1 Mike L., 47 yr old male, saw his family physician for an annual checkup. He re
ID: 84216 • Letter: 1
Question
1
Mike L., 47 yr old male, saw his family physician for an annual checkup. He reported that he had recently started his own business in the last year and had been extremely busy getting it established. Mike is a nonsmoker but both his father and grandfather had histories of MI before age 55. routine testing was performed CBC, Chem profile and Urinalysis) CBC and Urinalysis returned normal, Chemistry profile results were all within reference ranges except for Cholesterol. Mike's cholesterol was 305 mg/dL (Reference range < 200 mg/dL desirable) A week later, a lipid profile was performed on a 12 hour fasting specimen: Cholesterol - 305 mg/dL ; HDL Cholesterol - 45 mg/dL ; Triglycerides- 390 mg/dL What is your opinion of Mike's LDL cholesterol (LDLC), his risk of CHD and his risk factors, and whether he classifies for any of the Frederickson-Levy hyperlipoproteinemia (inherited disorders of cholesterol metabolism)
2
Various methods have been used for the separation and quantitation of serum lipoproteins. Give at least two of the methodologies and the principle of the methodology.
Explanation / Answer
Answer 1):
Total cholesterol= HDL+LDL+0.2*Triglyceride
Mike's LDL= Cholesterol-HDL-2*triglyceride= 305-45-0.2*390
=182mg/dl(high risk category)
In the US cholesterol levels are calculated in miligrams of cholesterol for each deciliter of blood. A result of under 200 mg/dL is ideal. A level between 200-239 is within the edge line of high risk class. More than 240 mg/dL is hogh risk class.
Since Mike has very high cholesterol level 305 mg/dL is under high risk catergory.
His LDL is under normal but little higher would be better and triglyceride (300 mg/dL is high risk category.
When you have too much cholesterol, it builds up in the walls of your arteries, This buildup causes the arteries to harden -- a process called atherosclerosis. It also narrows the arteries, which slows and even blocks the flow of blood. That’s where the problem starts. Your blood is supposed to carry oxygen to all parts of your body, including your heart muscle. Without enough oxygen, your body’s parts won’t function the way they’re supposed to. For instance, if your heart muscle doesn’t get enough blood and oxygen you'll have chest pain. And if the blood supply to a portion of your heart is completely cut off, you’ll have a heart attack. Mike has a very high risk of getting MI.
Mike comes under group IIa caterogy of Frederickson-Levy hyperlipoproteinemia - has elevated cholesterol and triglyceride levels and LDL level is also under high risk category.
HLPIIa is a rare genetic disorder characterized by increased levels of LDL cholesterol in the blood due to the lack of uptake (no Apo B receptors) of LDL particles.
Suggestions for lifestyle changes:
- Exercise: Physical activity helps you lose weight and boosts your HDL levels. Aim for 30 to 60 minutes a day of moderate cardio.
- Eat more fiber: Replace white breads and pastas with whole grains.
- Eat healthy fats: Olive oil, avocado, and nuts all have fats that won’t raise your LDL.
- Limit cholesterol intake: Reduce the amount of high-saturated fat foods like cheese, whole milk, and high-fat red meats.
- Quit smoking.
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