Cholesterol is a type of lipid compound (including fats and oils) that helps form the structure of all animal cell membranes. It is also a precursor for making other compounds such as steroid hormones, bile acid and vitamin D.

Cholesterol is produced in the liver but can also be obtained from our diet. Major sources of dietary cholesterol include red meat, shrimp, fish, poultry, eggs and milk products. Although cholesterol is essential, too much of it can potentially be dangerous.

An elevated cholesterol concentration (hypercholesterolaemia) is associated with cardiovascular diseases because it contributes to the buildup of plaque in the arteries (atherosclerosis). When the arteries are clogged, it narrows these pathways, limiting the flow of oxygen and nutrients in the blood to other parts of the body.

There are two main groups of cholesterol: the “bad cholesterol” known as low-density lipoproteins (LDL) and the “good cholesterol” known as high-density lipoproteins (HDL). LDL is responsible for plaque buildup in the arteries, while HDL carries cholesterol from other parts of the body back to the liver to break it down and send it out of the body.

Meanwhile, triglycerides are the most common type of fat in the body. When you consume excess calories, your body converts the extra calories into triglycerides and stores them in the fat cells.

A high triglyceride level combined with high cholesterol can further contribute to atherosclerosis. Thus, most people should aim to have low levels of triglycerides and LDL coupled with a high level of HDL.

Because cholesterol cannot be measured with the naked eye, a lipid profile test is taken to measure the amount of cholesterol and triglycerides in the blood. For an accurate result, this blood test is typically done after fasting for about 12 hours.

What do the results show?

In the US, cholesterol levels are measured in milligrams of cholesterol per decilitre of blood (mg/dL). However, in Malaysia and in many other European countries, cholesterol levels are typically measured in millimoles per litre (mmol/L).

In your report, you would get a figure for your total cholesterol (HDL + LDL). But because a higher total cholesterol (TC) could also be due to high levels of HDL, knowing the breakdown is important.

Here is a general guideline to understand your cholesterol test results:

	Desirable Target, mmol/L	Desirable Target, mg/dL
TC	< 5.2	< 200
LDL**	< 3.0 (low-risk individuals) < 2.6 (high-risk individuals) < 1.8 (very high-risk individuals)	< 116 (low-risk individuals) < 100 (high-risk individuals) < 70 (very high-risk individuals)
HDL	> 1.0 (males) > 1.2 (females)	> 40 (males) > 46 (females)
Triglycerides	< 1.7	< 150

**Very high-risk individuals are those with established heart disease and/or diabetes with kidney damage, while high-risk individuals are those at risk of heart disease and/or diabetes, or those with diabetes without organ damage. Other major risk factors such as smoking, hypertension and family history should also be taken into account before assessing which category you should fall into. Discuss with your doctor about your risk profile.

Your report might also list other figures such as your TC:HDL ratio or very low-density lipoprotein (VLDL) level. You can discuss with your doctor about how he or she will use your cholesterol results to decide the next course of action.

If your results are bad, don't be discouraged. Cholesterol levels can be improved with lifestyle changes such as quitting smoking, exercising regularly, eating healthy and reducing stress.

If you are at high risk of cardiovascular disease or stroke, cholesterol-reducing medications may also help.

Listen to the podcast ‘Cholesterol’:

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