Too much cholesterol and fat in the blood (dyslipidemia)

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What is it about ?

Fats are essential foods for health. Our body needs fat to build itself, and to function (thanks to the energy supplied). The two main types of fat in our body are cholesterol and triglycerides.

Cholesterol

Most of the cholesterol in our body is made by our body itself, in the liver. Cholesterol is involved in the production of certain hormones, and it is used in the manufacture of bile acids, which participate in the digestion of fats.

Normally, about 30% of our cholesterol comes from our food, especially in animal products such as meat and cheese (these products also contain other fats called saturated fatty acids).

Fats are not soluble in the blood. A distinction is made between HDL cholesterol, called “good cholesterol”, and LDL cholesterol, called “bad cholesterol”. HDL (High Density Lipoproteins) and LDL (Low Density Lipoproteins) are small molecules that bind to a cholesterol molecule. These proteins carry cholesterol in the blood.

HDL carries excess cholesterol from the tissues to the liver, where it is eliminated. LDL, on the other hand, carries cholesterol to tissues.

Excess LDL cholesterol gets deposited on the walls of blood vessels, making it harder for blood to flow. These deposits form plaques responsible for thickening of the vessel wall. This is an inflammatory process called arteriosclerosis. Arteriosclerosis, atherosclerosis or atheromatosis are synonyms.

Triglycerides

Triglycerides are fats that are primarily used for energy. They mainly come from food. Excess triglycerides build up in the tissues. In addition, excess sugars and alcohol in the diet are converted into triglycerides. Our body then stores them as a reserve, in the form of fat.

These fats associated with cholesterol have a role in the development of arteriosclerosis.

What are the forms of dyslipidemia?

Depending on the cause, there are several forms:

  • Too much cholesterol in the blood (hypercholesterolemia)
    • Ordinary hypercholesterolemia. It is the most common form of excess cholesterol. It is due to a combination of several factors: diet, obesity and hereditary predisposition.
    • Familial hypercholesterolemia. It is of genetic origin. The cholesterol level is high or even very high in members of the same family, sometimes already at a young age.
  • Too many triglycerides in the blood (hypertriglyceridemia): the mild forms are often related to lifestyle (obesity, excessive alcohol consumption, diet). There is also an inherited form.
  • Combined dyslipidemia: cholesterol and triglycerides are increased.
  • Secondary dyslipidemia: the lipid abnormality is due to an underlying disease, for example an underactive thyroid (hypothyroidism), certain kidney and liver diseases …
  • the metabolic syndrome. We speak of metabolic syndrome in the presence of three of the following five factors: increased waist circumference, increased triglycerides, decreased HDL cholesterol, high blood pressure and increased fasting blood sugar.

How to recognize them?

Too high a fat level in the blood is not felt. It is only after several years that symptoms appear, which are mainly due to the narrowing of the blood vessels. Too high a cholesterol level is therefore not a disease, but can increase the risk of cardiovascular disease.

An important symptom that can indicate poor blood supply is pain on exertion. The narrowed arteries then do not supply enough oxygen to the muscles. If the narrowing affects the blood vessels that supply the heart muscle with oxygen (coronary arteries), it causes chest pain (angina or angina). If the narrowing affects the arteries in the legs, it causes pain in the calves (intermittent claudication). You cannot maintain the effort because of the pain. At rest, the pain disappears.

Fat can also settle in places and become visible as fat deposits. For example, a ring of fat may be present at the eyeball, or yellowish spots made up of fat deposits may appear on the eyelids. Tendons, mainly in the heel, knee, and fingers, can also thicken. These accumulations of fat are mostly found in hereditary forms.

How is the diagnosis made?

Too high a fat level can be detected with a simple blood test measuring the different fats. You cannot eat for 12 hours before the blood test. We do not necessarily base ourselves on a single result. Sometimes the doctor may decide to wait and order a second or third blood test before saying for sure whether or not there is a problem.

Over the years, there has been a lot of talk about normal levels of cholesterol and triglycerides. Specialists tend to aim for lower values. Here we give guide values ​​which may change in the future.

  • total cholesterol (LDL + HDL): less than 190 mg / dl
  • HDL cholesterol (good cholesterol): greater than 35 mg / dl for men and greater than 45 mg / dl for women;
  • LDL cholesterol (bad cholesterol): less than 115 mg / dl;
  • triglycerides: less than 170 mg / dl.
  • The ratio of total cholesterol to HDL cholesterol must be less than 4.

The doctor will also check your fasting blood sugar (blood sugar) level and thyroid function. He will also order a urine test to check for kidney abnormalities. Depending on the results, your heredity and your symptoms, the doctor may decide to order additional tests.

Whether all patients should undergo these tests as a preventive measure is a matter of debate. In some people, however, the risk of abnormal fat balance is increased. These risk groups are people who have a hereditary predisposition and whose family member had a heart attack before the age of 50, overweight people, diabetics, people with high blood pressure … These people are at a higher risk of developing cardiovascular disease, so they should be well monitored. Additional tests are probably not justified in healthy people without risk factors.

Along with cholesterol and fat, blood pressure, gender, smoking, and age also play a role in the decision to seek further tests and start treatment.

The general practitioner will determine the general cardiovascular risk in all patients between 40 and 75 years old.

What can you do ?

The most important thing is to adopt a healthy lifestyle. By this we mean a healthy diet (not too much saturated fat, lots of vegetables …) and exercise (about 30 minutes a day). Stop smoking. Limit your alcohol intake. Ask your GP, dietitian or doctor for information.

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Source

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