Fat tests

The Star Malaysia - Star2 - - HEALTH - By Dr YLM DR Y.L.M.

In­ter­pret­ing lipid pro­files in a gen­eral blood test for health.

THE test I usu­ally pay the most at­ten­tion to is the choles­terol screen or lipid pro­file. Please elab­o­rate a bit about such tests.

Yes, we Malaysians are a choles­terol-screen­ing sen­si­tive bunch! The lipid pro­file is a group of blood tests that are very of­ten or­dered as part of a gen­eral blood screen­ing, or they can also be or­dered singly.

Since so much has been writ­ten about the risks of heart at­tacks and coro­nary heart dis­ease in gen­eral, Malaysians are more apt to be con­scious of what’s in­side the lipid pro­file.

High Ldl-choles­terol and low Hdl-choles­terol are two of the risk fac­tors as­so­ci­ated with coro­nary heart dis­ease (CHD). It is in the lipid pro­file that you see these lev­els.

Choles­terol is a type of fat that is found in your blood af­ter its con­ver­sion in your liver. Some of it comes from the food you eat – the more fat you eat, the higher your choles­terol. But since so much of it is pro­duced by your own liver, and this has a ge­netic ba­sis, you can’t help hav­ing high choles­terol even if you are re­ally care­ful about your diet if you have a fam­ily his­tory of high choles­terol.

Please bear in mind that you need choles­terol for your daily cell func­tion. You can­not live with­out choles­terol. It is the ex­cess that leads to dis­ease. DE­SPITE a con­cern about re­strict­ing sci­en­tific knowl­edge, the risks of pub­lish­ing po­ten­tially dan­ger­ous bird flu re­search out­weigh the ben­e­fits, says a Univer­sity of Michi­gan (U-M) vi­rol­o­gist and mem­ber of a fed­eral ad­vi­sory board that re­cently made the rec­om­men­da­tion that de­tails of the re­search not be pub­lished by two prom­i­nent sci­en­tific jour­nals.

Af­ter two stud­ies de­tailed how the H5N1 virus, or the avian flu, could po­ten­tially be­come trans­mis­si­ble be­tween hu­mans, there was con­cern that, if made public, the de­tails of the re­search could be used by ter­ror­ists or oth­ers bent on harm­ing a large num­ber of peo­ple, says U-M vi­rol­o­gist Michael Im­pe­ri­ale, a mem­ber of the US Na­tional Sci­ence Ad­vi­sory Board for Biose­cu­rity (NSABB).

The NSABB re­viewed the sub­mit­ted re­search and re­quested de­tails of the ex­per­i­ments be with­held from the jour­nals Sci­ence and Na­ture, based on con­cerns re­gard­ing public safety.

“If this in­for­ma­tion on how to make the virus trans­mis­si­ble got into the wrong hands, then that could be a huge prob­lem,” Im­pe­ri­ale says. “Be­cause world­wide, we’re just not pre­pared to deal with an in­fluenza pan­demic. Bet­ter to be cau­tious now, and let the de­tails What is in a lipid pro­file?

These are the test re­sults you can look out for:

> To­tal choles­terol (TC): ide­ally, this should be be­low 5.2 mmol/l. This sums up all the choles­terols that are be­ing mea­sured, such as Ldl-choles­terol and Hdl-choles­terol. The higher your to­tal choles­terol, the higher your risk of heart and blood ves­sel dis­ease.

> High den­sity lipopro­tein (HDLC): this is also called the “good choles­terol”. A lipopro­tein is a mol­e­cule that com­bines both lipids and pro­tein. HDL is con­sid­ered “good” be­cause it takes away the ex­cess choles­terol from your blood and brings it to your liver.

The higher your HDL, the bet­ter pro­tec­tion you have for your heart and blood ves­sels. In gen­eral, women tend to have higher HDLS than men. Some­times, you can also have a high HDL due to ex­ces­sive con­sump­tion of al­co­hol.

Yes, some peo­ple try to “cheat” their way into hav­ing a high HDL by drink­ing lots of al­co­hol! But re­mem­ber, there are plenty of other dis­eases as­so­ci­ated with drink­ing ex­ces­sive al­co­hol such as liver cir­rho­sis and al­co­holic hepati­tis.

So it’s ei­ther this or­gan be­ing dam­aged or the other one.

Nor­mal ranges are be­tween 1.04 and 1.55 mmol/l. And yes, this is one test that you aim to go higher than the up­per lim­its!

> Low den­sity lipopro­tein (LDLC): this is also called the “bad choles­terol”. This is be­cause its func­tion is to take the choles­terol from your Re­stric­tion or re­spon­si­bil­ity? Univer­sity of Michi­gan re­searcher ex­plains decision to with­hold bird flu re­search from the public. blood and carry it to your cells.

