CLINICAL Science Part 12.

Uploaded on:
Category: Medical / Health
Cholesterol esters are changed over into free cholesterol. Unsaturated fats are changed over into ... Most cholesterol union happens in the liver - Most cholesterol bringing down medications ...
Slide 1


Slide 2

INTRODUCTION When was the last time you requested a Double Bacon Cheeseburger, Supersized French Fries, a vast shake and a terminated apple turnover? Did you consider how all that fat got broke up into your blood? … Try dissolving a stick of spread in a glass of water. At whatever point it was, thank your LIPOPROTEINS! It\'s your Lipoproteins that permit all the nauseating fat you eat to enter your plasma without "cloging" things up. Lipoproteins give the transportation framework to various sorts of water insoluble greasy poo Actually, once in a while things do get obstructed - It\'s known as a Heart Attack!!! We have to study lipoproteins due to their relationship to coronary illness - The #1 reason for death in the United States

Slide 3

Arteriosclerosis CAD Cholesterol Chylomicrons Endogenous lipoproteins Exogenous lipoproteins Fatty Acids Friedwald Calculation HDL LDL Lipoprotein Triglycerides VLDL Saturated Fatty Acids Unsaturated Fatty Acids "Great Cholesterol" "Awful Cholesterol" Lipid Lipemic Fasting blood example KEY TERMS

Slide 4

Objectives Define the general capacity, starting point and structure of the lipoproteins Define the names, general piece and capacity of the accompanying HDL LDL VLDL Chylomicrons Discuss the connections between different lipoproteins and CAD List the reference ranges for the lipoproteins Discuss the fundamental test strategies for lipoprotein testing

Slide 5

What are lipoproteins and why do we require them? Lipoproteins are a modest bunch of various particles that collaborate with water insoluble fat atoms, and transports those fats in the plasma The reading material portrays the lipoproteins as "oil tankers" Different lipoproteins are in charge of the transportation of various fats Lipoproteins permit fat to be disintegrated into the plasma

Slide 6

There are 4 sorts of lipoproteins Chylomicrons Transport of dietary triglycerides from the GI tract to the liver Very Low Density Lipoproteins ( VLDL ) Transport of triglycerides from the liver to tissues for capacity and vitality Low Density Lipoproteins ( LDL ) Transports cholesterol to fringe tissues High Density Lipoproteins ( HDL ) Transports cholesterol far from the fringe tissues to the liver

Slide 7

Lipid Chemistry Lipids incorporate Cholesterol Triglycerides Phospholipids Glycolipids Lipids are critical segments of cell films

Slide 8

Fatty acids are short to long carbon fastened atoms Saturated unsaturated fats No twofold securities between carbons ( C – C ) Solid at room temperature Animal sources unsaturated fats Double securities between carbon securities ( C = C ) Usually fluid at room temp Plant sources

Slide 9

Triglycerides Glycerol with 3 joined unsaturated fats Exogenesis source : Dietary Endogeneous : Liver and tissue stockpiling 95 % of muscle to fat ratio ratios is triglycerides Energy source when plasma glucose is diminished Triglyceride catabolism is managed by lipase, epinephrine and cortisol Triglycerides transported by Chylomicrons ( exogeneous ) and VLDL ( endogenous )

Slide 10

Cholesterol Found just in creatures Important segment of layers, steroid hormones, bile and Vitamin D Exogeneous cholesterol originates from eating regimen Endogeneous cholesterol is blended by the liver 70 % of cholesterol connected with cell segments 30 % is in the plasma ( ⅓ free frame , ⅔ esterfied ) Transported by HDL and LDL

Slide 11

Phospholipids Important segments of cell layers Lecithin and sphingomyelin are used to decide fetal lung development from amniotic liquid ( L/S Ratio ) Glycolipids Lipids with a sugar segment ABO antigen are glycolipids

Slide 12

Apoliproproteins Outer protein "shell" of the lipoprotein atom The protein – lipid cooperation permits the water insoluble lipid to end up dissolvable in plasma The apolipoprotein is in charge of the communications with cell layers and catalysts to transport lipids to particular areas

Slide 13

Lipoproteins Classified by and electrophoresis movement Lipoproteins vary in their sizes, weights, concoction piece and artherogenicity ( relationship with coronary illness ) There are four principle sorts of lipoproteins CHYLOMICRONS VLDL LDL HDL

Slide 14

Chylomicrons Transports exogeneous ( dietary ) triglycerides 90 - 95 % by weight is triglycerides Absent from fasting plasma Removed from the plasma inside 6 hours by the liver Inadequate leeway delivers a rich layer on the plasma VLDL ( Very Low Density Lipoproteins ) Transports endogeneous triglycerides from liver to tissues 50 - 65 % by weight is triglycerides Excess dietary starches are changed over to triglycerides by the liver

