When does the atherogenic index increase? What is the coefficient of atherogenicity in a blood test: the norm of the indicator What is the coefficient of atherogenicity 3 2.

Many people know that high levels of cholesterol, "bad" lipoproteins, triglycerides, low levels of "good" cholesterol are associated with the development of atherosclerosis. In fact, both the change in the content of lipid fractions and the value of the ratio between them matter.

The atherogenic coefficient is an indicator that reflects the likelihood of developing cardiovascular diseases. The calculation of the index is especially important for people who are at risk of myocardial infarction, stroke.

Today, another ratio is increasingly being used: the ratio between total OH cholesterol and HDL. It is believed that it better reflects the likelihood of the disease. However, our doctors still use the atherogenic coefficient to determine the risk of developing atherosclerosis.

Atherogenic coefficient - what is it?

Cholesterol is a fat-like alcohol that is insoluble in water. Therefore, it cannot circulate through the bloodstream on its own. In the blood, cholesterol is in a bound state with complex protein-fat complexes - lipoproteins. There are the following classes of lipoproteins:

• "Bad" lipoproteins of low, very low density (LDL, VLDL), the high level of which contributes to the formation of cholesterol plaques;
• "Good" high-density lipoproteins HDL, a high concentration of which protects the body from the development of atherosclerosis.

The total amount of all lipoproteins is called total cholesterol (TC).

Atherogenic coefficient (KA) - the ratio of "bad" low, very low density lipoproteins to "good" high density lipoproteins. The higher it is, the stronger the imbalance between useful, harmful protein-fat complexes.

By definition, KA=(VLDL+LDL)/HDL. Not all lipidograms contain an indicator of VLDL. Therefore, more often the determination of the coefficient of atherogenicity is carried out according to the formula: CA \u003d (OH-HDL) / HDL.

Who is shown the delivery of the analysis

CA is part of the standard lipid profile, which also includes total cholesterol, VLDL, LDL, HDL, triglycerides. There are several reasons for this analysis:

1. Screening studies. Biochemical changes in the blood precede the development of clinical signs. Screening studies can identify markers of the presence of cholesterol plaques even before the onset of characteristic symptoms. Treatment of atherosclerosis at this stage brings the best results. The first blood test is taken at 9-11 years old, the second at 17-21 years old. Adults should be checked regularly every 4-6 years. The atherogenic index is determined more often if a person is at risk of developing atherosclerosis.
2. Diagnosis of pathologies associated with impaired cholesterol metabolism. If the doctor suspects that the patient has atherosclerosis, he writes out a referral for a lipid profile to confirm the diagnosis, as well as determine the severity of the disease.
3. Monitoring. Patients with cholesterol plaques regularly take a blood test for cholesterol, LDL, HDL, triglycerides, as well as their ratio. This helps the doctor evaluate the body's response to treatment, if necessary, adjust the therapy regimen or dose of drugs.

How to properly prepare for an analysis

The coefficient of atherogenicity is sensitive to many external factors. High CA values ​​can be the result of:

• pregnancy, cholesterol is not taken before the 6th week;
• prolonged fasting;
• smoking;
• eating food rich in animal fats;
• donating blood in a standing position;
• therapy with steroids, androgens, corticosteroids.

KA is reduced:

A false-positive result is undesirable, since a non-existent disease in a healthy person will be treated. A false negative is also bad. A patient who needs help will not receive it.

To obtain adequate results, before taking a lipidogram, it is necessary to exclude as much as possible all external factors. To do this, you must follow a few rules:

• donate blood in the morning (before 12:00) on an empty stomach. Only water is allowed to drink;
• for 1-2 weeks, do not disturb your usual diet;
• a day before the test, do not abuse fatty foods, refrain from alcohol;
• half an hour before blood sampling, do not smoke, do not exert yourself physically, do not worry;
• 5 minutes before the study, take a sitting position;

If you are taking any medications or supplements, discuss with your doctor the possibility of temporarily stopping your treatment. If this is not possible, it is worth considering their influence when analyzing the atherogenic index.

