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Subject: Cholesterol, Low-Density Lipoprotein (LDL)
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LDL cholesterol, also known as LDL-C, is produced by the metabolism of VLDL cholesterol and consists of mostly cholesterol, protein, and phospholipids that carry cholesterol in the bloodstream from the liver to the peripheral tissues. LDL-C is termed the “bad cholesterol,” and LDL-C levels are associated with atherosclerosis and coronary heart disease.
Normal range: see Table 16.20.
To determine risk of heart disease and atherosclerosis. LDL-C is calculated when ordered in combination with total cholesterol, HDL cholesterol, and triglycerides as a lipid profile.
Chronic renal failure
Hyperlipidemia types II and III
Lecithin cholesterol acyltransferase deficiency
Apo C-II deficiency
Hyperlipidemia type I
LDL-C values may be high because of a diet high in saturated fats and cholesterol, pregnancy, or use of steroids.
LDL values should be measured only on fasting samples.
LDL cholesterol may be decreased because of acute stress, recent illness, and estrogens.
Other factors that may affect LDL-C values: cigarette smoking, hypertension (blood pressure >140/90 mm Hg or taking antihypertensive medication), family history of premature CHD (CHD in male first-degree relative <55 years; CHD in female first-degree relative <65 years), and age (men >45 years; women >55 years). See Table 16.21 for additional information.
At this time, there are no specific recommendations on the routine measurement of LDL particle size and number.
The lipid profile does not measure LDL level directly but rather estimates it using the Friedewald equation:
Note: The formula is only valid from a fasting specimen, and triglycerides must be <400 mg/dL.
LDL-C can be measured directly when the triglycerides are elevated.