This mysterious lipoprotein (a) (LP (a)) does not exist in cholesterol (cholesterol) metabolism regimens. Why does the body need it? An unequivocal answer can not give anyone. And yet it is present in the blood.

On the one hand, lipoprotein (a) is a low-density cholesterol-free compound, it is also called “bad”, since a high content of LDL leads to atherosclerosis and its complications. On the other hand, it is a “relative” of beneficial plasminogen, which is involved in the softening and excretion of blood clots.

High LP (a) is a common cause of hereditary vascular pathologies that provoke heart attacks and strokes. At the same time, this indicator for long-livers who have stepped over the 100-year-old frontier is consistently high.

Is it worth dealing with him to clarify all the details? When calculating cholesterol, we take into account lipoprotein (a). What we call our values, in fact, is the sum of the LDL cholesterol and the LP (a). How to correctly decipher the result of lipidogram?

Lipoprotein (a) - what is it?

A dangerous relative of "harmful" cholesterol is actually LDL, only with the appendage. The glycoprotein, called apo (a), is alipoprotein (a) associated with alipoprotein apo b, which is also present in the LDL complex. It consists of cholesterol, triglycerol, phospholipids, Apo B, alipoprotein Apo (a).

It is produced in LP (a) in the liver when LDL and Apo (a) are combined with a disulfide bond of the covalent type. Compared with other types of LP, catabolism of such lipoproteins occurs in the kidneys.

The plasma value of lipoprotein (a) is associated with Apo (a): the smaller the aliproprotein (a), the higher the LP (a), it is determined by the genes encoding Apo (a). The content of lipoprotein (a) varies from<0,1 до >200 mg / dl. For up to 14 mg / dL.

In (a) there is a LDL C along with its main alipoprotein B. These components have little effect on the content of LP (a) (only 10%). 90% of this indicator determines the genes, and it is associated with the rate of formation of Apo (a). Since infancy, the indicator LP (a) is constantly growing, reaching a maximum in adulthood. Then this figure remains unchanged, with the exception of women in the postmenopausal period, when they see another increase in its concentration.

When compared with other risk conditions, the danger of a high lipoprotein (a) is neither sex nor age. It does not depend on diet and living conditions. But the prerequisites affecting the level of lipoprotein (a) are still defined.

Causes of lipoprotein growth (a)

The lipoprotein catabolism (a) is carried out in the kidneys, therefore, lipoprotein (a) is significantly increased in the following conditions:

• Renal failure;
• Everyone on hemodialysis;
• Persons with nephrotic syndrome.

According to the results of tests in volunteers with the last disease on this list, the lipoprotein index (a) was 69.1 mg / dl. When compared with analyzes of healthy participants (18.2 mg / dL), it can be concluded that the rate is exceeded several times. During remission, patients had a decrease in the level to 8.9 mmol / l.

With a change in catabolism, the values ​​of lipoprotein (a) reach 100 mg / dl, and with a drop in the glomerular filtration rate below 70 ml / min. this figure may be even higher.

An increase in the values ​​of lipoproteins (a) is actually related to renal dysfunction, but there are cases when renal pathologies developed against the background of an already high LP (a). Doctors associate this phenomenon with hereditary predisposition.

Long-term observations of the objective picture of the physiology of lipoprotein (a) did not reveal. It has been reliably established that, as a component of LDL and a “relative” of plasminogen, it participates in the coagulation and metabolism of cholesterol and triglycerol.

In this regard, lipoprotein (a) actually provokes cardiovascular diseases (CVD) and stimulates the formation of blood clots. In blood clots (plaques) lipoproteins (a) involved in thrombus formation were detected. The American Heart Association, the authoritative association of cardiologists, claims that high lipoproteins (a) increase the risk of fatal coronary thrombosis by 70%.

• Atherogenic capabilities enhance the effect of transporting oxidized phospholipids.
• An indicator of 26 mg / dl provokes the formation of blood clots.
• LP (a) is a plasminogen inhibitor that breaks down fibrin, dissolving blood clots.
• Lipoprotein (a) can overcome the barrier of the spine, falling into the cerebrospinal fluid, it has a negative effect on the central nervous system.

Most scientists adhere to the concept that a high plasma lipoprotein index (a) increases the risk of CVD, especially for men. But long-term observations of 32 thousand women confirmed that a high rate of CVD statistics.

In the process of aging of the body, the relationship between the values ​​of this component and cardiorisc decreases: in the elderly, this factor is already associated with longevity, and for the elderly after 65 years, there is no sense in defining it. One person out of 10,000 lives to the centenary milestone in the world, so it’s not worth counting on this criterion.

