Cholestrol result

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Sharron1

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Type 2
Hi,
I wonder if someone can explain what is the cholestrol result to concentrate on. Either the total chloestrol or the ratio result? My result for total was 5.6 and the ratio was 2.5. I have spoken to the nurse who was confused as me after we both did some googling!
 
Sharron1 said:
Hi,
I wonder if someone can explain what is the cholestrol result to concentrate on. Either the total chloestrol or the ratio result? My result for total was 5.6 and the ratio was 2.5. I have spoken to the nurse who was confused as me after we both did some googling!
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The total cholesterol of 5.6 is probably higher than would be considered desirable as for people 'at risk' ie those with diabetes etc the total cholesterol should be below 4. As far as the ratio, that is either the ratio of LDL /HDL or triglycerides but with out the breakdown of those individual numbers hard to say as you don't know what specifically that ration refers to.
 
Leadinglights said:
The total cholesterol of 5.6 is probably higher than would be considered desirable as for people 'at risk' ie those with diabetes etc the total cholesterol should be below 4. As far as the ratio, that is either the ratio of LDL /HDL or triglycerides but with out the breakdown of those individual numbers hard to say as you don't know what
Leadinglights said:
The total cholesterol of 5.6 is probably higher than would be considered desirable as for people 'at risk' ie those with diabetes etc the total cholesterol should be below 4. As far as the ratio, that is either the ratio of LDL /HDL or triglycerides but with out the breakdown of those individual numbers hard to say as you don't know what specifically that ration refers to.
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She was quite happy to leave statins for a while as you say 4 is the preferred level for diabetics. Then she said your ratios are good. Very confusing. I was just interested in the differences.
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What confuses me is, now they have total serum cholesterol, non-HDL, LDL, HDL and triglycerides so what is non-HDL cholesterol?
 
Leadinglights said:
What confuses me is, now they have total serum cholesterol, non-HDL, LDL, HDL and triglycerides so what is non-HDL cholesterol?
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Yes, far too many different systems now.
That's why I'm just staying with the classic model, and always get a fasting test.
 
Sharron1 said:
Hi,
I wonder if someone can explain what is the cholestrol result to concentrate on. Either the total chloestrol or the ratio result? My result for total was 5.6 and the ratio was 2.5. I have spoken to the nurse who was confused as me after we both did some googling!
Click to expand...
Hi. The traditional figures were under 5 total chols for non-diabetics and under 4 for diabetics because they were the tipping points for the acceleration of cvd as proved by Edwin Biermann in the 1990s. Then an emphasis on ratios came in e.g. total divided by hdl. Now there seems to a renewed emphasis on 'bad' chols with the promotion of Total chols minus hdl as the formula. The Mayo Clinic suggests that figure should be under 3.3. I haven't checked what the Joslin Institute has to say about it yet. Controlling chols/lipid profile is an important aspect of the management of diabetes given that 85% of diabetics die of cvd. It's mainly LDL that's depositing cholesterol at critical points such as coronary arteries, carotid and femoral arteries. The Qrisk assessment tells you if you should consider a statin. 20% of people who have had a heart attack have another one within 7 years. 20% of Type 2 Diabetics have a heart attack within 7 years. That's why an eminent diabetologist said being diagnosed with Type2 Diabetes is the equivalent of having had your first heart attack ( at the 2009 DUK Professional Conference). So controlling chols is a major issue for us. Unfortunately the anti-statin warriors have turned it , quite unnecessarily, into a minefield of misinformation.
 
travellor said:
Yes, far too many different systems now.
That's why I'm just staying with the classic model, and always get a fasting test.
Click to expand...
That is interesting. I have never had a fasting blood test although this time I was asked if I had fasted. She didn't seem too concerned that I hadn't.I wish I had asked what the difference is. Oh well, next time.
 
Sharron1 said:
That is interesting. I have never had a fasting blood test although this time I was asked if I had fasted. She didn't seem too concerned that I hadn't.I wish I had asked what the difference is. Oh well, next time.
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Fasting affects triglyceride readings.

"Triglycerides are a type of fat (lipid) found in your blood. When you eat, your body converts any calories it doesn't need to use right away into triglycerides. The triglycerides are stored in your fat cells. Later, hormones release triglycerides for energy between meals"

So if you eat, the reading can be up by around 0.5 compared to a fasting test,
And that affects your "bad" cholesterol reading.

The problem was people don't want to fast nowadays, so a test variation was invented to cope with that, and the surgery rarely even bother asking anymore.
All mine are fasting, because I simply don't eat from the night before, even if it's an afternoon test.
The test is more consistent that way, and the results are more meaningful to me.
(I do try to get a morning test by preference though)
 
Leadinglights said:
What confuses me is, now they have total serum cholesterol, non-HDL, LDL, HDL and triglycerides so what is non-HDL cholesterol?
Click to expand...
Non-HDL is just total chol minus HDL. It is a measure of the amount of LDL and triglycerides.

It seems to be increasingly viewed as the best marker by the expert bodies, internationally - as reflected in the NHS England guidelines linked above.

(Actually, apoB is probably seen as the best, increasingly, but non-HDL is an OK-ish proxy for this & it is commonly measured, unlike apoB.)

Conversely, the total / HDL ratio seems to be increasingly deprecated as a metric. The reason is that increasing your "good" HDL cholesterol while LDL and trigs remain the same doesn't actually reduce risk, according to lots of studies.

Which may be an issue for those who mistakenly think that increasing your LDL is OK if you also increase your HDL and hence keep your "ratios" at some level.

(Basically, what's important for CV risks is the number of apoB particles, and these are associated with LDL and trigs. Increasing HDL won't increase the amount of apoB, but it won't reduce it either, if LDL and trigs remain the same, so no effect on risks.)
 
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