Pathophysiological functions of HDL
HDL (good cholesterol) is important for the clearance of LDL (bad cholesterol) from the blood circulation and atherosclerotic plaque depositions. HDL cholesterol carries fats in the form of cargo towards the liver to recycle or eliminate fatty acids. It plays a vital role in protecting the heart from cardiac diseases. They protect LDL from undergoing oxidation that is more active in plaque formation than in non-oxidized forms and play other significant roles such as decreasing pro-inflammatory responses in artery walls, stimulating nitric oxide production to stimulate arterial valve relaxation, thereby preventing clot formation inside the arteries. Therefore, the levels of HDL play an important role in regulating anti-inflammatory, anti-oxidant, and anti-coagulatory functions that significantly impact the health of an individual, and any value below 40 mg/ dl indicates progressive heart disease deteriorating health. The inflammation in adipose tissue and blood vessels blocks the transport of HDL from arterial vessel walls into the circulation, thereby leading to decreased HDL cholesterol in the blood.
Regular physical exercises, keeping weight under control, developing good eating patterns, limiting or quitting smoking and alcohol are effective measures in improving HDL levels and in the prevention of the onset of heart diseases.
Vitamin B3 fibrates are effective in improving HDL levels and decreasing the risk associated with heart diseases. In addition, statins are the drugs that lower LDL levels and improve HDL, are also prescribed to a group of people under the risk category.
Having the right food would balance the HDL to LDL ratio, and consuming diets rich in omega 3, omega 6, and unsaturated fatty acids improve HDL levels. Foods containing olive oil, fishes, avocados, vegetable oils, and nuts improve cholesterol levels.
Causes of imbalanced HDL to LDL ratio
Factors that govern the HDL levels are as follows:
Inheritance patterns: Individuals carrying low HDL and high LDL genes are more vulnerable to heart diseases.
Eating patterns: Food that is high in refined or processed carbohydrates, sugars, and saturated and trans fats leads to decreased HDL.
Physical activity: Leading inactive life with no exercise and not burning calories leads to an imbalanced HDL to LDL ratio.
Metabolic syndrome: Metabolic conditions such as obesity, hypertension, diabetes, deregulation of thyroid and pituitary functioning can lead to imbalanced cholesterol ratios.
Smoking and alcohol: Lifestyle choices, importantly smoking and boozing, affect cholesterol levels and metabolism.
Medications such as beta-blockers, progestins, and anabolic steroids are known to decrease HDL levels.
Leading a sedentary lifestyle and stress is also shown to imbalance cholesterol levels in the body.
Recent reports indicate that gut microbiota plays a major role in determining oneâ€™s health, including cholesterol levels.
Chemical composition and metabolism of HDL
HDL is chemically composed of cholesterol, lipid, and protein molecule. Protein and lipid collectively form apolipoprotein that carries cholesterol from one tissue to another. The three are common components in HDL and LDL. However, the ratios of these components and the sizes of particles differ. HDL is higher in density compared to LDL. The protein and the lipids around the surface of HDL particles are the actual protective components of HDL cholesterol, and the higher the amounts of HDL, the lower are the risk associated with heart diseases. The lipid molecules serve an anti-oxidant function and protect the arteries of the heart from damage.
More than the quantity of HDL, the quality of HDL particles is considered to be important. In individuals with high-HDL cholesterol in the blood, they contain high lipid composition, while those with less HDL contain smaller amounts of lipid molecules.
The transport of excess cholesterol from the arteries of the heart and other peripheral organs towards the liver is called reverse cholesterol transport. It is a vital process of getting rid of plaques in the heart. The liver excretes the excess cholesterol in the form of bile.
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