In diabetes mellitus (DM), the values ​​of lipoprotein (a) in the analyzes are often elevated, but the relationship between the nature of diabetes and lipoprotein (a) is not established above the norm. Only the fact of increasing the likelihood of retinopathy in type 2 diabetes and lipoproteins (a) above normal is proven. In insulin-dependent diabetics, with liposupple (a) values ​​of 36 mg / dL, the risk of death increases.

In a prospective experiment, 186 children under the age of 12 years took part, it was revealed that lipoproteins (a)\u003e 30 mg / dl increase the likelihood of venous thromboembolism as early as childhood. The increased results of lipoprotein analysis (a) are noted primarily in children with excess body weight.

Why does the body need lipoprotein (a)

Vital indispensable this type of lipoprotein is not. People with little content of it do not observe obvious ailments. Lipoprotein values ​​(a) can change up to 1000 times. It is believed that it improves wound healing, helps restore tissue and blood vessels.

Experiments have shown that Apo (a) contributes to the reduction of the primary tumor. By blocking its development, it increases the survival of experimental animals with primary human malignant neoplasms.

A high lipoprotein (a) (\u003e 30 mg / dL) predicts an increase in CVD, especially at high (from 60 mg / dL) LDL-C. The experiments, in which 1486 eighteen-year-old boys participated, showed that parents of young people with a plasma level of 25 mg / dL had a heart attack 2.5 times more often than those with whom this indicator was normal.

In another experiment, lipoproteins (a) were studied in males 40-50 years old as a predictor of mortality, not associated with other risk factors. This indicator also depends on race: in people with white skin, it is higher than in blacks. 14 mg / dl is considered to be the norm for men, and 15 mg / dl for women.

Values ​​above 30 mg / dL are elevated. Such an indicator, according to large-scale studies, is in 25% of US citizens.
In hypercholesterolemia, it is important to determine not only the lipoprotein data (a), but also the size of the particles themselves, which genetically determines the degree of cardiac risk.

Lipoprotein test - what is it?

To determine a competent and economically viable course of treatment with high levels of LDL cholesterol and Apo B, it is important to clarify the role of the genetically determined growth of lipoprotein (a) and apo (a) in analyzes.

Since lipoprotein (a) is a familial risk factor for coronary conditions, CVD, stroke, it is imperative to check them:

Patients with early CVD history.

Patients with a familial predisposition (there are many cases of CVD in the case history of the next of kin).

When guided by the reference indicators:

• <14 мг/дл – норма;
• 14-30 mg / dl - borderline condition;
• 31-50 mg / dL - high level;
• \u003e 50 mg / dL is a very high degree of risk.

And in conclusion - the main question on lipoprotein a: how to reduce the high rates of lipoprotein (a)? Due to the fact that its content is laid at the genetic level, a special diet, weight correction, lifestyle changes, statin therapy cannot lower the concentration of the drug (a).

Some results are recorded when using nicotinic acid and hormone replacement treatment, but this information requires confirmation. There is no medicine to reduce the concentration of lipoprotein (a), and it is not known whether the decrease in its concentration leads to a real decrease in cardiac risk.

Cholesterol plays an important role in maintaining optimal hormonal levels. But in its pure form, it can not independently move with the blood flow. This is due to its inability to dissolve in water. Therefore, the only possibility to transport cholesterol in the bloodstream was its entry into the composition of complex complexes, together with apoliproteins.

This complex is called lipoprotein. Scientists identify 4 main types of compounds:

• VLDL These are very low density and large size lipoproteins or.
• LDL. Low density lipoproteins, which are smaller than the compounds of the previous group.
• HDL. High-density lipoproteins or lipoprotein a, or alpha cholesterol.

It is about a-lipoprotein and will be discussed. So, what are these compounds and what role do they play in the vital activity of the organism?

Scientists have found that alpha lipoproteins are the most pronounced protein compound from all lipoprotein complexes. The protein content in them is at least 55%, the amount of phospholipids is at least 30. And the percentage and cholesterol is very small. Outwardly, this compound looks like a waxy mass of soft consistency. It is found in all tissues and organs and is called cholesterol.

This is the only compound that is synthesized by the liver cells and decomposed by the kidney tissues.

The main function that α-lipoproteins perform is to remove excess fat from the cells and tissues of the body. Consequently, the greater their percentage in the bloodstream, the less fat will be deposited on the walls of blood vessels. And this, in turn, will significantly reduce the risk of developing cardiovascular diseases.

Scientists call high density lipoproteins "good cholesterol." Its task is to transport fat cells to the liver, normalize hormonal levels by stimulating the work of the adrenal glands, as well as coordinating the psycho-emotional state, preventing the development of depression.

