Lipid Profile

Normal Total cholesterol

<200

Normal Tg

<150

Normal LDL-C

<100 in normal population, <70 in moderate risk, <50 in very high risk px

Normal HDL-C

>40 in male, >50 in female

What is the difference between fibrates and statins

Fibrates used to lower TG, statins used to lower CHOLESTEROL

A Px that has fasted 10-12 hrs should not have which lipoprotein presence

Chylomicron and its remnant should not be found

What does total cholesterol measure

VLDL, IDL, LDL, HDL

What does Tg measure

Tg exist in all lipoprotein but is highest in VLDL → Assumed that Tg is mostly from VLDL

LDL calculation formula

LDL = TC - (Tg/5) - HDL

*Tg/5 = VLDL that CANNOT be >400; assumed that IDL is so small it is negligible

If your patient forgot to fast before doing lipid profile, which one can you still send

DIRECT LDL ONLY → cannot calculate bc Tg will be too high

Why is hs-CRP a measure for atherosclerosis

hs-CRP is measure of endothelial damage → CRP <10 is detectable by hs-CRP → Indicates possibility for LDL to enter sub endothelium

Non HDL formula

Total cholesterol - HDL cholesterol; <130 optimal for normal pp, <100 for high risk

Total cholesterol/HDL cholesterol ratio

Measure cholesterol to HDL → Higher value = lower HDL which is bad

What is the rationale beheind Tg/HDL ratio

High Tg + low HDL → Bad FFA exchange = increased CETP function that changes LDL into sdLDL → Easier to enter endothelium to cause plaque

What is LDL/HDL ratio

Upward shift = high LDL or low HDL → Trigger cascade of vascular damage

What is ApoA-1

Measure of HDL → there is one ApoA-1 for one HDL

What is ApoB

Measure the amount of ApoB containing particles (VLDL, IDL, LDL)

What is ApoB/Apo A-1 ratio

Measure balance between cholesterol deposition (ApoB) and clearance (ApoA-1)

What is lipoprotein(a)/Lp(a)

Covalently linked to ApoB → ApoB cannot bind to LDL

Looks like plasminogen → inhibit real plasmin = no fibrinolysis

What is sdLDL

Find small dense LDL that is more likely to become atherogenic

What is oxLDL

Measure of oxidated LDL that will be eaten by MC → Lab does not reflect real level since atherosclerosis occurs in sub endothelial but lab measures in blood