Cholesterol, like every other good thing, is only harmful when there is too much of it in the wrong places

Cholesterol has long been vilified as a silent killer lurking in our bloodstreams. But this waxy, fat-like substance is less like a malicious intruder and more like the essential oil that keeps the gears of our physiological machinery running smoothly.Cholesterol is present in all cells of our body and contrary to common belief, isn't solely detrimental but plays a very crucial role in several vital functions.(1)

Every individual carries some amount of cholesterol, In fact, our bodies need cholesterol to perform essential functions that contribute to our overall well-being.

Key functions of cholesterol:

• Maintaining integrity of cell membranes
• Precursor to essential hormones like oestrogen, testosterone and cortisol
• Key role in Vitamin D synthesis
• Bile acid synthesis crucial for digestion and absorption of fats

Far from being a mere troublemaker, cholesterol is a multifaceted contributor to the orchestra of our body's functions.

Understanding Your Cholesterol/Lipid Report: Navigating the Numbers

When faced with the complexity of a lipid profile test, deciphering where you stand can be a challenge. Let's break down the essentials to empower you when interpreting your cholesterol report.

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Imagine cholesterol as a traveler in your body, but since it doesn't mix well with blood or water, it needs a companion. Enter the "lipoprotein"—the shuttle that ferries cholesterol through your system.

Let's spotlight the key players in your lipid profile:

LDL Cholesterol - "The Bad Cholesterol":

• LDL, or Low-Density Lipoprotein, is responsible for transporting cholesterol from your gut or liver into the bloodstream and then to various tissues. It's tagged as the "Bad Cholesterol" because excessive levels can lead to fatty buildups in blood vessels.(4)

HDL Cholesterol - "The Good Cholesterol":

• HDL, or High-Density Lipoprotein, is the hero of the story. It removes excess cholesterol deposited by your body, returning it to the liver for breakdown. Aptly named the "Good Cholesterol," it helps maintain a healthier balance.(2)

Triglycerides - Indicators of Carbohydrates:

• Triglycerides (TG) act as converted sugars, transporting excess carbohydrates. While not technically cholesterol, it plays a crucial role in your body's fat metabolism. Elevated levels can signal high carbohydrate intake.(5)

Total Cholesterol - The Overall Picture:

• Total cholesterol is the sum of all cholesterol types in your body. It provides a comprehensive snapshot of your cholesterol levels.

Non-HDL Cholesterol - Calculated Precision:

• This calculated value excludes good cholesterol from the total, comprising LDL cholesterol, VLDL cholesterol, lipoprotein a, and other intermediary density lipoproteins. 

VLDL Cholesterol - Transporting Triglycerides:

• VLDL, or Very Low-Density Lipoprotein, plays a role in transporting triglycerides produced by the liver to the bloodstream and various body part(6)

Apolipoprotein B/Apolipoprotein A1 Ratio - Balancing Act:

• Apolipoproteins B and A1 are crucial proteins guiding cholesterol transport.The ratio offers insights into the balance between atherogenic and anti-atherogenic lipoproteins, serving as a complementary tool for assessing cardiac risk.(7)

Lipoprotein A - The Uncharted Territory:

• Lipoprotein A is a variant of LDL cholesterol, and ongoing research suggests its association with heart-related diseases. While targeted treatment isn't standard, its elevated levels may warrant attention.(8)

Armed with this knowledge, navigating your cholesterol report becomes a more informed journey, empowering you to prioritize your heart health.

References

1.Zampelas and Magriplis, “New Insights into Cholesterol Functions: A Friend or an Enemy?,” Nutrients, vol. 11, no. 7. MDPI AG, p. 1645, Jul. 18, 2019. doi: 10.3390/nu11071645. Available: http://dx.doi.org/10.3390/nu11071645

2.S. Misra, T. Lyngdoh, and R. Mulchandani, “Guidelines for dyslipidemia management in India: A review of the current scenario and gaps in research,” Indian Heart Journal, vol. 74, no. 5. Elsevier BV, pp. 341–350, Sep. 2022. doi: 10.1016/j.ihj.2022.07.009. Available: http://dx.doi.org/10.1016/j.ihj.2022.07.009

3.National Cholesterol Education Program Expert Panel. (2001). Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA, 285(19), 2486-2497. https://doi.org/10.1001/jama.285.19.2486

4. Narasingan ,Newer lipid guidelines: Interpretation and applications for Indians

5.Masala Study. (2017, April 3). Have You Ever Wondered What the Healthiest Weight for You Should Be? [Blog post]. Retrieved from here

6.Joshi SR, Anjana RM, Deepa M, Pradeepa R, Bhansali A, et al. (2014) Prevalence of Dyslipidemia in Urban and Rural India: The ICMR–INDIAB Study. PLoS ONE 9(5): e96808. doi:10.1371/journal.pone.0096808 

7.An International Atherosclerosis Society Position Paper 2013,Global Recommendations for the Management of Dyslipidemia [Full report] 

8.Indian Heart Association. (n.d.). Cholesterol and South Asians. Retrieved from here.