Plasma lipids Sample Clauses

Plasma lipids. Generally, the risk of CHD is high in countries where the average serum cholesterol is high, compared to those where the average cholesterol concentration is low. Raised serum cholesterol concentrations are usually due to increases in the low density lipoprotein (LDL). LDL is derived from the metabolism of very low density lipoprotein particles (VLDL) that are secreted from the liver. VLDL is converted to LDL first by TAG removal from VLDL through the action of lipoprotein lipase to produce smaller particles, referred to as intermediate-density lipoproteins (IDL). IDL can be either cleared from the circulation by the liver particularly if they contain apolipoprotein E or converted to LDL by further removal of their TAG by hepatic lipase. LDL contains apolipoprotein B100 and is enriched with cholesterol. Serum LDL cholesterol (LDL-C) concentrations are usually estimated by determining the total cholesterol concentrations, high density lipoprotein cholesterol (HDL-C) and triacylglycerol (TAG) concentration using the Friedwald formula (total cholesterol – [HDL-C+TAG/2.2]). Desirable levels of LDL-C are less than 3 mmol/L. Serum LDL-C concentrations are determined mainly by the activity of LDL receptors which are expressed mainly in the liver (Xxxxxxxxx & Xxxxx, 2009). Various hormonal and genetic factors influence the activity of the receptors. First discovered by Nobel Laureates Xxxxxxxxx and Xxxxx, this receptor was found to be lacking in patients with familial hypercholesterolemia (FH). Heterozygous FH, where only half of the numbers of LDL receptors are function, is characterised by very high LDL-C typically well above 6 mmol/L and a 25 fold increase in risk of CHD before the age of 60 years. The prevalence of FH is above 1:500 in the general population. Increases in LDL-C occur with increasing age and it is believed that LDL receptors activity declines with age and is affected by thyroid hormone activity and oestradiol. The increase in LDL-C seen in women post menopause is believed to be due to a decline in LDL receptors activity due to the loss of oestradiol. LDL particles play a crucial role in the atherogenic process, but native LDL particles required to undergo oxidative modification before they are taken up by scavenger receptors on macrophages within the sub-endothelial space (Xxxxxxxxx, 1989). The accumulation of lipid laden macrophages results in fatty streaks in the artery and these can progress to form the more complex lesions of atherosclerosi...
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