Atherogenic coefficient: norm in a blood test

It is known that the level of cholesterol in men and women is not the same. Also, the values ​​of the indicator are influenced by age, in women - by the physiological state. CA is less dependent on gender and age factors, since it reflects not the absolute, but the relative content of individual fractions of lipoproteins. But still there are some differences for men and women.

Norm for women

The risk of developing atherosclerosis in young women is lower than in men. However, they also need to undergo regular examinations. Especially careful should be girls taking oral contraceptives. They are able to increase the amount of cholesterol, LDL.

Norm for men

The atherogenic index in men is slightly higher than in women. The stronger sex is more prone to the development of atherosclerosis, so he needs to be especially attentive to his health.

Reasons for the high index

It is usually impossible to determine the cause of the increased atherogenic coefficient. Atherosclerosis is a chronic disease that develops over 20-30 years. During this time, external, internal stimuli gradually damage the vessels, provoking the formation of cholesterol plaques.

Indicators of lipid metabolism are more sensitive to changes in metabolism, but still not fast enough to be able to name the exact cause.

There are the following factors that can lead to a high coefficient of atherogenicity:

• smoking;
• age: men over 45, women over 55;
• hypertension (blood pressure above 140/90 mm Hg);
• obesity;
• the presence of close relatives with early coronary heart disease, heart attack, stroke;
• diabetes;
• the use of excess animal fats;
• sedentary lifestyle;
• alcohol abuse.

What is the danger of increasing the coefficient?

If the coefficient of atherogenicity is increased, this does not yet indicate that a person has serious problems, especially if the difference between the norm and the result of the analysis is small. This indicator determines the risk of developing cardiovascular complications in the future. It is also not a sign of the presence of cholesterol plaques.

The coefficient of atherogenicity is dangerous in the future. Uncontrolled disorders of fat metabolism contribute to the development of atherosclerosis. Depending on the location, size of plaques, it can lead to:

• cardiac pathologies: coronary heart disease, myocardial infarction;
• cerebrovascular insufficiency, stroke;
• impaired blood supply to the limbs, which is manifested by trophic ulcers, in advanced cases - necrosis of the feet;
• dysfunction of internal organs.

How to reduce the coefficient of atherogenicity

With high values ​​of the atherogenic coefficient, the patient needs to undergo an additional examination, as well as reconsider his lifestyle:

• quit smoking;
• move more;
• avoid stress;
• review your diet.

Depending on the results of the examination, further treatment may include drug therapy or surgery. - reduce blood viscosity, prevent platelets from sticking together. Prevention of thrombus formation reduces the likelihood of blockage of blood vessels, as well as deterioration of the blood supply to internal organs;

Surgical treatment consists in excision of the cholesterol plaque, replacement of the damaged vessel. But more often, minimally invasive techniques are used that are minimally traumatic for the body:

• shunting - creating an additional path for blood to bypass the cholesterol plaque from an artificial or natural vessel;
• stenting - expansion of the narrowed area using a miniature inflatable balloon with subsequent installation of a metal frame inside the artery. It prevents re-constriction of the vessel.

To avoid surgery, you need to get diagnosed on time. In the early stages of atherosclerosis, it is always possible to get by with a revision of the diet, giving up bad habits, and acquiring healthy ones. Progressive disease can be controlled with medication. Usually, the sooner a person reconsiders his lifestyle, the later he will have to start taking pills.

Last update: September 29, 2019

Any average person knows that high blood cholesterol is “bad”. Possessing a rather meager amount of knowledge on the subject, as soon as he sees a result above the norm in the column “total cholesterol” or “HDL-cholesterol” (before having obtained information about the interpretation of analyzes on dubious sites), a person goes on a strict diet or, even worse, begins to exercise self-medicating and taking statin drugs.