Why is it important to do an analysis

The conditional division of cholesterol into "" and "good" allows you to identify the beneficial effects of alpha lipoproteins on the human body. And the violation of the optimal indicator indicates serious violations that occur in the human body.

Increasing the concentration of LP (a) twice indicates an increased risk of atherosclerosis. Studies have shown that the normal level of cholesterol in a person’s blood with an increase in the alpha lipoprotein index of just 0.3 g / l increases the risk of developing coronary heart disease by a factor of 2 or more. And if a patient, according to the results of proper preparation for the delivery of tests and their high-quality implementation, revealed an increase in both indicators, then the risk of developing pathology increases by 8 times.

How to prepare for the analysis

Proper preparation for a blood test determines the reliability of the result and the subsequent effectiveness of the course of treatment. Specialists point out several mandatory nuances that should be followed by all patients without exception:

• From the moment of the last meal to the taking of biological material for research, at least 8 hours should pass. Ie the blood test is taken on an “empty stomach”. Not even tea, juice or coffee is allowed. But ordinary water without gas in small quantities is permissible.
• On the eve of the patient is recommended to refuse to receive fatty, smoked and fried foods. And also to exclude from the diet alcoholic beverages.
• An hour before the time of blood collection should stop smoking.
• Also, it is not necessary to prescribe blood sampling and such studies as ultrasound, x-rays, fluorography and other physical procedures for one day.
• 30-40 minutes before taking the biomaterial for the study physical or emotional loads are contraindicated for the patient.

Material for delivery of the LP (a).

The material for determining the amount of alpha cholesterol in the patient's body is serum obtained from venous blood. The collection of biological material is carried out in a vacuum tube immediately before the study.

The analysis period for determining the LP (a) is on average 1 working day.

What are the normal alpha cholesterol levels?

Risk assessment of the development of diseases of the cardiovascular system is possible only if there is a certain average norm adopted by experts as the optimal HDL rate. So, what is the norm of lipoprotein (a) in different periods of a person's life?

Experts note that the rates of indicators may vary slightly. This is due to the reagents, as well as the accuracy of the equipment on which the patient's blood test is performed.

It is also important to understand that the gender of the patient also affects the optimal indicator of lop lipoproteins. So, in men it is slightly lower than in women. Consequently, if according to the results of the performed blood test, it was established that the male indicator is 1.036 mmol / l, and in a female patient it is equal to 1.3 mmol / l, then in both cases we are talking about a reduced HDLS value. The increased risk of developing cardiovascular disease requires physicians to pay close attention to the patient's health.

Objectively assess the patient's condition and identify risks, allows derived by experts. His task is to show the relationship between good cholesterol and the amount of total cholesterol (good and good) in human blood.

The optimal coefficient of atherogenicity should be in the range of 2-2.25. For newborn babies, it does not exceed 1, and for representatives of the male age group over 40, not more than 3.5.

Increases in lipoprotein a

The erroneous opinion of many patients that an increase in the amount of HDL in the blood indicates a favorable situation in the body does not always correspond to reality. At first glance, the higher the “good cholesterol” indicator, the more fat will be transported to the liver, and the cleaner the vessels will be.

Experts say that a slight excess of the optimal HDLH indicator may be due to the individual characteristics of the organism, which reduces the likelihood of developing coronary heart disease. But a significant increase in alpha lipoproteins in the patient’s blood may indicate the presence of such diseases as:

• Hyperlipoproteinemia. This term scientists call a pathological condition characterized by a high content of lipproteins in the blood. It has a hereditary nature and can be diagnosed in several generations within the same family.
• Cirrhosis of the liver. We are talking about biliary or, as it is also called, primary cirrhosis.
• Chronic course of hepatitis of any type.
• Chronic intoxication of the patient. For example, drug or alcohol addiction.
• Patients with nephrotic syndrome.
• Hypothyroidism.
• Myocardial infarction in the acute phase of the pathological process.
• Patients with uremia who are on hemodialysis.
• Diabetes mellitus type 1 or 2.

Also, an elevated level of LP (a) can lead not only to damage to the vessels of the brain and heart, but also cause damage to peripheral arteries. Increased levels of LP (a) are often diagnosed in patients with high blood glucose levels, and may also indicate aortic atherosclerosis.

When analyzing the results of laboratory studies, the specialist takes into account the factors that have a direct impact on the levels of high-density lipoproteins in the patient’s blood. These factors include:

• Pregnancy. Do not donate blood to determine the amount of "good cholesterol" immediately after childbirth. It is necessary to wait a period of 6-8 weeks and only after that rely on the accuracy of the analysis.
• Medication. Estrogens, cholistyramines, or insulin, as well as neomycin, omega-3 fatty acids and neocin can distort the actual clinical picture, and the analysis will give the wrong result.

