Cholesterol is a substance of a fat-like nature, which is localized in the shell of every cell in the body. Most of it is formed in the liver (about 80%), the rest comes with food.
The role of cholesterol
Adequate levels of this compound are important for optimal functioning of many organs and good he alth.
In addition to the fact that cholesterol is part of the cell membranes, it performs a number of the following functions:
- ensures the strength of cell membranes;
- regulates the permeability of cell membranes by activating the appropriate enzymes;
- participates in the metabolism of fat-soluble vitamins and other metabolic processes;
- is a compound that affects the synthesis of adrenal hormones and androgens;
- contained in the myelin sheaths of nerve fibers;
- takes part in the formation of vitamin D;
- protects red blood cells from the negative effects of hemolytic toxins;
- takes part in the formation of bile and bile acids in the liver, which are responsible for the absorption of alimentary fats in the intestine;
- affects workserotonin receptors responsible for good mood and a sense of satisfaction.
Quantitative and qualitative norm of cholesterol
Total cholesterol is elevated if its level is more than 5 mmol/L. If a person has concomitant diabetes mellitus or heart disease, then this indicator should be no more than 4.5 mmol / l.
It should be noted that not only the quantitative content of cholesterol in the blood should be taken into account, but also qualitative indicators - the ratio of its various fractions. So, low-density cholesterol is elevated if its content is more than 100-130 mg / dl. The amount of HDL and triglycerides is also taken into account.
It should be said that low-density lipoproteins are called "bad" because they carry most of the cholesterol throughout the body. In this case, oxidation processes occur, which are accompanied by the synthesis of antibodies and the formation of unstable compounds that are able to penetrate the walls of the arteries and cause an inflammatory process in them.
High-density lipoproteins are considered "good" because they take cholesterol from the blood vessels and return it to the liver, and also prevent oxidation processes.
Causes of hypercholesterolemia
A hereditary factor may lie in the etiology of high cholesterol levels. This form of pathology is defined as primary or familial. With it, high cholesterol is detected in children. The disease is due to the fact that the childreceives from his parents a defective gene that is responsible for lipid synthesis, therefore, a pathological concentration of fat-like compounds is diagnosed in his body.
It should be noted that quite often high cholesterol in children is not detected, since everything passes without clinical symptoms. The problem becomes noticeable at a more mature age.
Secondary forms of the disease develop when exposed to certain factors that act as catalysts or risk factors:
- liver disorders;
- stress and nervous strain;
- age over 55;
- gender (total cholesterol is increased more often in men);
- smoking;
- alimentary factor - excessive consumption of fatty and high-calorie foods;
- hypodynamia.
Pathologies accompanied by hypercholesterolemia. The mechanism of its development
Most often, elevated cholesterol levels are observed in liver damage, diabetes, hypothyroidism. Nephrotic syndrome is also characterized by a high concentration of this compound.
It should be noted that the systematic use of certain drugs, the presence of arterial hypertension and overweight also provoke hypercholesterolemia.
If we talk about the mechanism of development of this pathology, then you should know that the accumulation of cholesterol in cell membranes is a natural defense against dehydration. That is why hypercholesterolemia indicates the passage of reactions aimed atto prevent water from passing through the cell membrane, ensuring their normal functioning. So, in non-nuclear cells, fatty acids allow you to endure a lack of water.
If we conclude, we can name another important etiological factor of high cholesterol - dehydration of cells and the body as a whole.
How is hypercholesterolemia diagnosed?
To make a correct diagnosis, the symptoms of high cholesterol alone are an unreliable criterion. It is recommended to undergo a comprehensive examination and pass a series of tests.
Diagnosis typically includes the following:
- collection of an anamnesis and its full analysis, taking into account the patient's complaints;
- determining the possibility of developing familial hypercholesterolemia or other associated he alth problems;
- examination with auscultation and measurement of blood pressure;
- general analysis of urine and blood to rule out inflammatory pathologies;
- biochemical blood test with the determination of the concentration of creatinine, glucose and uric acid;
- lipidogram, which allows you to detect high levels of lipoproteins;
- immunological tests;
- additional genetic testing of next of kin to identify a genetic defect.
During the diagnosis, it is important to find out the patient's dietary habits, his lifestyle, the presence of bad habits. It is also necessary to determine the time when the last medical examination was carried out, the nature of complaints andfeatures of their occurrence.
What are the symptoms of high cholesterol?
It should be said right away that hypercholesterolemia itself is not clinically manifested. Certain complaints appear in the patient when there are corresponding pathologies associated with impaired lipid metabolism.
Main symptoms of high cholesterol include the following:
- the patient has chest pain, may develop a heart attack or heart attack, which is associated with damage to the coronary vessels;
- if an excessive amount of cholesterol is detected in men, then impotence or erectile dysfunction may also occur, which is associated with blockage of the corresponding arteries by cholesterol;
- atherosclerosis and cerebral stroke are life-threatening symptoms of high cholesterol;
- if, against the background of hypercholesterolemia, the walls of peripheral vessels are affected, then obliterating diseases of the legs, as well as vein thrombosis with the development of thrombophlebitis, may develop;
- indirect signs of high cholesterol can be considered pain in the lower extremities, memory impairment and discomfort in the heart.
