Lipid function test is done on a fasting blood sample for identifying various lipid abnormalities and it includes the estimation of total cholesterol, Triglycerides, HDL-cholesterol, LDL-cholesterol.
The major lipids present in the blood are cholesterol and triglycerides, which are transported in blood after incorporation into lipoproteins like chylomicrons, very low-density-lipoproteins (VLDL), intermediate-density lipoproteins (IDL), low-density lipoproteins (LDL), and high-density lipoproteins (HDL).
Disorders of lipoprotein metabolism (Dyslipidemia) include primary and secondary conditions that increase circulating lipids.
HDL is considered as good cholesterol as it carries cholesterol to the liver from where it can be removed from the bloodstream before it builds up in the arteries. LDL on the other hand takes the cholesterol directly to the arteries which can cause plaque buildup and atherosclerosis which can eventually lead to heart attacks. Hence, LDL is termed as bad cholesterol.
Hypercholesterolemia (increased total cholesterol in blood), is a cause of cardiac diseases that is highly treatable and, therefore, persons should be actively screened. It is recommended by the National Cholesterol Education Program that a fasting lipid profile should be carried out every 5 years beginning at the age of 20 years.
Preparation needed for Lipid Profile Test:
- Sample for lipid analysis requires 12-hour fasting.
- Triglycerides and LDL are affected by recent ingestion of food. Patients should be on a routine diet for 2-3 weeks before analysis.
- Lipid analysis should not be performed during acute illness and should be postponed for 3 months after a major illness.
- Drugs affecting lipid levels like steroids, oral contraceptives should be avoided.
Possible underlying causes for Lipid profile abnormalities:
- Patients with high serum triglycerides>200 mg/dl have the risk of atherosclerosis, and those with >1000 mg/dl are at increased risk of acute pancreatitis.
- An increase in triglyceride is associated with low HDL. Low HDL-cholesterol is a risk factor for coronary diseases even if the total cholesterol level is normal.
- High LDL-cholesterol is a strong risk factor for atherosclerotic heart disease and is associated with obesity, high carbohydrate food intake, diabetes mellitus, lack of exercise, smoking.
- Secondary lipoprotein diseases arise from underlying causes like diabetes mellitus, alcohol abuse, hypothyroidism.
Management of Dyslipidemia:
- For patients who are overweight, weight loss can help to reduce triglyceride levels.
- Obesity or overweight care involves three essential elements of lifestyle: dietary habits, physical activity, and behavior modification.
- Lifestyle changes are the first thing to tackle to reduce your chance of heart disease.
- Patients should receive dietary counseling to reduce the content of saturated fats, artificial trans fats, and cholesterol in the diet.
- The primary focus of diet therapy is to reduce overall calorie consumption. This reduction is consistent with a goal of losing 0.5-1kg/week. Examples include:
- Choose smaller and frequent meals at regular intervals.
- Eat more fruits and vegetables.
- Increase intake of dietary fiber.
- Consume more whole-grain cereals, beans, peas.
- Select leaner cuts of meat and skimmed dairy & dairy products.
- Reduce consumption of fried foods and foods with added fats and oils.
- Drink water instead of sugar-sweetened beverages, reduce sugar and sweets.
- Decrease sodium intake.
- Reduce saturated fat intake which you find in animal products.
- Foods with low-energy-density include soups, fruits, vegetables, oatmeal, and lean meats should be preferred.
- Foods with high-energy-density such as dry foods and high-fat foods such as cheese, egg yolks, potato chips, and red meat have a high-energy-density and should be avoided.
- The purpose of a Very Low-Calorie Diet (VLCD) is to have rapid and significant short-term weight loss over a 3 to 6 month period.
- A combination of dietary modification and exercise is the most effective behavioral approach for the treatment of obesity.
- Adults should engage in 150 min of moderate-intensity or 75 min of vigorous-intensity aerobic physical activity throughout the week.
- Regular aerobic exercise can lower bad cholesterol (LDL) and raise good cholesterol (HDL). Maintain adequate weight for your height.
- Have foods with unsaturated fats like nuts, fish, vegetable oil, olive oil, canola, and sunflower oils.
- Patients who drink alcohol should be encouraged to decrease or preferably eliminate their intake.
If diet and exercise don’t lower cholesterol levels, then medications or a combination of treatments are prescribed by your physician after ruling out secondary causes.
-Dr. Pendurthy Anoosha
- Jameson, Fauci, Kasper, Hauser, Longo, Loscalzo: Harrison’s principle of internal medicine, 20th ed, Ch 400, pg 2889-2902.