Meanwhile, it is necessary to evaluate the results of laboratory tests and interpret them correctly according to special rules. Separate columns of the description will not allow to draw a correct conclusion about the processes occurring in the body. To talk about the risk of developing atherosclerosis and other diseases, directly or indirectly caused by an increased level of "bad" cholesterol, a special value has been introduced in medical practice: the atherogenic coefficient.

What is the coefficient of atherogenicity in a blood test?

Atherogenic coefficient- this is the balance of "good" cholesterol and total cholesterol, which in the future can go into a bound state (LDL), is their proportional ratio.

What is this ratio? At a general, everyday level, everyone knows that there is a “bad” (or LDL-cholesterol) and “good” (HDL-cholesterol) cholesterol. The complex molecules of good cholesterol are too large to be absorbed into the tissues, they "collect" the molecules of "bad" fatty alcohol and forward them to the liver for processing. On the contrary, "bad" cholesterol settles on the walls of blood vessels and forms plaques that narrow the lumen of the blood vessel and worsen blood circulation. In addition, total cholesterol, that is, a substance in an unbound state, also circulates in the blood.

At the moment, this is the most accurate indicator of the state of lipid (fat) metabolism in the body and the assessment of the risk of atherosclerosis and other cardiovascular diseases (although the role of fatty alcohol in the development of pathologies of this kind is debatable).

In addition, the definition of this indicator can be informative in the following cases:

Control of the dynamics of cholesterol (with drug therapy);

During the initial preventive examination of the patient.

The norm of the coefficient of atherogenicity

When calculating the coefficient of atherogenicity, experts use a simple formula:

Atherogenic coefficient (Atherogenic index) = (Total cholesterol - HDL) / HDL

The norm of the atherogenic index varies from laboratory to laboratory, in general, this indicator is normal in the range from 2 to 2.5 units (but not higher than 3.2 for women and 3.5 for men). An indicator above the specified norm may indicate the presence of atherosclerosis. However, the coefficient alone does not allow us to accurately state the presence of the disease.

If the atherogenic index is below the specified norm, this is not a cause for concern. This result is irrelevant.

Increased atherogenic coefficient, what to do?

If the results of laboratory studies revealed a high coefficient, this indicates that the body produces mainly “bad” cholesterol. Despite the lack of evidence of the direct and main role of fatty alcohol in the formation of cardiovascular diseases and pathologies, it is not worth the risk. Measures should be taken immediately to normalize the indicator.

You can do this in two ways:

Change lifestyle and diet.

Start taking prescription drugs.

Lifestyle

The increase in the index is due to a number of reasons:

The presence of bad habits (smoking, alcohol abuse, drug use). Psychoactive substances "inhibit" normal fat metabolism and disrupt the synthesis of fats.

Sedentary lifestyle. Hypodynamia entails stagnant processes. Fats and fatty complexes are synthesized too actively.

From this we can conclude that to normalize the index you need:

Lead a more active lifestyle. Feasible physical activity can normalize the concentration of cholesterol in the blood and lipid metabolism. A healthy person is recommended to conduct 4 classes during the week for 35-40 minutes each. If you have a history of diseases, you should consult a doctor to rule out contraindications and select the optimal mode of physical activity.

Give up bad habits.

Diet

It is advisable to limit or completely avoid the following foods:

Sausages;

Fatty dairy products (sour cream, cream, butter);

Products rich in trans fats (margarine, palm oil spreads, etc.)

On the contrary, include in the diet:

Fish. Cod, hake, flounder and others. Frying should be excluded, preferring cooking.

Cereals.

As well as other products containing fats of vegetable, not animal origin.

Taking medications is another way to reduce the atherogenic index. However, statins (cholesterol-lowering drugs) have many side effects and should be taken strictly on the advice of a doctor and in a very limited number of cases.

What factors can affect the result of the analysis?

