Cholesterol, total

The Problem. Suppose that the total serum cholesterol level in normal adults has been established as 200mg/100mL (mg%) with a standard deviation of 25 mg%, that is, p = 200 and ct = 25. (Please distinguish between mg% and % probability.) A patient s serum is analyzed for cholesterol and found to contain 265 mg% total cholesterol. 

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... 

As part of a collaborative study of a new method for determining the amount of total cholesterol in blood, two samples were sent to ten analysts with instructions to analyze each sample one time. The following results, in milligrams of total cholesterol per 100 mb of serum, were obtained... 

Significant increases in LDL, total cholesterol and LDL F[DL ratio No significant effect on levels of plasma cholesterol, FfDL cholesterol or triglyceride... 

No significant effect on levels of total cholesterol, FfDL or LDL... 

Levels of total cholesterol, LDL and FfDL significantly reduced Levels of LDL significantly reduced... 

For ISIS 301012, a second-generation antisense inhibitor of apoB-100 in November 2006. Isis announced results from two Phase 2 clinical trials of ISIS 301012. In the first study repotted, patients with high cholesterol on stable doses of statins were treated with ISIS 301012 for 5 weeks. Patients who received 300 mg/week of ISIS 301012 in this study achieved a 51% reduction in LDL-cholesterol (LDL), a 42% reduction in total cholesterol (TC), and a 4l% reduction in triglycerides (TG) beyond the levels achieved with statins alone. 

Statins may reduce total cholesterol and LDL-cholesterol levels in plasma by 50-60%, reduce plasma... 

While the fibric acid derivatives have antihyperlipidemic effects, their use varies depending on the drug. For example, Clofibrate (Atromid-S) and gemfibrozil (Lopid) are used to treat individuals with very high serum triglyceride levels who present a risk of abdominal pain and pancreatitis and who do not experience a response to diet modifications. Clofibrate is not used for the treatment of other types of hyperlipidemia and is not thought to be effective for prevention of coronary heart disease. Fenofibrate (Tricor) is used as adjunctive treatment for the reduction of LDL, total cholesterol, and triglycerides in patients with hyperlipidemia. 

A daily intake of 25 and 30 g of GA for 21 to 30 days reduced total cholesterol by 6 and 10.4%, respectively (Ross et al., 1983, Sharma 1985). The decrease was limited only to LDL and VLDL, with no effect on HDL and triglycerides. However, Topping et al. (1985) reported that plasma cholesterol concentrations were not affected by the supply of GA, but triglyceride concentration in plasma was significantly lower than in controls. 

Total cholesterol greater than 240 mg/dL (6.22 mmol/L) High-density lipoprotein less than 40 mg/dL (1.04 mmol/L) Triglycerides greater than 200 mg/dL (2.26 mmol/L) Fasting blood serum or plasma glucose... 

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... 

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). 

Patients presenting with a total cholesterol level exceeding 200 mg/dl (5.18 mmol/L) or LDL cholesterol exceeding 100 mg/dL (2.59 mmol/L) should be evaluated for high cholesterol. 

Children between 2 and 20 years old should be screened for high cholesterol if their parents have premature CHD or if one of their parents has a total cholesterol greater than 240 mg/dL (6.22 mmol/L). Early screening will help to identify children at highest risk of developing CHD in whom early education and dietary intervention is warranted. 

Lipid-Lowering Drug LDL Cholesterol HDL Cholesterol Triglycerides Total Cholesterol... 

LC is a 51 -year-old female with a history of CHD (stent placement in the left anterior descending coronary artery 3 years prior) and type 2 diabetes who is referred to you for follow-up of her cholesterol. She is taking simvastatin 20 mg once daily in the evening for her cholesterol, and metformin 2000 mg once daily in the evening and piogliti-zone 15 mg once daily for diabetes. Her diabetes is well controlled. Her laboratory test results are within normal limits, except for her fasting lipid profile total cholesterol 215 mg/dL (5.57 mmol/L), triglycerides 135 mg/dL (1.53 mmol/L), HDL cholesterol 51 mg/dL (1.32 mmol/L), and LDL cholesterol 137 mg/dL (3.55 mmol/L). 

---