Cholesterol: Size counts!

May 27, 2008 8:33:15 AM PDT
Ever wonder what cholesterol really is? The American Heart Association defines cholesterol as a soft, fat-like, waxy substance found in the bloodstream and in all the cells of the body. Everyone has and needs cholesterol because it's used for producing cell membranes and some hormones; but when cholesterol builds up, it can cause heart disease, heart attacks and strokes. The higher a person's cholesterol is, the higher the risk of heart disease. The HDL, or "good," cholesterol can help protect hearts; but when there is too much LDL, or "bad," cholesterol in the blood, it can accumulate in the inner walls of major arteries leading to the heart and the brain. The plaque that results causes atherosclerosis -- a hardening of the arteries.

WHAT SIZE ARE YOU? Lots of people know what their total cholesterol number is, but few people know the size of their cholesterol or that cholesterol size is even important; but cholesterol size is a vital piece of information that a simple test can tell you. The test, called the lipoprotein subfraction test, is a tool to measure cholesterol size and alert people when their cholesterol particles -- both good and bad -- are too small. When "bad" or LDL cholesterol particles are too small, it's believed they can get into the heart's vessels and form damaging plaque more easily. When "good" or HDL particles are too small, they can't do their job as well. A vital function of HDL cholesterol is to vacuum, or clean up, bad cholesterol from vessel walls and transport it to the liver where it can be excreted from the body. If those particles are too small, they're less efficient. Arthur Agatston, M.D., from the University of Miami Miller School of Medicine, says, "Some people, particularly diabetics and pre-diabetics, have very small LDL and HDL particles."

INCREASE YOUR SIZE: Dr. Agatston says, "The size of the cholesterol is very amenable to lifestyle changes -- to healthy diet and to exercise." By making healthy lifestyle changes, you may or may not change your total cholesterol number, but you will change the size. Dr. Agatston says, "It makes both the healthy cholesterol bigger and more effective at its cleaning job and it makes the little LDL particles bigger, so they don't move into the vessel wall as easily."

WHO SHOULD GET THE TEST? The test is not automatically given when people get their cholesterol checked. You have to ask for it. Anyone can get the test, but Dr. Agatston says there are some groups of people who should get it sooner than later. They include people with high blood pressure, people with diabetes or pre-diabetes (diabetic and pre-diabetic women are most likely to have small LDL particles, but they often don't have a high total cholesterol number), people who have triglyceride levels of more than 100 and HDL levels of less than 60 and people with a family history of heart disease.


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