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Lipidology

Cholesterol Explained

What is Cholesterol?

plaque Cholesterol is a type of molecule that is included in a family of molecules known as lipids. Cholesterol is important for cell membrane integrity, a source for steroid production and bile salts and it is also a source of fatty acid/energy for our body and cells. Cholesterol along with triglycerides is transported from our digestive system to numerous cells and tissues through carrier molecules known as lipoproteins.

Lipoproteins are complex structures in which cholesterol and other lipid substances are “dissolved” into a round shaped complex which due to its chemical properties allow the particle to move in a water solution. Anyone who has cooked knows that fat and water don’t mix. Lipoproteins make it possible for our body to move cholesterol and fatty molecules through our blood. Imagine the various lipoproteins being similar to “soap bubbles”.

While some cholesterol is necessary for our bodies, too much of it can cause problems such as atherosclerosis (the hardening of blood vessels), heart disease, and an increased risk of heart attack and stroke. High cholesterol is a common problem, but with the right management and the right doctor, cholesterol can be reduced to healthy levels.

Advanced Testing, the Lipidologists’ specialty

Fort Myers lipidology Because of our growing understanding of the complexities of different types of lipoproteins, scientists have developed several advanced blood tests that use chemistry to measure more specific risk factors associated with high cholesterol. In order to manage cholesterol most effectively, a new specialty called Lipidology has emerged. Specialists in this field are experts in analyzing advanced lipid tests, understanding complex mechanisms of high cholesterol, and knowing the best cholesterol management for each individual.

Doctor Kordonowy is the only specialist in Lipidology in Lee County. His expertise in this field has helped many patients increase their longevity by effectively managing tricky cases of high cholesterol.

Symptoms and Diagnosis of Abnormal Cholesterol

blood-sample There are no distinctive symptoms associated with high cholesterol. For this reason, blood tests are the only way to detect elevated cholesterol levels.

A lipid profile (blood test to check cholesterol levels) typically reports

  • Total cholesterol
  • LDL cholesterol
  • HDL cholesterol
  • Triglycerides

LDL stands for Low-density Lipoprotein. This is also known as “bad” cholesterol.

For the past few decades the scientific community has established that elevated LDL cholesterol drives the disease process known as atherosclerosis (hardening of the arteries). Learning from this pathology, the medical and pharmaceutical community has developed different products to lower/modify LDL cholesterol levels. The most powerful drug class to lower LDL cholesterol are known as statins. Over the past 2-3 decades statins have proven to significantly lower LDL cholesterol and this has translated to substantial reduction in heart attack and stroke rates.

HDL stands for High-density Lipoprotein, and is also known as “good” cholesterol (high levels are actually healthy!). At the basic science level we are learning a lot about HDL cholesterol. The main function of HDL cholesterol is its involvement in what is called reverse cholesterol transport. Cholesterol is utilized by our tissues and cells for a variety of purposes. However, if cholesterol is not used by a cell, it cannot be broken down-it either collects in the cell or it has to transferred back into the bloodstream to be recirculated. HDL lipoproteins are intimately involved in this movement from our cells back into the blood stream and ultimately to the liver for either elimination through bile and stool or repackaging to be taken to other tissues and cells. This recirculation of cholesterol by HDL lipoproteins is known as reverse cholesterol transport.

Another set of functions that HDL lipoproteins are involved in include the inflammation pathway. Inflammation in biological tissues increases cellular death. Inflammation is involved in the disease process of arteriosclerosis. If HDL is functioning properly it helps the movement of unneeded cholesterol out of cells and it reduces inflammation while promoting healing. If our arterial cells (endothelial cells) become over-burdened with cholesterol then the cells excrete inflammation signals to try to get a special group of white killer cells known as macrophages to come and scavenge the cholesterol up (imagine a packman eating cholesterol). HDL lipoproteins secrete chemical signals that allow the macrophages (packmen) to release some of that accumulated cholesterol back to the HDL lipoprotein and thus allow the cholesterol to be moved back to the liver and other tissues for clearance.