What are these lipoproteins in your blood? Let's find out the details!

Have you ever heard the word "lipoproteins"? Your doctor may have used this word when talking about cholesterol . What exactly are these? How are they important to our bodies? Don't worry, we'll talk about this very simply today, in a way that you can understand.

What are lipoproteins?

Simply put, lipoproteins are little ball-like particles made up of fat (lipids) and protein. They travel through your bloodstream, carrying things to every cell in your body. They're like a courier service. Cholesterol and triglycerides are the two main types of fat found in these lipoproteins.

Different types of lipoproteins are produced in our bodies. If the levels of some of these lipoproteins increase, they can be harmful to our heart. However, there are some lipoproteins that protect the heart, that is, they are beneficial. So it is very important to know about these.

What are cholesterol and triglycerides?

Both are waxy fats found in our blood , but the way our bodies make and use them is slightly different .

• Cholesterol: Your liver is the main producer of cholesterol. In addition, we get cholesterol from the foods we eat, especially animal fats, such as meat and dairy products. This cholesterol helps the body make vitamin D and hormones such as estrogen, testosterone, and cortisol. It is also essential for the production of cells in the nervous system.

• Triglycerides: These are made by your liver and the intestines in your digestive system. If you eat a lot of fat and calories, your body makes more triglycerides. The extra triglycerides are stored in your body's fat cells. Later, when your body needs energy, these stored triglycerides are released into the blood.

What are the main types of lipoproteins?

There are five main types of lipoproteins . Let's take a look at what they are.

• HDL (High-density lipoprotein): This is called " good cholesterol ." HDL carries unwanted cholesterol from various parts of the body back to the liver. After the liver removes it from the body, it is excreted. If your HDL levels are high, you have a lower risk of developing cardiovascular disease . That's why it's called good cholesterol.

• LDL (Low-density lipoprotein): This is called " bad cholesterol ." If it increases, it is not good for the heart. When LDL levels increase, the risk of developing serious diseases such as coronary artery disease, heart attacks, and stroke increases. LDL carries cholesterol and deposits it in the blood vessels. This cholesterol deposits and forms a film (plaque) inside the blood vessels. This is called atherosclerosis . Then the blood vessels narrow and blood flow is obstructed.

• VLDL (Very low-density lipoproteins): This is another type that falls into the "bad cholesterol" category. VLDL mainly carries triglycerides – and to some extent cholesterol – to your tissues.

• IDL (Intermediate-density lipoproteins ): These are formed when VLDL is stripped of its fatty acids. These IDL are then either removed by the liver or converted to LDL.

• Chylomicrons: These are the largest lipoprotein particles. They also mainly transport triglycerides.

What is lipoprotein (a) or LP(a)?

Lipoprotein (a) or LP(a) is a special type of LDL, the "bad cholesterol" we talked about earlier. What's special about this is that another protein called apolipoprotein (apo(a)) is wrapped around this LDL particle. This apo(a) protein makes the LDL particles more "sticky." As a result, this LP(a) is easily deposited in the blood vessels, increasing the risk of heart disease. Elevated LP(a) levels are a risk factor for atherosclerosis.

Although we can change our HDL and LDL levels through things like our diet and lifestyle , your LP(a) level is determined primarily by your genes. Some people have genetic changes/mutations that can cause their LP(a) levels to be elevated. Such people are at higher risk of developing heart disease at a younger age.

What is a Lipid Panel Blood Test?

Doctors use this lipid panel blood test to measure the total amount of cholesterol in your blood. This test can also measure HDL, LDL, triglycerides, and total cholesterol separately.

This is a very simple blood test. It takes less than five minutes to draw a small amount of blood. You can have it done at your doctor's office, at a blood testing lab, or at a hospital. But the most important thing is that you need to fast for about 8 to 12 hours before the test. That means not eating or drinking anything. You may also be asked to stop taking some medications for a while. So, it's important to follow your doctor's instructions exactly.

How to check LP(a)?

Not everyone's LP(a) level is usually tested. Your doctor will only check your LP(a) level along with your lipid profile test if you specifically request it.

Most of the time, this test is only done on people who already have risk factors for heart disease. That means:

• If you have had a previous heart condition.
• If anyone in your family, especially several first-degree relatives, has had heart disease at a young age.
• If your LDL level is abnormally high.
• If you have risk factors for familial hypercholesterolemia , a genetic condition that causes high LDL.

What is the purpose of a lipid profile test?

High cholesterol often doesn't cause any symptoms, which is why getting this test is the best way to identify cholesterol problems that are affecting your heart and blood vessels.

