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DOCTOR AT THE DESK

All About Cholesterol Metabolism

"How does cholesterol metabolism affect one's health?"
By: Stef dela Cruz, MDAll About Cholesterol Metabolism

Overall, excess cholesterol in the blood may be deposited in the arteries. This leads to plaque formation, causing arterial narrowing and, eventually, blockage.

Once an artery is blocked, it cannot supply organs with oxygen and, eventually, irreversible organ damage ensues. And if major organs of the body are affected, the consequences can be devastating.

Plaques can also rupture, leading to the formation of blood clots in the arteries. These clots can bring about sudden and complete arterial blockage. They can also detach and deposit in a distant site. These phenomena can lead to heart attack, stroke, or pulmonary embolism, all of which can be lethal.

Genetic mutations may lead to abnormal cholesterol metabolism, leading to elevated “bad cholesterol” (LDL) or abnormally low “good cholesterol” (HDL). Environmental factors can either increase or decrease one’s propensity for cholesterol problems.

A triglyceride (TAG), as its name implies, is composed of three molecules of fatty acid and one molecule of glycerol. Triglycerides are basically fat commonly found in fatty food. During digestion, triglycerides are broken down into their component molecules. They are then reassembled and attached to different cholesterol molecules, forming HDL, LDL, and VLDL.

More LDL is formed when more fat is absorbed by the body. Since TAG is fat, the higher the TAG levels are, the more “bad cholesterol” is formed. Thus, elevated TAG levels (defined by the National Cholesterol Education Program as levels greater than 149 mg/dL) are often associated with a higher risk for plaque buildup, a phenomenon called atherosclerosis.­

But even with normal HDL and LDL levels, an elevated level of triglycerides can still lead to atherosclerosis. It is important to lower TAG levels in a patient at risk for stroke or heart attack, especially in diabetic patients.

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