most commonly used drugs are statins, less often other drugs, such as ezetimibe, ion exchange resins or PCSK9 inhibitors.
In conclusion, thin people can have high cholesterol. This is often due to a genetic predisposition or various diseases that predispose to such a condition. However, most cases of hypercholesterolaemia are caused by poor diet and lifestyle.
They often lead to overweight and obesity. Therefore, hypercholesterolaemia most often occurs in people with excess kilograms. Regardless of this, it is advisable for each person to follow a he althy lifestyle. It can protect you from many different diseases, not only from high cholesterol.
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