The blood cholesterol report measures the cholesterol that is produced by our body. Cholesterol is involved in the making of lipoproteins. You might know lipoproteins as HDL (High-Density Lipoprotein)and LDL (Low-Density Lipoprotein) from your cholesterol report. Lipoproteins are vehicles to transport fat, primarily triglycerides and also cholesterol to our cells. We need protein as fats cannot travel through our water-based blood. Fats just like oil would float on the surface and would not mix with water. So, our body puts fats inside proteins and sends them along. That's why the name lipoprotein where lipo means lipids or commonly known as fats. The total cholesterol is the sum of cholesterol carried by the different fat transporters, HDL, LDL, and VLDL.
Recently we started classifying cholesterol based on the underlying fat transporters. Cholesterol carried by HDL is called "good" cholesterol as HDLs are clean-up vehicles ( garbage trucks) that remove cholesterol from our blood vessels. On the other hand, the cholesterol carried by LDL is called "bad" cholesterol as LDLs are the ones that carry cholesterol from the liver to all the cells in the body.
To transport cholesterol or for that matter any cargo, we can either choose big or small trucks. If we choose big trucks, we only need a few of them. Fewer the number of trucks, lesser the probability of trucks getting into the walls of our blood vessels. HDLs are smaller in size as they are in higher in density. Since HDLs are classified as good, they are given a free pass regardless of their size. On the other hand, LDLs are bigger in size as they are less dense. There are 2 types of LDLs, bigger LDLs and small-dense LDL, sdLDL. We need to have less number of sdLDLs as they are more prone to oxidation and live longer. So, they cause the most damage [1]. As you can see, the focus must be not on the cargo, but the type of vehicles.
Now, we have 2 tests that determine the number of LDLs and their size. One test is called Nuclear Magnetic Resonance. The other is called Ion Mobility. Either of the tests will give you a true picture of our fat transporters. For folks who cannot get these advanced tests done, there is a solution as well. If we keep our triglycerides to be not more than two times our HDL , we are more likely to have large trucks , which puts us at less risk of organ failures.
But we should not stop with reducing the number of smaller trucks. We must delve deeper to find out why our blood vessels are damaged to begin with and address them. Click here to find out what injures our blood vessels.
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