The result will exceed the normal values ​​if:

The patient sits for a long time on a strict diet (close to starvation). To avoid exhaustion, the body begins to break down fat reserves. Lipids enter the bloodstream and can artificially increase the index.

Taking hormonal drugs (steroids).

Nicotine addiction.

Peak hormone-dependent states. Pregnancy, menopause.

The result will be below normal if:

The patient is on a hypocholesterol diet.

The patient is taking statin drugs.

The patient is actively involved in sports (which is rather controversial).

Thus, the index (or coefficient) of atherogenicity is the proportion of total cholesterol to high density lipoprotein complex. The indicator characterizes the lipoprotein balance in the body and can help in determining the early stages of atherosclerosis and other cardiovascular diseases caused by an increased concentration of cholesterol in the blood.

Education: Diploma of the Russian State Medical University N. I. Pirogov, specialty "Medicine" (2004). Residency at the Moscow State University of Medicine and Dentistry, diploma in Endocrinology (2006).

Atherosclerosis is a chronic progressive vascular disease that is the cause of many diseases of the cardiovascular system, brain and other organs.

Scientists have proven that 95% of people suffering from atherosclerosis have an increased atherogenic coefficient, which is directly related to lipid metabolism disorders in the human body.

Atherogenic coefficient - what is it?

Cholesterol is the main lipid of human plasma, the physiological purpose of which is that it is part of cellular structures and is necessary for the synthesis of other substances (vitamin D, steroid hormones, bile acids).

Thanks to cholesterol, nervous excitation is transmitted to all organs and systems; it is one of the energy depots in the body.

The atherogenicity of cholesterol (the ability to cause the development of atherosclerosis) depends on which class of lipoproteins it belongs to.

Lipoproteins are complex proteins and the transport form of cholesterol, the following groups are distinguished:

1. LDL and VLDL(low density lipoproteins and very low density lipoproteins). The groups of proteins richest in cholesterol, they are also called "bad" cholesterol, since they carry out the transportation of excess cholesterol from the blood to the tissues, mainly in the arterial vessels, which provoke the deposition of cholesterol deposits.
2. LNVP(high density lipoproteins). The second fraction of transport proteins necessary to maintain normal blood cholesterol levels. This group of lipoproteins is called "good" or anti-atherogenic cholesterol because it captures excess cholesterol from peripheral tissues and transports them to the liver.

Therefore, the coefficient or index of atherogenicity is a value that determines the correlation between low and high density lipoproteins and indicates the stage of development of atherosclerosis.

Risk group

Determination of the coefficient of atherogenicity is mandatory assigned to people who are at risk of developing atherosclerosis, namely:

1. Men over 40, women over 45. It has been proven that the risk of developing atherosclerosis increases with age, but there are cases of the disease at an earlier age.
2. Smokers and people who abuse alcohol. Nicotine and alcohol not only provoke the development of the atherosclerotic process, but also significantly aggravate its course.
3. People with a genetic predisposition. It is known that there is a genetic link between the development of atherosclerosis and the presence of diseases of the cardiovascular system in relatives (coronary heart disease, hypertension, or the presence of myocardial infarction / stroke in relatives in the past).
4. People who are overweight or obese (BMI over 25).
5. People suffering from diabetes.

Symptoms when you need to get tested

Atherosclerosis is often called the "silent killer" precisely because it develops slowly and imperceptibly.

But if you have the following symptoms, you should contact your doctor to determine the atherogenic index:

1. From the side of the heart: pain in the region of the heart of a burning or pressing character, radiating to the left shoulder blade, arm, shoulder, which occur after physical overstrain or against the background of stress (an attack of angina pectoris or "angina pectoris"); jumps in blood pressure or its increase, shortness of breath, general weakness.
2. From the side of the brain: recurrent headaches, dizziness, impaired memory, attention, concentration, sleep.
3. From the peripheral arteries: the presence of pain in the legs that occurs after walking short distances, chilliness, sensory disturbances, the presence of intermittent claudication.
4. From the side of the intestine: paroxysmal abdominal pain not associated with eating.
5. From the side of the kidneys: pain in the transverse spine, urination disorders.