Experts note the need for blood donation to determine the content of the drug (a) only 2 months after infectious and other serious diseases, stress, the end of taking medicines that affect the change in the number of HDL, and pregnancy.

Studies have shown that 90% of the level of LP (a) in patients laid genetically. And to reduce its drug is unlikely to succeed. Changing diet and lifestyle, giving up bad habits will slightly correct the excessive increase in performance. But to completely normalize their value will not succeed.

As a result of the research, scientists found that there is an inverse relationship between myocardial infarction and an increase in the level of the LP (a). If a patient is diagnosed with MI at an early age, then the LP (a) indicators will be higher than in other people. For such patients, continuous monitoring of lipoprotein a is necessary throughout life.

Lower norm

There are several reasons that can cause a decrease in the amount of lipoprotein alpha. Unbalanced diet, lack of daily regimen and the presence of bad habits can move the atherogenic index downward. But we should not discount the fact that a number of diseases can lead to the same succession of events. And a decrease in the number of HDL in the patient’s blood should be a signal for a specialist to conduct a comprehensive examination to identify a pathological condition.

Among the most common causes provoking a decrease in lipoproteins in the blood can be:

• Atherosclerosis of vessels.
• Pathologies of the kidneys and liver, including diseases such as cirrhosis of the liver or nephrosis.
• Disorders in the endocrine system.
• Cholelithiasis.
• Infectious diseases in the acute stage of the pathological process.

Strong stress or just a nervous shock can lead to a violation of the amount of "good" cholesterol produced by the body. It should also be understood that a decrease in HDLH may occur if the patient has been taking certain medications for a long period of time. Among other side effects could be a decrease in the number of high-density lipoprotein.

Who will consult

If according to the results of the study, the patient's blood serum revealed a deviation from the norm of alpha lipoprotein, then consultation with experts would be the best solution. Contact in this case should be to a cardiologist and therapist. And already on the basis of the diagnosis, consultation of an endocrinologist or an infectious disease specialist may be required.

Is it possible to increase the content of liprotein a in the body? Experts recommend that you follow certain rules in order to increase the amount of "good cholesterol" in the patient's body:

• Reduce the amount of trans fat consumed with food. They are part of the products of animal origin.
• Reduced daily calorie intake. Achieved through the introduction in the diet of foods rich in fiber.
• Increase physical activity through regular cardio and gymnastic exercises.
• Rejection of bad habits. Alcohol, smoking, etc.
•   . The habit of regularly drinking green tea saturates the body with polyphenols, which reduce the total amount of cholesterol in the human body and increase HDL. It should be noted that freshly squeezed cranberry juice has similar properties.

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In diagnosing problems of the cardiovascular system, doctors perform various blood tests, including high-density lipoproteins (HDL) - one of the cholesterol fractions of human blood. In some cases, the analysis may show that the number of a particular fraction is increased. What are PAPs, and what can a change in their level indicate?

Cholesterol and its role in the body

High-density lipoproteins are one of the cholesterol types involved in the metabolic processes of the human body. In itself, cholesterol is a very important participant in metabolism.

It ensures the normal functioning of all living cells, in addition, cholesterol is an integral component of the synthesis of a number of hormones produced by the body:

• cortisol;
• estrogen;
• progesterone;
• testosterone.

The substance is also involved in the synthesis of vitamins (in particular, vitamin D, or ergocalciferol), and a number of bile acids.

But scientists and doctors in recent years, a lot of talk about the harmful effects of cholesterol on the body.

These statements really have a scientific rationale, and the cause of cholesterol harm lies in the fact that it has a complex structure consisting of three components, divided by the ratio of cholesterol to protein:

1. (also called LDL). In them, the ratio of cholesterol to protein is quite high. When they say "bad cholesterol" - they mean precisely the substances of low density. They carry cholesterol to the blood vessels and cells of the body. The increase in the concentration of these substances in the bloodstream significantly increases the risk of the patient having various diseases of the blood vessels, heart, and increases the risk of stroke. They contribute to the appearance of cholesterol plaques in the vessels. Over time, the number of such formations grows, they cover the blood vessels from the inside, narrowing the lumen of the vessels up to their blockage. Also, if the plaque ruptures, it can lead to vascular thrombosis. This is followed by a heart attack, or even a heart attack.
2. HDL, characterized by a predominance of protein over cholesterol. Often they are called "good cholesterol", because it is HDL that protect the body from many problems. The more HDL cholesterol prevails in the body, the better, since alpha lipoproteins protect the heart from various diseases, such as tachycardia, arterial insufficiency, stroke, rheumatic heart disease, and much more. Speaking about what cholesterol A is, one cannot forget its very important metabolic function - the transport of cholesterol to the liver, where the substance is processed, and the decay products are derived through the excretory system. The efficiency of the process directly depends on the level of HDL: the more there are, the better the system as a whole works, leaving no “material” for the formation of plaques in the vessels.
3. There are also very low density lipoproteins, in which, the protein is even less.

