Friday, August 20, 2010

Cholesterol

It is a fatty substance found in animal tissues. The human body produces cholesterol, but this substance also enters the body in food. Meats, egg yolks, and milk products, such as butter and cheese, contain cholesterol. Such organs as the brain and liver contain much cholesterol.

Cholesterol is a type of lipid, one of the classes of chemical compounds essential to human health (see LIPID). Cholesterol makes up an important part of the membranes of each cell in the body. In addition, the liver uses cholesterol to make bile acids, which aid digestion. The body also uses cholesterol to produce vitamin D and certain hormones, including sex hormones.

Cholesterol and triglycerides, another lipid, are two of the major fatty substances in the blood. Triglycerides may be used by cells for energy, or they may be stored for later use. Doctors often measure the amount of cholesterol and triglycerides in blood to help determine a patient's overall health. High levels of cholesterol, particularly if accompanied by high levels of triglycerides, increase the risk of heart disease.

Both cholesterol and triglycerides are carried through the bloodstream in large molecules called lipoproteins. There are two chief types of cholesterol-carrying lipoproteins, low-density lipoprotein (LDL) and high-density lipoprotein (HDL). Cholesterol in blood can thus be identified as either LDL-cholesterol or HDL-cholesterol, depending on which lipoprotein carries it. High levels of LDL-cholesterol in blood are a primary cause of heart attacks. LDL can be found in the wall of heart arteries. Low levels of HDL-cholesterol also increase the risk of heart attack. Some scientists believe that HDLs help remove cholesterol from tissues.

Factors that cause high cholesterol levels.
The amount of cholesterol in the human body is controlled by cellular molecules that are called LDL-receptors. These molecules allow LDL-cholesterol to attach to and be used by the cell. LDL-cholesterol accumulates in blood in large amounts when the LDL-cholesterol in the body far exceeds the number of available LDL-receptors. This condition most commonly occurs in people whose diets are high in cholesterol or in saturated fats. Saturated fats are found primarily in animal fats and in certain vegetable fats, such as coconut oil and palm oil.

People also may have high cholesterol levels if they have an abnormal gene that prevents a full number of LDL-receptors from forming. This inherited disorder is called familial hypercholesterolemia. Other factors that can cause high blood cholesterol include a malfunctioning thyroid gland, kidney disease, diabetes, and the use of various medicines, including certain diuretics.

Cholesterol and heart disease.
In adults, a cholesterol level of less than 200 milligrams per 1 deciliter (3 ounces) of blood is considered desirable. Above that level, the risk of heart disease increases dramatically. Adults also are at an above-average risk of heart disease if they have an LDL-cholesterol level of more than 160 milligrams per deciliter of blood or an HDL-cholesterol level of less than 35 milligrams per deciliter.

Besides cholesterol levels, other factors increase the risk of heart disease. These factors include cigarette smoking, high blood pressure, diabetes, a family history of premature heart disease, and being a male over 44 years of age or a female over 54. Individuals with two or more of these factors have high risk of heart attack, particularly if they also have atherosclerosis (narrowing of the arteries because of fatty deposits).

Treatment of high blood cholesterol consists of first reducing the amount of saturated fat and cholesterol in the diet. Poultry and fish are low in cholesterol. Cereals, fresh fruit, and vegetables contain no cholesterol. Regular aerobic exercise--such as bicycling, running, and swimming--can further lower the cholesterol level. Medication should be considered only for people who are at high risk of heart disease and who have been unable to control their cholesterol with diet. Medications shown to reduce cholesterol levels and the risk of heart disease include cholestyramine, colestipol, gemfibrozil, lovastatin, and niacin.

Clinical research trials have indicated that lowering the amount of cholesterol in the blood can reduce the risk of heart attack in middle-aged men who had no history of heart disease. In men and women with atherosclerosis, reducing cholesterol in blood prevents further narrowing of the heart arteries.

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