What analysis needs to be done?

To determine the coefficient of atherogenicity, it is necessary to donate blood on an empty stomach for a biochemical blood test or lipidogram (in vitro), where it is diagnosed:

1. The level of total cholesterol (TC) (norm 3.6 - 5.2 mmol / l);
2. The concentration of VLDL (the norm is 0.17 - 1.05 mol / l);
3. The level of LDL (the norm in men is 2.2 - 4.8 mmol / l, in women 1.9 - 4.5 mmol / l).
4. The level of HDL (the norm in men is 0.7 - 0.75 mmol / l, in women 0.85 - 2.27 mmol / l).

Which doctor should be consulted?

See your family doctor or general practitioner.

Formulas for calculation

To calculate the coefficient of atherogenicity (CA), there are several formulas:

1. CA \u003d TC - HDL / HDL

Decryption:

• The norm is less than 3;
• 3-4 - moderate probability of developing atherosclerosis;
• More than 4 - a high probability of developing atherosclerosis;
• More than 7 - strongly pronounced atherosclerosis of the vessels.

1. CA \u003d (LDL + VLDL) / HDL

Decryption:

• 1-2 - low risk of atherosclerosis;
• More than 3 - there is a risk of developing atherosclerosis;
• More than 4 - a high risk of atherosclerosis.

Evaluating the results of biochemical analysis, doctors take into account the physiological characteristics of the body - the sex and age of the person.

Table with normal indicators of the coefficient of atherogenicity in men and women, depending on age.

What is the danger of increasing the coefficient?

Atherosclerosis develops over years and even decades, so the first symptoms may be invisible and do not attract much attention.

If, during diagnosis, the atherogenic index shows more than 4, this indicates the presence of progressive deposition of cholesterol plaques and the possibility of developing the following diseases and their complications:

1. Cordially- vascular system - angina pectoris, hypertension. risk of developing acute myocardial infarction.
2. Brain- cerebral atherosclerosis. The threat of developing hemorrhagic / ischemic stroke.
3. peripheral arteries- atherosclerosis of the vessels of the lower extremities. The risk of developing trophic ulcers and gangrene of the leg, disability.
4. Intestines- acute thrombosis of mesenteric vessels.
5. kidneys development of chronic renal failure.

What does a low level of atherogenicity mean?

In the case of a low coefficient of atherogenicity in a biochemical blood test (1 - 2), there is no talk of atherosclerosis, there are no signs of vascular damage by cholesterol plaques.

A low atherogenic coefficient occurs in the following situations:

1. Long-term treatment with cholesterol-lowering drugs.
2. Long-term cholesterol-lowering diet.
3. For professional athletes.

How to reduce the coefficient of atherogenicity?

An increased atherogenic coefficient is not a sentence, but only an indicator of a modification of lifestyle and behavior.

In order to reduce the coefficient of atherogenicity, the following is recommended:

1. Review your diet. The transition to a healthy diet should be gradual and provide the body with all the necessary nutrients. When cooking food, preference should be given to boiling, stewing and steaming. Number of meals: 4-5 times a day, in small portions. There are foods high in polyunsaturated fatty acids that reduce the amount of "bad" cholesterol and reduce the atherogenic coefficient: avocados, beans, lentils, flax seeds, green tea and ginger.

A table of essential nutrients with recommended foods and those to avoid.

