HDL: LDL ratio

A 42-year-old man presents with a chief complaint of intermittent claudication during exercise. His fomHy history is significant for the presence of cardiovascular disease on his fether s side, but not on his mother s side. Physical exam reveals xanthelasmas and bilateral tendon xanthomas. A plasma lipid profile reveals a cholesterol level of 340 mg/dL, with a high LDL/HDL ratio. He is given instructions for dietary modifications and a prescription for Zocor (simvastatin). 

This finding has been replicated several times in clinical studies. Let me cite one example. In a careful metabolic study carried out in 1990, Mensink and Katan determined the plasma LDL/HDL ratio when 10% of the energy from oleic acid was replaced in the diet by either the corresponding trans fat or the corresponding saturated fatty acid, stearic acid. The resulting LDL/HDL ratios were 2.02 on the oleic acid diet, 2.34 on the stearic acid diet, and 2.58 on the trans fatty acid diet. This is one more example of the impact of small structural changes in molecules on their biological properties. 

Elderly In patients older than 70 years of age, the AUC of lovastatin, pravastatin, and simvastatin is increased. Pravastatin does not need dosage adjustment. The safety and efficacy of atorvastatin, rosuvastatin, and lovastatin extended-release in patients 70 years of age and older were similar to those of patients younger than 70 years of age. Elderly patients (65 years of age and older) demonstrated a greater treatment response in respect to LDL-C, total-C and LDL/HDL ratio than patients younger than 65 years of age. 

The presence of Qg tram-fatty acids in milk fat is the result of incomplete biohydrogenation of the unsaturated dietary lipids in the rumen. These fatty acids have attracted attention because of their adverse nutritional affects. Clinical trials have shown that traus-octadecenoic acids, relative to the cis isomer, can increase the LDL-cholesterol and decrease the HDL-cholesterol, thus, producing an unfavourable affect on the LDL HDL ratio (Mensink and Katan, 1993). 

Clinical studies show that dietary cholesterol is a less potent regulator of plasma cholesterol than are saturated fatty acids. Results from meta-analyses predict that plasma cholesterol response to a 100 mg/day change in dietary cholesterol will be from 0.06 to 0.07 mmol/L. The data show that although dietary cholesterol elevates plasma total cholesterol and LDL-cholesterol level, it also increases the level of HDL-cholesterol such that there is little overall effect on the LDL HDL ratio (McNamara, 2000). 

General effects Androgens increase serum LDL and lower serum HDL levels therefore they increase the LDL/HDL ratio and potentially increase the risk for premature coronary heart disease. Androgens can also cause fluid refention leading to edema. 

High serum levels of cholesterol cause disease and death by contributing to the formation of atherosclerotic plaques in arteries throughout the body. This excess cholesterol is present in the form of the low density lipoprotein particle, so-called "bad cholesterol. "The ratio of cholesterol in the form of high density lipoprotein, sometimes referred to as "good cholesterol," to that in the form of LDL can be used to evaluate susceptibility to the development of heart disease. For a healthy person, the LDL/HDL ratio is 3.5. 

Although the data on HbAj reduction by about 1% (an indicator of possible late injuries) are contradictory, this may be the major reason to use acarbose. Serum cholesterol, triglycerides and the LDL/HDL ratio are... 

In another study of pistachio consumption among 44 men and women, subjects were randomized to either a regular diet or a pistachio diet in which pistachio nuts provided 20% of energy intake for a 3-week period. After 3 weeks on the pistachio diet, significant dcCTeases were seen in total cholesterol, total cholesterol/HDL cholesterol ratio, and LDL/HDL ratio, and patients also experienced a decrease in plasma malondialdehyde, an important indicator of lipid peroxidation [23],... 

Sheridan et al. [28] recently reported on randomized crossover study with 15 subjects (11 men and 4 women) with moderate hypercholesterolemia (serum cholesterol >210mg/dL). Subjects consumed 15% of their daily caloric intake in the form of pistachio nuts (about 2-3 ounces per day) for 4 weeks. The authors reported statistically significant reductions in triacylglycerols/HDL cholesterol and LDL/HDL ratios and statistically significant increases in HDL cholesterol [28],... 

In an early study in rabbits (55), LDL cholesterol levels and LDL HDL ratios were significantly reduced in rabbits fed 0.5% CLA. Furthermore, cholesterol deposition in the aorta was reduced by 30% in the CLA-fed rabbits. Although this latter finding was not statistically significant, it was consistent with the results of histological examination of atherosclerosis in a small number of animals (6/group). 

A clinical study carried out by Egert et al. (2009) reported that quercetin leads to a decrease in the systolic blood pressure in an entire study group and more particularly in subjects between 25-65 years together with a decrease in the concentration of plasma atherogenic oxidized Low Density Lipoprotein (LDH) ( bad cholesterol ), therefore providing protection against cardiovascular disease. However, quercetin also decreased the serum High Density Lipoprotein (HDL) concentration, but the LDL HDL ratio was unaltered. 

High-density lipoprotein (HDL), or good cholesterol , carries about 30% of cholesterol in the blood. They are called high density because they contain a higher proportion of protein compared to cholesterol than LDL. It is now believed that HDL carries cholesterol away from the arteries and back to the liver, where it is metabolized and removed. It may even help remove excess cholesterol from the plaques, slowing their growth. Blood tests typically report the amount of cholesterol in LDL and HDL, and it s the LDL HDL ratio that s crucial in the risk factor for heart disease. 

The cholesterol in fatty foods ends up being transported in LDLs, and the body then reduces its rate of production of HDL to keep the overall concentration of cholesterol constant. Thus, the LDL HDL ratio increases, and with it the cardiac risks. 

A controlled study of patients treated with an EGA for 6 weeks followed by either risperidone or clozapine reported more adverse lipid changes with risperidone, while the clozapine and control groups differed only on lower HDL and increased TC/HDL and LDL/HDL ratios [56 ]. 

The details of population dietary guidelines for the quality and quantity of fat intake differ between countries. However, in consideration of prevention of CHD, dietary guidelines generally reflect advice to reduce average total fat intakes to 30-35% dietary energy and to lower saturated fat intakes to approximately 10% of dietary energy. Though the effect of trans fatty acids on the plasma LDL/ HDL ratio is less favorable than that of saturated fatty acids, dietary advice needs to reflect the relative intakes of these two types of fatty acids. Since... 

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