- Shirish M. Kawthalkar: Essentials of clinical pathology, 7th ed, ch 5, pg 69-74.
There is a lot of confusion among people about COVID-19 antibody testing. Most people think that they are tested positive for COVID-19 if they test reactive for antibodies. The misconceptions are cleared below.
What is COVID-19 antibody test?
COVID-19 antibody test is also known as serology test which is usually a blood test. The test tells if there are antibodies present against SARS-CoV-2, the virus that causes COVID-19. Presence of antibodies in the blood usually indicates our body is fighting or has fought against an infection. Antibodies help you to fight against the infections and can protect you from getting the same infection again. How long the protection lasts is different for each disease and each person.
Antibody test results are not taken into consideration to diagnose someone with active infection.
What are the types of antibody testing?
- IgM antibodies, which happen early in an infection. You will be tested positive for IgM antibody if you have been infected recently and that your immune system has started responding to the virus. When IgM is detected you may still be infected, or you may have recently recovered from a COVID-19 infection.
- IgG antibodies, which are more likely to show up later. These antibodies indicate that you have had COVID-19 in the recent past and have developed antibodies that may protect you from future infection. It is unknown at this point how much protection antibodies might provide against reinfection.
Do we need to isolate ourselves if we are tested positive for COVID antibodies?
- If you are tested positive for both antibodies (IgM and IgG) and have symptoms related to COVID-19, it is advisable to go for RT-PCR test to confirm if there is any active infection. Isolation is suggested till you are symptom free.
- If you have tested positive for IgG antibody and don’t have any symptoms, no isolation is needed.
What if the Antibody test is Positive?
Below are the few possibilities if you are tested positive for antibodies:
- You must have been infected with COVID-19 in the past.
- You can test positive for antibodies even if you have never had symptoms of COVID-19. Asymptomatic infection in which there will be no symptoms even if you have been infected, can be the cause for such a result.
- You have to talk to your doctor if it is positive, as there are 2 types of antibodies as explained above and to know if there is any active infection based on the type of antibody tested and current clinical condition.
- There is a chance that a positive result means you have antibodies from an infection with a different virus from the same family of viruses called coronaviruses.
What if Antibody test is Negative?
There are few possibilities which can be the reason for negative result:
- You have current active infection in which antibodies are not developed yet and you need to go for RT-PCR to confirm the diagnosis if you have symptoms related to COVID-19.
- You may not have been infected with COVID-19 in the past.
- Some people may take longer to develop antibodies.
- The result may be wrong, which is a false negative.
- As the vaccine is out now and soon most of the people will be vaccinated. In case you are vaccinated, you can’t see antibodies if you go for antibody testing.
Whatever the result may be, taking good precautions to prevent the disease is a must.
Dr. Y. Alekhya.
The United Nations has set targets to diagnose 90% of all people living with HIV by 2020. Currently, it is estimated that only 70% of people living with HIV know their HIV status. In order to fill the gaps, countries are looking for ways to rapidly increase access to and use of HIV testing services, especially for populations with low service coverage and at higher risk that would otherwise Would not carry out a screening test. One approach is HIV self-testing, which means that the person does the HIV diagnostic test and interprets the results in private. WHO has been working on HIV self-testing since April 2013. In 2016, WHO published the first global recommendations and guidelines for HIV self-testing.
Globally, 2.1 million women die due to diabetes as opposed to 1.8 million men and diabetes is the ninth leading cause of death among women. Diabetes increases risk of heart disease by six times and reduces life span by 8 years as compared to women without diabetes.
In India, prevalence of the disease is 17.7% among urban middle class women while it is 10% in rural areas. Higher body fat percentage and abnormal lipid profile has been attributed as the major factors responsible for increased prevalence of diabetes among women in the developed and developing countries Continue reading “WOMEN AND DIABETES -WORLD DIABETES DAY 2017”
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Continue reading “Risks of high Uric Acid levels in blood”
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Diabetes is caused when the blood glucose (blood sugar) level is too high & it affects proper functioning of the body. The blood sugar levels is maintained by insulin which is hormone produced by pancreas.
Type 1 diabetes is caused when body doesn’t produce any insulin at all, while type 2 diabetes is caused when body doesn’t produce sufficient insulin to control your blood sugar.
Diabetes is a progressive diseases and usually worsens with age. The consequences of uncontrolled diabetes can be visible on the entire body & its organs – heart, foot, skin, kidneys, eyes, sexual organs, nervous system and many more. Continue reading “Impact of uncontrolled diabetes”