In addition to the three mentioned, there is another blood fraction associated with cholesterol levels - these are triglycerides. These are the fats from which the body extracts energy.

The ratio of triglycerides and one type of cholesterol can signal problems in the body, for example, if HDL is low and there are a lot of triglycerides, this can trigger a stroke and various heart complications.

HDL Assay

The doctor may prescribe HDL high density lipoprotein tests if you are suspicious of such diseases as:

• diabetes of any type;
• atherosclerosis;
• various diseases of the kidneys, liver;
• heart ischemia;
• obesity;
• acutely current infections.

Also, tests for alpha cholesterol (alternative name) are done if the patient has to undergo any surgical intervention, if he needs to prescribe a new medicine, change the diet. Analysis of cholesterol fractions helps to control how effective was the diet or the treatment strategy chosen by the doctor.

For example, if a patient suffering from obesity had abnormalities in tests for A cholesterol, then after he went on a diet and began to lose weight, the indicators should be normalized. Thus, the level of HDL in the blood serves as an indicator of the effectiveness of the weight loss method prescribed by the doctor.

If the analysis shows that A cholesterol is lower than normal, this may indicate a significant likelihood of subsequent atherosclerosis in the patient, along with his attendant illnesses.

But by itself, this analysis does not indicate problems in a particular organ or system of a person, therefore, to make a correct diagnosis, additional research will be required.

Blood sampling for analysis occurs early in the morning, on an empty stomach. Blood is taken from a vein. Before you donate blood, the patient must not eat for 12 hours so that the level of cholesterol in the blood can normalize, it is only allowed to drink plain clean water. This is necessary to obtain the most accurate data.

In addition to abstinence from food, the patient should not experience physical and psychoemotional stress. In advance at least one day prior to blood sampling, it is necessary to abandon alcohol, fried and fatty foods, spicy, smoked meats, fast food, etc. Usually, the doctor gives advice on preparing for testing for HDL cholesterol, and they must be followed. If there are any questions, it is better to clarify them at the preparatory stage, so that there is no need to retake blood in the future.

Norm indicators

  For HDL there is no universal indicator of the norm for all: it depends on the age of the subject and his gender.

On average, data on the norm for A cholesterol are as follows (figures are given in mg / dL):

• 0-14 years: 30-65 for women, 30-60 for men;
• 15-19 years: 30-70 and 30-60;
• 20-29 years: 30-75 and 30-70;
• 30-39 years: 30-80 and 30-70;
• 40 years and above: 30-85 and 30-70.

If high-density lipoprotein cholesterol is lowered, it can be a warning signal to the doctor. A decrease in the level may indicate that the patient has functional impairments in the body. This is especially relevant in light of the threat of atherosclerotic plaques that clog blood vessels. Therefore, a decrease in HDL cholesterol (another alternative name) is a signal of a real threat to human life and health.

In order to properly decipher the results of the analysis, the physician must be highly qualified. The specialist evaluates all the data obtained in the course of the study, brings the results together and makes a conclusion about what the patient is sick with and what diagnosis to put.

After the disease is detected, the treatment process begins, which must also be prescribed and monitored by a specialist. Self-diagnosis, and even more self-treatment is dangerous, and can lead to unpredictable and sad consequences.

  Why cholesterol drops, and how to treat it?

Low HDL cholesterol signals that the patient has impaired fat metabolism in the body, and there is a risk of atherosclerosis. Also, such an analysis result can be a marker of the risk of the rapid development of cardiac ischemia, and if you do not take measures to prevent and eliminate the problem, the disease can become complicated over time, leading to a stroke or heart attack.

In addition, they lower A cholesterol and human diseases, for example, celiac disease or various food allergies. The fact is that having such diseases, the patient does not receive enough nutrients from food, as a result, the number of high-density lipoproteins decreases. Another reason is hypothyroidism, as well as liver disease. These problems significantly change the metabolism, which leads to a drop in HDL. Act on their level and medicines. A drop in lipoproteins can be observed on the background of pregnancy, the use of contraceptives or during menopause in women.