Artikel
Does a normal total cholesterol exclude lipid-related cardiovascular risk?
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Veröffentlicht: | 26. April 2013 |
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Introduction: For comprehensive risk assessment in the primary and secondary prevention of cardiovascular diseases, measurement of plasma total cholesterol, low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL –C) and triglycerides is recommended after 12-14 hours fasting. Furthermore two consecutive plasma lipid measurements are recommended because of the considerable diurnal variation in lipid levels. LDL-C is directly related to CHD risk, while HDL-C is inversely related to risk. Triglycerides are associated with increased risk particularly in the presence of low HDL-C. Measurement of plasma cholesterol only is therefore not sufficient to identify all patients at increased risk.
Material and methods: Clinical Chemistry laboratory based study including all blood samples for lipid profile having total cholesterol <5 mmol/L
Results: Raised LDL-C and triglyceride levels were found in the presence of total cholesterol <5.0 mmol/L. In addition low HDL was also noted. Out of 1616 patients 1030 (62%) showed raised LDL-C or Triglycerides or low HDL-C. Out of these 1030 samples 530 (51.4%) had triglycerides >1.5 mmol/L, 510 (49.5%) had HDL-C <1.0 mmol/L and 584 (56.6%) were found having LDL – C >3.0 mmol/L. 35% had two or more abnormal lipid fractions.
Conclusion: The results obtained from this study clearly showed that total cholesterol could be within normal limits in the presence of abnormal lipid fractions and triglycerides. These could be independent risk factors for cardiovascular disease. The findings may have implications for local lipid screening policies.