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HDL Cholesterol

A high-density lipoprotein (HDLtest measures the level of good cholesterol in your blood. Cholesterol is a waxy substance that’s found in all of the cells in your body. … HDL is known as the good cholesterol because it carries LDL, triglycerides, and harmful fats and returns them to your liver for processing.

Also Known As:  HDL,  HDL-C, High-density Lipoprotein Cholesterol

Test Panel: CholesterolHDL CholesterolLDL CholesterolTriglyceridesVLDL CholesterolNon-High Density Lipoprotein Cholesterol

Why Get Tested:

  • Advised to evaluate the coronary artery disease risk.
  • This can be advised as the part of a lipid profile.
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When to Get Tested:

  • Screening: as part of a regular health exam with a lipid profile.
  • when no risk factors for heart disease are present.
  • once every four to six years in adults.
  • children should have a lipid profile screening at least once between the ages of 9 and 11 and then again between the ages of 17 and 21.

Sample Required:

  • This test is done on the serum.
  • Fasting sample is preferred. Advised the patient to fast for 12 to 14 hours.
  • This test can be done on plasma as well.
  • Can store serum or plasma at 4 °C for 4 days (can keep for 5 to 7 days).

Normal Value:

  • Male = 40 – 60 mg/dL
  • Female = 40 – 60 mg/dL

Abnormal values of HDL:

  1. <25 mg/dl             =  Coronary heart disease risk is 2 times and this is a dangerous level.
  2. 26  to 35 mg/dl    =  The risk is 1.5 times. This is a high-risk group.
  3. 36  to  44 mg/dl   = The risk is 1.2 times. This is a moderate risk group.
  4. 45 to 59 mg/dl     = This is average risk group.
  5. Above 60 mg/dl  = Below average risk group.
  6. Critical values:
    1. Male = less than 35 mg/dl.
    2. Female = less than 40 mg/dl.

Increased HDL-C value seen in:

  • A chronic liver disease like cirrhosis, hepatitis, and alcoholism.
  • Long-term vigorous exercises.
  • Familial hyper- alpha-lipoproteinemia.
  • The increased level may be due to some drugs.
    • Estrogen therapy.
    • Moderate intake of alcohol.
    • Insulin therapy.

Decreased HDL-C values seen in:

  • Poorly controlled diabetes
  • Cholestasis.
  • Chronic renal failure, uremia, and nephrotic syndrome.
  • Hypertriglyceridemia.
  • Familial hypo-alpha-lipoproteinemia.
  • alpha and beta – lipoproteinemia.
  • The decreased level may also be seen in some of the drugs.
    • Steroids.
    • Antihypertensive drugs.
    • Diuretics.
    • Beta-blockers.
    • Thiazide.

Table showing the summary of characteristics of the lipoproteins

CharacteristicsChylomicronHDLLDLVLDL
PLasma appearanceCreamy layer, slightly turbidClearClear, or yellow-orange tintTurbid to opaque
Size (diameter nm)>70.04 to 1019.6 to 22.725 to 70
Electrophoretic mobilityOriginα – regionβ – regionPre – β region
Molecular weight 0.4 to 30 x 1093.6 x 1092.75 x 1095 to 10 x 109
Synthesized in (Tissue of origin)IntestineIntestine and liver IntravascularLiver and intestine 
Composition by weight in %    
                     Cholesterol esterified5384911 to 14
                    Cholesterol unesterified210 135 to 8 
                    Triglycerides8491144 to 60
                    Phospholipids7222720 to 23
                    Proteins221234 to 11
TriglyceridesMarkedly raisedNormalNormal/ RaisedModerately to Markedly raised
Clinical significance ofPancreatitis and acute abdomenDecreased risk of CADIncreased risk of CADIncreased risk of CAD
FunctionsTransport dietary lipids to tissueCarry cholesterol from tissue to liverCarries cholesterol to tissueTransport endogenous TG from liver to adipose tissue

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