If you are rel­a­tively healthy, you should aim for a level of less than 4.1 mmol/l. Any­thing higher than this and you are con­sid­ered to have high LDL-C. For high-risk pa­tients (such as those hav­ing coro­nary artery dis­ease or di­a­betes), you should aim for a LDL-C level of less than 2.6 mmol/l.

High lev­els of LDL-C are re­lated to an in­creased risk of heart and blood ves­sel dis­ease. And yes, this means heart at­tacks and angina.

> Triglyc­erides (TG): this has been also found to be as­so­ci­ated with heart and blood ves­sel dis­ease, un­like what was pre­vi­ously thought long ago. They can be raised in di­a­bet­ics or peo­ple who eat sug­ars and drink al­co­hol. They are also likely to be raised in peo­ple who are out later when we’re more pre­pared, whereas if you let it out now, you can’t pull it back if there’s a prob­lem.”

The board’s ex­pla­na­tion of its rec­om­men­da­tion was pub­lished re­cently on­line in Sci­ence and Na­ture. The manuscripts re­main un­pub­lished un­til the is­sue of how to dis- over­weight, have thyroid or liver dis­ease, and cer­tain ge­netic con­di­tions. Nor­mal val­ues should be less than 1.7 mmol/l. How long do I need to fast for a lipid pro­file?

Ac­tu­ally, you do not need to fast when go­ing for to­tal choles­terol or HDL-C. The ones you need to fast for are LDL-C and TG. You need a 12-hour fast, prefer­ably with no food or drinks ex­cept for plain water. I see this test called ‘uric acid’ in my blood pro­file. What does that mea­sure?

Your uric acid nor­mal range should be 155 to 357 mi­cro­mol/l. High lev­els in­di­cate hy­pe­r­uri­caemia, or hav­ing a lot of uric acid in sem­i­nate the in­for­ma­tion to those with a le­git­i­mate need to know is re­solved.

The board’s decision has caused a stir in the re­search com­mu­nity be­cause of the prece­dent it cre­ates for re­strict­ing the avail­abil­ity of po­ten­tially risky, yet ben­e­fi­cial knowl­edge. Im­pe­ri­ale says the board’s decision was a your blood. High uric acid is as­so­ci­ated with dis­eases like gout and gouty arthri­tis. n Dr YLM grad­u­ated as a med­i­cal doc­tor, and has been writ­ing for many years on var­i­ous sub­jects such as medicine, health ad­vice, com­put­ers and en­ter­tain­ment. For fur­ther in­for­ma­tion, e-mail starhealth@thes­tar.com.my. The in­for­ma­tion con­tained in this col­umn is for gen­eral ed­u­ca­tional pur­poses only. Nei­ther The Star nor the au­thor gives any war­ranty on ac­cu­racy, com­plete­ness, func­tion­al­ity, use­ful­ness or other as­sur­ances as to such in­for­ma­tion. The Star and the au­thor dis­claim all re­spon­si­bil­ity for any losses, dam­age to prop­erty or per­sonal in­jury suf­fered di­rectly or in­di­rectly from reliance on such in­for­ma­tion. dif­fi­cult one, and the con­cerns of lim­it­ing re­search were not taken lightly.

How­ever, he says, the re­spon­si­bil­ity to public health and safety out­weighed the con­cerns in this in­stance.

“We have to look at the world in which we live; we know there are in­di­vid­u­als who do want to do harm to mankind for what­ever rea­son,” Im­pe­ri­ale says. “We have to be aware that as sci­en­tists we have a re­spon­si­bil­ity to the public. We’re do­ing this re­search to ben­e­fit the public so we owe it to them to show we’re be­hav­ing re­spon­si­bly.”

Im­pe­ri­ale said the re­search de­tails will be avail­able to those who can use them to fur­ther the sci­ence and safety sur­round­ing bird flu pan­demics.

“It’s im­por­tant to know what types of changes or mu­ta­tions would al­low the virus to be­come trans­mis­si­ble and to al­low le­git­i­mate sci­en­tists an op­por­tu­nity to fol­low up on this re­search,” he says.

“Our best de­fence against ter­ror­ism is a strong of­fence. If we can move the sci­ence for­ward, then we will be pre­pared to deal with all these things.”

Ul­ti­mately, Im­pe­ri­ale says the sci­en­tific re­search com­mu­nity must be more aware of the re­spon­si­bil­ity it has to the public, and per­haps this in­ci­dent will in­crease that aware­ness.

“We want to show we’re think­ing about these is­sues through­out the re­search process, and I think that’s the thing that will hope­fully change in the com­mu­nity,” he says. “Maybe this par­tic­u­lar in­ci­dent is an eye-opener to the sci­en­tific com­mu­nity that we re­ally need to be more en­gaged with the public be­cause of the spe­cial re­spon­si­bil­ity that we have as sci­en­tists.” – Healthnewsdigest.com

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