Lipid profile is a series of tests, done to identify the risks that predispose to atherosclerosis, stroke, and cardiovascular disease, which enables timely intervention. Interpretation is done considering the other risk factors. Lipo-proteins transport the water-insoluble Triglycerides and Cholesterol via the blood to various parts of the body. The liver is the main organ involved in Lipo-proteins metabolism therefore lipid profile estimation can be considered as a Liver Functioning Test (LFT).
The following are the parameters measured in the Basic Lipid profile:
- HDL Cholesterol is lipo-protein that carries cholesterol from various parts of the body to the liver for excretion via the bile. It is considered good cholesterol. It is directly measured.
- VLDL is Lipo-protein synthesized in the liver and is rich in Triglycerides (lesser amounts of cholesterol). As it travels in the blood vessels most of the Triglycerides are taken away by the tissues and, this converts VLDL to IDL and then subsequently to LDL. VLDL is calculated from Triglyceride concentration.
- LDL Cholesterol is prone to get deposited in the blood vessels causing atherosclerosis and CVD, hence considered bad cholesterol. It is directly measured.
- Total Cholesterol is a sum of all the cholesterol present in all the above lipo-proteins. It is directly measured. Its increase predisposes to CVD.
- Triglyceride is the sum of all the Triglycerides present in VLDL and Chylomicrons which is a lipo-protein that transports lipid absorbed in the intestine to the liver. It is directly measured. The increase is associated with metabolic syndrome and is a risk factor for CVD, fatty liver, and acute pancreatitis(very high levels)
- Calculated parameters -ratios like TC/HDL, LDL/HDL, and non-HDL elevation also predispose to CVD.
Extended lipid profile includes:
- Apo B & ApoA1- These are protein components of LDL-C and HDL-C.(Direct Measure)
- Lipo(a)- this an abnormal protein attached to LDL-C (Direct Measure)
- hsCRP- is a protein produced in the liver during inflammation. (Direct Measure)
- Homocysteine- is an amino acid metabolite. (Direct Measure)
- Increased levels of Apo B, Lipo(a), Apo B/ApoA1 ratio, and Homocysteine as well as a moderate increase in hsCRP, are better predictors of AS & CVD.
Regular lipid profile estimation enables us to identify abnormal lipid levels which may be caused by unhealthy lifestyles and disorders such as DM, CKD, liver diseases hypothyroidism commonly, giving a window period to the attending physician to intervene in the form of lifestyle modifications and drugs like statins and fibrates which helps in slowing the progress of ASCVD.