Doctors use this lipid test for things like:

• Screenings: These can be done as part of a routine annual medical checkup. They can help you find out if you are at increased risk for heart disease. Once you know you are at increased risk, you can take steps to prevent problems like heart attacks and strokes.
• Diagnosis: This cholesterol test also helps diagnose conditions like atherosclerosis.
• Monitoring: These test results can help you see if your cholesterol levels are getting worse, need treatment, or are responding well to treatment.

How often should lipoprotein tests be done?

The risk of high lipoprotein and total cholesterol levels increases with age. As your risk increases, your doctor may recommend more frequent testing.

Here are general recommendations for lipid testing:

• For men over 35 years old and women over 45 years old.
• For men between the ages of 20-35 and women between the ages of 20-45, if there is a high risk of atherosclerosis.
• For children, it is recommended to have one between the ages of 9 and 11, and another between the ages of 17 and 21.

What is the normal range for lipoproteins?

Labs measure cholesterol and lipoproteins in milligrams per deciliter (mg/dL) . However, the methods used by each lab can vary. This means that results from the same blood sample can vary slightly from lab to lab. It's best to use the same lab to monitor your levels whenever possible.

Healthy ranges for HDL, LDL, triglycerides, and total cholesterol vary by age and gender. Talk to your doctor about what healthy levels are right for you. In general, if you don't have other risk factors, these values ​​are considered to be in the healthy range:

• Total cholesterol: 100-199 mg/dL for those over 21 years old; 75-169 mg/dL for those 20 years old and younger.
• HDL (good cholesterol): 45 mg/dL or higher.
• LDL (bad cholesterol): less than 100 mg/dL.
• Triglycerides: Less than 150 mg/dL.

A lipid panel can't directly measure VLDL levels, and there's no specific test for it. Instead, labs estimate your VLDL levels by dividing your triglycerides by five. A healthy VLDL level should be less than 30 mg/dL. However, this method isn't always accurate if your triglycerides are very high.

What is the normal range for lipoprotein (a) or LP(a)?

Labs report LP(a) levels in mg/dL or nanomoles per liter (nmol/L) . A level above 50 mg/dL or 75 nmol/L is considered high, and it increases the risk of atherosclerosis, heart attack, and stroke.

What are the risk factors for high bad cholesterol (LDL)?

Women who have gone through menopause and adults over 40 are at the highest risk of high LDL levels. But even children can have cholesterol problems. As you age, your metabolism slows down, and your liver becomes less able to remove bad cholesterol from your body.

Race and ethnicity also play a role. Asian Americans are more likely to have elevated LDL levels, while whites are more likely to have elevated total cholesterol levels.

Additional risk factors that can increase LDL levels include:

• A diet high in calories, saturated fats, and cholesterol.
• Conditions such as diabetes and kidney disease .
• A family history of high cholesterol.
• Excessive alcohol consumption and smoking.
• Medications such as corticosteroids and medications for high blood pressure, HIV , and AIDS .
• Overweight ( obesity ).

How are high LDL levels treated?

People who have high LDL levels and are at increased risk of heart attack, stroke, and other problems often need cholesterol-lowering medications like statins, ezetimibe, and PCSK9 inhibitors . You can also make dietary and lifestyle changes to help improve your cholesterol levels.

What can you do to improve lipoprotein levels?

Dietary and lifestyle changes can help lower bad cholesterol (LDL) and increase good cholesterol (HDL). These steps can help you:

• Be physically active for at least 150 minutes a week (that's at least 30 minutes a day). This can be done by walking, running, or cycling.
• Eat a heart-healthy diet. That means eating foods that are low in unhealthy fats and simple carbohydrates and high in fiber. Include foods like fruits, vegetables, legumes, nuts, and fish in your diet.
• Control conditions like high blood pressure and diabetes.
• Sleep well. You need 7-8 hours of sleep a day.
• Maintain a healthy weight. If you are overweight, losing even 5% to 10% of your body weight can have a positive effect on your cholesterol levels.
• Find good ways to manage stress. Things like yoga and meditation can help.
• Reduce alcohol consumption.
• Ask for help to quit smoking. Nicotine increases LDL levels and lowers HDL levels.

Remember, it's best to talk to your doctor before doing any of these things. Then you can do these things in a way that's right for you.

Take-Home Message

As we've seen, lipoproteins play a very important role in our bodies. HDL, or "good cholesterol," helps remove LDL, or "bad cholesterol," from the arteries. Things like what you eat, how much you exercise, and whether you smoke can all affect your lipoprotein levels.

Some people may have high levels of a "sticky" lipoprotein called lipoprotein (a) or LP(a) due to genetic factors. This can build up in the arteries and increase the risk of heart disease.

But the good news is that it is possible to lower LDL and LP(a) levels and raise HDL levels with lifestyle changes and, if necessary, medications like statins. So, take care of your cholesterol levels, get regular medical checkups, and try to live a healthy lifestyle. Your heart will thank you!

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