Slide 15

LDL ( Low Density Lipoproteins ) Transports cholesterol from liver to the tissues Synthesized in the liver Approximately 50 % by weight cholesterol Most atherogenic lipoprotein … " Bad Cholesterol "

Slide 16

HDL ( High Density Lipoprotein ) Transports abundance cholesterol from the tissues back to the liver ( reverse transport ) Synthesized in the liver and entrails Composition 30% PHOSPHOLIPIDS 20% CHOLESTEROL half APOPROTEIN The "great " cholesterol

Slide 18

Lipoprotein physiology and digestion system Water insoluble lipids are processed unto more water solvent ( polar ) mixes in the GI tract Triglycerides are processed into unsaturated fats Cholesterol – esters are changed over into free cholesterol Fatty acids are changed over into triglycerides by the liver anf fat tissues ( fat ) Most cholesterol combination happens in the liver - Most cholesterol bringing down medications focus on this union Cholesterol is a fundamental segment of bile ( required for dietary assimilation of fat )

Slide 19

Exogeneous Pathway Transport of dietary lipids, generally the chylomicrons transportation of triglycerides to the liver Endogeneous Pathway Transportation of lipids from the liver to the tissues ( VLDL & LDL )

Slide 20

Effects of hormones Insulin Remember, insulin dependably diminishes plasma glucose Inactivates lipase … diminishes lipolysis and the catabolism of triglycerides to unsaturated fats/glucose Stimulates lipogenesis ( unsaturated fat transformation to triglycerides ) Insulin makes fat In diabetes mellitus, insulin insufficiency advances the arrival of unsaturated fats and their change to triglycerides by the liver

Slide 21

Lipoprotein investigation Laboratory estimation of the lipoproteins is imperative due to their relationship with Coronary Artery Disease ( CAD ) CAD is the # 1 reason for unexpected passing in the United States Because of its association with general wellbeing, lipid testing and translation has been institutionalized to give predictable results that can be used for the danger evaluation of CAD

Slide 22

Total Cholesterol Methodologies Cholesterol ester Free cholesterol Free cholesterol H 2 O 2 H 2 O 2 + Chromogen Colored Chromogen Cholesterol-Ester-Hydrolase Cholesterol Oxidase Peroxidase

Slide 23

Triglyceride testing Most philosophies use compounds that break glycerol from its unsaturated fats Free glycerol is corresponding to the underlying triglyceride fixation

Slide 24

HDL ( High Density Lipoprotein ) testing Non – HDL is accelerated from plasma Dextran sulfate ( encouraging specialist ) is added to patient\'s plasma Non – HDL hastens and is centrifuged to the base The supernate contains just HDL in the supernate is measured utilizing a traditional aggregate cholesterol approach Elevated triglycerides ( > 400 mg/dl ) may interfer with the partition of non – HDL Many labs won\'t perform HDL testing when triglyceride fixations surpass 400 mg/dl

Slide 25

LDL ( Low Density Lipoprotein ) testing "Terrible cholesterol " … Artherogenic Direct estimation if LDL is exceptional on account of specialized difficulities Friedewald estimation ( count ) Test: Total Cholesterol, Total Triglycerides and HDL with routine strategy Estimate the LDL with the accompanying : VLDL = Trig/5

Slide 26

Disease counteractive action and treatment Arteriosclerosis #1 reason for death and incapacity Cholesterol stores ( plaque ) in coronary veins block blood stream Heart ( CAD ) Arms/Legs ( PVD ) Brain (CVD ) Plaque arrangement is connected with Increased plasma cholesterol Increased plasma LDL Decreased plasma HDL Diet, activity and diabetes are major contributory variables of CAD

Slide 27

Target Ranges ( NECP ) Total Cholesterol < 200 mg/dl High Density Cholesterol ( HDL ) > 35 mg/dl Low Density Cholesterol ( LDL ) < 130 mg/dl Triglycerides Reference Ranges Total Cholesterol 140 - 200 mg/dl HDL 30 - 75 mg/dl LDL 55 - 130 mg/dl Triglycerides 65 - 155 mg/dl

Slide 28

Other Risk Factors for CAD Gender – Males at higher danger Increased age Family history Genetic Abnormalities Stress – Type An identities Hyperlipidemia Physical inertia Hypertension Smoking Diabetes Elevated CRP Elevated homocysteine Elevated Lp(a)

Slide 29

Ultracentrifuge High plasma lipid fixations can bring about unreasonable plasma turbidity and meddle with spectrophotometric strategies. Lipoproteins can be spun down in this unique axis. Plasma is put inside the "doughnut." Lipids twist to the outside of the doughnut.

Slide 30

Lipoprotein Top 10 Lipoproteins transport different lipids ( fats ) through plasma to various areas High relationship between particular lipoproteins and CAD Apolioproteins are the protein "shells" that communicate with lipids and permit them to be water dissolvable HDL ( Good Cholesterol ) transports cholesterol far from tissues

View more...