Cholesterol, HDL

DAOS = 3,5-dimethoxy-AT-ethyl-Ar-(2-hydroxy-3-sulfopropyl)-aniline sodium salt 

Reactive components of the precipitate solution Dextran sulfate Magnesium chloride (0.1 M) 

Storage The strips should be stored between 2-25°C. After opening the aluminium foil the strip should be used immediately. 

Sample material Serum, heparin plasma, EDTA plasma or fluoride plasma after pretreatment. 

Pretreatment of the sample Add 100 nl serum or plasma to 100 al precipitate solution. After good mixing (10 times) allow the mixture to stand for 5 min. at room temperature. Then centrifuge the sample for 9 min. in the Cobas Ready centrifuge. Use the clear supernatant for analysis. 

---

Cholesterol is biosynthesized in the liver trans ported throughout the body to be used in a va riety of ways and returned to the liver where it serves as the biosynthetic precursor to other steroids But cholesterol is a lipid and isn t soluble in water How can it move through the blood if it doesn t dis solve in if The answer is that it doesn t dissolve but IS instead carried through the blood and tissues as part of a lipoprotein (lipid + protein = lipoprotein) The proteins that carry cholesterol from the liver are called low density lipoproteins or LDLs those that return it to the liver are the high-density lipoproteins or HDLs If too much cholesterol is being transported by LDL or too little by HDL the extra cholesterol builds up on the walls of the arteries caus mg atherosclerosis A thorough physical examination nowadays measures not only total cholesterol con centration but also the distribution between LDL and HDL cholesterol An elevated level of LDL cholesterol IS a risk factor for heart disease LDL cholesterol is bad cholesterol HDLs on the other hand remove excess cholesterol and are protective HDL cholesterol IS good cholesterol... 

Prazosin, a selective a -adrenoceptor antagonist, exerts its antihypertensive effect by blocking the vasoconstrictor action of adrenergic neurotransmitter, norepinephrine, at a -adrenoceptors in the vasculature (200,227,228). Prazosin lowers blood pressure without producing a marked reflex tachycardia. It causes arteriolar and venular vasodilation, but a significant side effect is fluid retention. Prazosin increases HDL cholesterol, decreases LDL cholesterol, and does not cause glucose intolerance. 

The distribution between LDL and HDL cholesterol depends mainly on genetic factors, but can be... 

There are two types of complexes low-density (LDL), which contain mostly cholesterol, and high-density (HDL), which contain relatively little cholesterol. Commonly, these complexes are referred to as "LDL cholesterol" and "HDL cholesterol." respectively. 

The relative amounts of LDL and HDL cholesterol in your bloodstream depend, at least in part, on your diet In particular, they depend on the total amount and the type of fat that you eat. Fats (triglycerides) are esters of glycerol with long-chain carboxylic acids. The general structure of a fat can be represented as... 

The maximum changes achieved in a study were -20% total serum cholesterol, -40% serum triglycerides and +15% HDL-cholesterol [2]. However, there are considerable short- and long-term side-effects. The treatment should therefore be monitored by a doctor. 

Brand-Herrmann SM, Kuznetsova T, Wiechert A et al (2005) European Project on Genes in Hypertension Investigators. Alcohol intake modulates the genetic association between HDL cholesterol and the PPARgamma2 Pro 12Ala polymorphism. J Lipid Res 46 913-919... 

HDL cholesterol protects against heart disease so the higher the numbers the better. An HDL level less than 40 mg dL is low and considered a major risk factor for heart disease Triglyceride levels Hiat are borderline (150-190 mg dL) or high (above 190 mg dL) may need treatment in some individuals. 

In our study, consumption of rye bread or rye bread with phloem did not have an effect on serum lipids (total, LDL or HDL cholesterol or triglycerides) (Table 14.4). This is contrary to a recent finding suggesting that soluble fiber from rye bread decreased the concentrations of cholesterol (Leinonen et al., 2000). In that study ingestion of rye bread (220 g/d) with naturally high amounts of insoluble (18 g/d) and soluble fiber (4 g/d) decreased the LDL concentrations by 8% in hypercholesterolemic men. The researchers speculated that soluble fiber, maybe P-glucan, was responsible for the hypocholesterolemic effect. The amount of rye bread (70 g/d vs 220 g/d), the amount of total (5.9-11.8 g/d vs 22.1 g/d) and soluble fiber (0.6-1.3 g/d vs 4 g/d) ingested in this study was considerably less, and could explain the lack of effects on blood lipids in our study. 

Low high-density lipoprotein (HDL) cholesterol (less than 40 mg/dL or 1.04 mmol/L in males and less than 50 mg/dL or 1.3 mmol/L in females) or active treatment to raise HDL cholesterol. 

Fasting lipid profile total cholesterol 233 mg/dL (6.03 mmol/L), HDL cholesterol 30 mg/dL (0.78 mmol/L), LDL cholesterol 165 mg/dL (4.27 mmol/L), triglycerides 188 mg/dL (2.12 mmol/L) other labs within normal limits... 

A fibrate derivative or niacin should be considered in select patients with a low high-density lipoprotein (HDL) cholesterol less than 40 mg/dL (1.04 mmol/L) and/or a high triglyceride level greater than 200 mg/dL (2.26 mmol/L). In a large randomized trial in men with established CAD and low levels of HDL cholesterol, the use of gemfibrozil (600 mg twice daily) significantly decreased the risk of non-fatal myocardial infarction or death from coronary causes.78... 

Patients with metabolic syndrome have an additional lipid parameter that needs to be assessed, namely non-high-density lipoprotein (non-HDL) cholesterol (total cholesterol minus HDL cholesterol). The target for non-HDL cholesterol is less than the patient s LDL cholesterol target plus 30 mg/dL (0.78 mmol/L). 

After assessment and control of LDL cholesterol, patients with serum triglycerides of 200 to 499 mg/dL (2.26 to 5.64 mmol/L) should be assessed for atherogenic dyslipidemia (low HDL cholesterol and increased small-dense LDL particles) and metabolic syndrome. 

Combination drug therapy is an effective means to achieve greater reductions in LDL cholesterol (statin + ezetimibe or bile acid resin, bile acid resin + ezetimibe, or three-drug combinations) as well as raising HDL cholesterol and lowering serum triglycerides (statin + niacin or fibrate). 

Reducing LDL cholesterol while substantially raising HDL cholesterol (statin + niacin) appears to reduce the risk of atherosclerotic disease progression to a greater degree than statin monotherapy. 

Patients with serum triglycerides from 150-500 mg/dL (1.70-5.65 mmol/L) and serum HDL cholesterol less than 40 mg/dL (1.04 mmol/L) may have metabolic syndrome and need to be evaluated. 

---