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Flashcards in Biochemistry Lipids Deck (59)
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1

Lipoproteins: types

Bad (Non-HDL)

Good

2

Bad (Non-HDL)

Chylomicron and Chylomicron remnant
VLDL Very low Density lipoprotein
IDL – Intermediate Density lipoprotein
LDL – Low density lipoprotein

3

Good

HDL – High density Lipoprotein (cholesterol rich)

4

IDL only present in

Significant amounts in disease – Type 3 hyperlipidaemia
→ Usually not present

5

Chylomicron

Normally present after a meal
Abnormal in fasting state – Type 1 Hyperlipidaemia

6

LDL calculation

TC – HDL – TG/2.2

7

LDL cholesterol target

2 mmol/l

8

NON HDL calculation

TC-HDL

9

Non HDL target

2.5 mmol/l

10

Bad non HDL includes

VLDL and LDL

11

Total cholesterol includes

VLDL, LDL and HDL

12

Metabolism of Exogenous and Endogenous Fat

1. Dietary fat is transported via chylomicrons across the epithelial wall.
2. Lip Lipase hydrolyses FFA
3. FFA (from triglyceride)
4. Chylomicrons and TG produce VLDL = produces IDL to LDL

13

What can go wrong:

1. Eat too much → push too much through pathway
2. Overweight – over production of VLDL (liver)
3. Diabetes: over production
4. Smoke – LDL
5. Genetic – Familial hypercholestreamia

14

HDL Metabolism:

➢ Apo A1 gathers Cholesterol from a peripheral (macrophages) (ABCA1 – gets energy for ATP – aids binding of cholesterol) produces HDL
➢ HDL is taken up by the liver in SRB1 (receptor ligand)
➢ High levels are good.

15

Total Cholesterol
Normal/Average
Ideal/Target

5.9
<4

16

Triglyceride
Normal/Average
Ideal/Target

<1.2

17

HDL Cholesterol
Normal/Average
Ideal/Target

1.2 (M) 1.4 (F)
1.2-2

18

LDL Cholesterol
Normal/Average
Ideal/Target

4
<2

19

Non-HDL cholesterol
Normal/Average
Ideal/Target

4.5
<2.5

20

Who to test

➢ CVD or at risk (family history; diabetes; age >50)

21

Measuring TG’s vs total cholesterol process

➢ Fasting essential for accurate measurement of TG’s, but makes little difference to total cholesterol

22

To calculate LDL

➢ Need fasting profile and TG <4 to calculate LDL

23

To pick up mixed hyperlipidaemia

➢ MST measure full profile (Chol; Trig; HDL at least once before starting Rx –to pick up mixed hyperlipidaemia)

24

Measuring Chol and HDL

➢ (and therefore Non-HSL cholesterol) on non-fasting sample

25

Post trauma or MI

➢ NB Chol FALLS by -30% in 24 HRs for 3/12 months after MI

26

Secondary Causes of High cholesterol measure first:

1. Glucose
2. LFT’s
3. U and E
4. TSH
5. Dipstick urine

27

Cholesterol (High)

Accelerated atherosclerosis

28

Low HDL leads to

Accelerated atherosclerosis

29

Triglyceride

2-10 mmol/l – accelerated atherosclerosis
>10 mmol/L – acute pancreatitis

30

Secondary Causes of High cholesterol

Diabetes
Liver disease
Renal disease
➢ Nephrotic syndrome
Hypothyroidism
Alcohol
HIV
Anorexia
Drugs:
➢ Ani retrovirals
➢ Retinoids
➢ Steroids (anabolic)
➢ Antidepressants
➢ Pscyhotrophics

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