What Is Blood Cholesterol Word

• • • • •

• • • •

What is Blood Cholesterol? A fat-like substance in the blood. Made in the liver and comes from some foods we eat. Too much cholesterol can build up in arteries over time. Can cause heart attacks and strokes. Do You Know Your Cholesterol Number? High cholesterol rarely has symptoms. Know your cholesterol number!

Have a blood test done called the “Lipoprotein Profile”

•

Lipoprotein Profile

Includes:

 Total Cholesterol  LDL Cholesterol  HDL Cholesterol  Triglycerides

•

What is the Recommended Level? The National Cholesterol Education Program recommends…

•

What Are Some Ways To Control Blood Cholesterol and Triglycerides?

• • • • • • •

Healthy Eating Physical Activity Weight Loss Medication Eating Healthy Improving Fats Eat fewer solid fats

– Shortening – Stick butter/margarine – Excess fat on meats • •

Substitute liquid or soft fats “Heart-Healthy Fats” Monounsaturated oils

–

• •

Olive, Canola, Peanut oil

Trans Fatty Acids Limit Trans fats

– Fried foods, cookies, cakes, crackers, snack foods

•

Dietary Cholesterol

• •

Can raise blood cholesterol levels Limit foods high in cholesterol

–

•

• • •

Liver, organ meats, egg yolks, full-fat dairy products

The American Heart Association recommendations?

Triglycerides Limit sugar and refined carbohydrates Eat Fiber (Soluble)

– Dried beans, peas, oats, fruits and vegetables

• • •

Physical Activity Important even as we get older! HDL Cholesterol LDL Cholesterol Lower triglycerides 30 minutes or more on most days.

– Moderate activity

• •

Weight Management Weight loss can…

– –

LDL Triglycerides

–

• • • • • • • • • • • •

• • •

HDL

Just 5 to 10 pounds will help show improvements!!! Be sure to talk with your doctor. Medication Medication needed by some people. Continue with healthy eating and physical activity. Your doctor will help decide the best type of drug. Points to Remember Know your cholesterol and triglyceride numbers! Eat plenty of fruits and vegetables, whole grains, low-fat dairy products, and less fat and cholesterol. Exercise regularly Lose weight if overweight. Talk with your doctor about medicine if lifestyle changes aren’t enough CHOLESTEROL TESTS 2 GENERAL REACTIONS 1. SALKOWSKI – dehydration of cholesterol with H2SO4 and then oxidation by acetic anhydride to form a red cholestadienyl disulfonic acid

• • • • • • • • • • • •

2. LIEBERMANN-BURCHARDT – oxidation of cholesterol with H2SO4 and then oxidation with acetic acid /anhydride to form cholestadienyl monosulfonic acid, a green compound.

Other tests for cholesterol ENZYMATIC METHOD CHOLESTERYL ESTERS ARE HYDROLYZED BY CHOLESTERYL ESTER HYDROLASE TO RELEASE CHOLESTEROL, WHICH IS THEN OXIDIZED WITH CHOLESTEROL OXIDASE FORMING CHOLESTA-4-1 + H202 H202 + PHENOL + AMINOANTIPYRINE WT PEROXIDASE = QUINONEIMINE DYE + H20

OTHER METHODS 1. ONE STEP- DIRECT COLORIMETRIC 2. TWO STEP- EXTRACTION AND COLORIMETRIC 3. THREE STEP- SAPONIFICATION, EXTRACTION AND COLORIMETRIC 4. FOUR STEP- SAPONIFICATION, EXTRACTION, PRECIPITATION AND COLORIMETRIC

CLINICAL SIGNIFICANCE Increased Blood Cholesterol Values:

– Hypothyroidism – Atherosclerosis

– Myocardial Infarction – Diabetes Mellitus – During Pregnancy – Obstructive Jaundice – Familial Hypercholesterolemia – Hypertension – Obesity

• • • • • • • • • • •

SOURCES OF ERRORS Presence of hemolysis Prolonged Incubation time of color developer Presence of Chromogenic substances like Hemoglobin and Bilirubin Introduction of water causes rapid fading of color Extreme exposure to light Presence of metallic contamination Anticoagulated blood TRIGLYCERIDES are esters of fatty acids and are hydrolyzed to glycerol and free fatty acids.

PRINCIPLE

• • • • • • • • • • • • • • •

Enzymatic reaction

Triglycerides

lipase Glycerol + fatty acids

Glycerol + ATP

Glycerol kinase

Glycerol-1-phosphate + ADP

Glycerol-1-phosphate + O2 G-1-P oxidase DAP + H2O2 H2O2 + 4 AAP + DHBS POD

Quinoneimine Dye + 2 H2O

OTHER TESTS Van Handel and Zilversmit Hans Condensation Method SPECIMEN Fresh, clear, non-hemolyzed serum from fasting patients (12 – 14 hrs) is recommended. TAG in serum appear stable for three days when stored at 2-8 ̊ C. Prolonged storage of the samples at room temp is not recommended. Blood collection devices lubricated with glycerin (glycerol) should not be used. CLINICAL SIGNIFICANCE Elevated values of Triglycerides

– Atherema – Atherosclerosis

– Hypertension – Coronary Artery Disease – Diabetes Mellitus – Hypothyroidism

• • • • • • • • • • • • •

SOURCES OF ERROR Specimen should be from a fasting patient. Use of glasswares with water – causes rapid fading of the color Use of hemolyzed serum as specimen – increase results Anticoagulated blood, oxalates and fluorides Serum is preferred than plasma

CONVERSION FACTORS Glucose – 0.0555 Cholesterol – 0.0258 Triglycerides – 0.1128 BLOOD UREA NITROGEN Urea is a product of metabolism in the Krebs – Henseleit urea cycle.

PRINCIPLE

• • • • • • • •

Based on the reaction of diacetyl monoxime to form a colored complex which absorbs at 520 nm. The diacetyl monoxime and acid form the unstable compound diacteyl, which is the actual substance reacting with urea. BERTHELOT’S REACTION In Berthelot’s reaction, catalysts such as nitroprusside are added to facilitate the conversion of ammonia to indophenol. NORMAL VALUES 8 – 20 mgs % 2.86 – 7.14 mmol/L CLINICAL SIGNIFICANCE Increased BUN

– Massive GIT hemorrhage •

Increased absorption of amino acids following the digestion of blood proteins

– Increased protein catabolism •

• • • •

Such as fever, stress and burns

SOURCES OF ERROR Use of anticoagulant such as Na Fluoride Specimen which is contaminated with Bacteria Measurement using whole blood instead of plasma or serum