External manifestations of cholesterolemia
In addition to complaints indicating damage to blood vessels, patients may experience external signs of high cholesterol. Among them, the appearance of a lipoid corneal arch should be mentioned. This symptom indicates, as a rule, the development of familial hyperlipidemia and is detected in patients whose age isis no more than 50 years old.
Another important manifestation of high cholesterol is xanthelasma. These formations look like dirty yellow nodules, which are localized under the upper layer of the epithelium of the eyelids. Sometimes they are small in size, can go unnoticed, so they are often detected only by specialists. Hypercholesterolemia is also characterized by the appearance of xanthoma - cholesterol nodules, which are located above the tendons.
It should be noted that the described manifestations appear only with the progression of the pathological process, when the disease has a severe course, is characterized by various concomitant lesions and cholesterol levels, which grow to significant numbers.
Cholesterol and pregnancy
During the gestation of the fetus, the female body is radically rebuilt in order to ensure the normal development of the child. During this period, lipid metabolism changes. So, high cholesterol during pregnancy can be considered the norm, since at this time the body of the expectant mother needs more of this compound in order for optimal synthesis of steroid hormones to take place.
It should be noted that such physiological hypercholesterolemia should have certain limits and not exceed the norm by more than 2 times. In addition, it is interesting that high cholesterol during pregnancy has different indicators depending on age.women. So, if a pregnant woman is not more than 19 years old, it is 3.08-5.18 mol / l. If she is 40 or over, then the cholesterol level is 6.94. In both cases, such indicators are normal.
The highest concentration of fats in the blood of pregnant women is observed in the third trimester. After giving birth, cholesterol levels return to normal within 4-6 weeks.
Pharmacological treatment of hypercholesterolemia
When high cholesterol and clinical manifestations associated with this disorder of fat metabolism are diagnosed, the following groups of drugs are recommended:
- Statins. They block the synthesis of enzymes that are involved in the formation of cholesterol, are the most popular drugs for hypercholesterolemia. Depending on the characteristics of the course of the disease and the individual reaction of the body, these funds can reduce the concentration of cholesterol by almost 60%. In addition, they reduce the amount of triglycerides and increase HDL levels. The most commonly prescribed drugs are Mevacor, Baikol and Leskol.
- Fibric acids - reduce the amount of triglycerides and HDL, promote the oxidation of fatty acids in the liver. This group includes the funds "Atromed-S", "Trikor" and "Lopid".
- Pharmacological agents that are able to bind to bile acid and reduce the synthesis of cholesterol in the liver (drugs Colistin, Questran).
Supplements that reduce cholesterol
Pharmacotherapy is carried outwith severe or complicated course of hypercholesterolemia. With its milder forms, the following is used:
- vitamin E is a strong antioxidant, prevents the formation of cholesterol plaques and reduces the risk of developing cardiovascular pathologies;
- Omega-3 fatty acids - found in large quantities in fish oil, evening primrose oil, flax and rapeseed seeds; they reduce triglyceride levels and prevent thrombosis, protect against inflammation, which is a good prevention of atherosclerosis;
- nicotinic acid in high doses, which mobilizes fatty acids in all tissues, reduces triglycerides and LDL, increases HDL by 30%;
- folic acid and vitamin B12 - with their lack, the level of homocystin decreases, which significantly increases the risk of atherosclerotic vascular changes and coronary heart disease.
It should be noted that taking certain medications does not eliminate the need for a he althy lifestyle. Symptoms of high cholesterol will not develop if you eat right, monitor your weight, move more, do not smoke and systematically undergo preventive examinations.
Diet for hypercholesterolemia
The goal of dietary nutrition is an anti-sclerotic effect and the removal of excess cholesterol from the body through an appropriate set of products.
What principles should be followed?
It is imperative to reduce the amount of fat, exclude high-cholesterol foods from the diet,limit the intake of saturated fatty acids and increase the amount of polyunsaturated fatty acids. It is recommended to consume less s alt, more vegetable fiber, it is useful to replace animal fats with vegetable ones.
He althy foods include fish, lean meats, nuts and soybeans, cereals and bran, and green tea, which is not only an antioxidant, but also a drink that improves lipid metabolism.
Eating raw minced garlic has a positive effect. It is able to thin the blood, prevent the formation of blood clots and reduce the concentration of cholesterol due to the presence of alliin in its composition.
When elevated cholesterol is detected, the symptoms, treatment, and presence of comorbidities depend on the particular etiology of the disorder. This should also be taken into account when prescribing therapy, which should be comprehensive and aimed at normalizing lipid metabolism.