1. Quit smoking and drinking alcohol. Alcohol and nicotine greatly exacerbate the atherosclerotic process and wear out the vessels.
2. Drink enough water. An adult should drink at least 1.5 liters of pure water per day. Pure water is the most budgetary and quite effective means for cleansing blood vessels from cholesterol deposits and toxins.
3. . Moderate exercise or walking is a great alternative to physical inactivity. Family cycling trips to the park or forest, a 15-minute set of exercises or collective sports games will set the tone and help avoid the deposition of extra pounds.
4. Avoid stress. Constant, daily nervous overstrain is a trigger for the development of many diseases, namely, cardiovascular diseases. Walking in the fresh air, yoga or meditation is a great way to relieve fatigue and nervous exhaustion.
5. Don't Forget Regular Medical Examinations. For timely diagnosis and treatment of atherosclerosis, concomitant diseases, periodic examinations by a doctor are necessary.

Treatment with drugs

There are cases when dieting does not bring results, and in order to reduce the atherogenic coefficient, doctors prescribe medications.

Cholesterol-lowering agents have been taken continuously since laboratory confirmation of a high atherogenic index.

The following groups of drugs are distinguished:

1. Statins (atorvastatin, rosuvastatin, lovastatin). Reduce the concentration of cholesterol by inhibiting the enzyme responsible for its level. They are taken under laboratory control of the level of hepatic fractions.
2. Fibrates (gemfibrozil, ciprofibrate, fenofibrate). Raise HDL and lower LDL.
3. Bile acid sequestrants (colesteramine, colestepol). Binds bile acids and excess cholesterol.
4. Fish oil preparations (fish oil). Due to the presence of polyunsaturated fatty acids, they reduce the level of "bad" cholesterol.
5. A nicotinic acid. Reduces the rate of production of cholesterol and LDL.

Folk remedies - recipes

Treatment of an increased atherogenic coefficient with alternative methods is effective in combination with other methods. Before using this method, you need to consult with your doctor to clarify the course of admission, in order to avoid allergic reactions and contraindications.

The most proven and effective methods:

1. Honey with cinnamon. An effective and proven method. Honey in combination with cinnamon not only cleanses the vessels of excess cholesterol, but eliminates increased blood clotting, cleanses the lymphatic system.

Recipe: 1 teaspoon of cinnamon pour 200 ml of hot water and leave for half an hour. After that, strain it and add 1 tablespoon of honey. Take half a glass 2 times a day, after meals. Course 4 weeks.

1. Garlic-lemon tincture

This method has also proved its effectiveness in course use, garlic and lemon help get rid of "bad" cholesterol, reduce the atherogenic coefficient, and have anti-inflammatory functions.

Recipe: skip 3 lemons and 3 peeled garlic heads in a meat grinder, put the mixture in a two-liter jar, pour hot boiled water. Put for three days in a dark, cool place. Then strain, take 2 tablespoons 3 times a day between meals. The course of admission is 4 weeks.

1. red clover tincture

Red clover is a proven and effective remedy for lowering cholesterol levels and cleansing blood vessels.

Recipe: Rinse 1 cup of clover inflorescences and put in a liter jar, pour half a liter of vodka, leave for two weeks in a cool place, stirring occasionally. After straining, take 1 tablespoon 3 times a day. The course of admission is 6 - 8 weeks.

Ginger root is a well-known remedy for getting rid of cholesterol plaques, correcting metabolism and reducing the atherogenic coefficient. Ginger also has anti-inflammatory and antioxidant properties.

Ginger tea recipe: Grate 5 cm of peeled ginger root on a fine grater and pour 1000 ml of boiling water. Infuse for about an hour, then strain and drink a glass 4-5 times a day between meals. You can also add garlic, honey or lemon to enhance the effect. Course 4 weeks.

1. Oat bran

Oat bran is a useful "vacuum cleaner" for blood vessels and the digestive tract, as well as a source of many vitamins and minerals.

Recipe: 2 teaspoons of bran pour 100 ml of boiling water, leave for 30 minutes. Drink 3 times a day, after meals. Course 2 months.

Juice therapy has long been used to treat high cholesterol levels and reduce the atherogenic coefficient, it is especially popular due to its good cleansing effect and beneficial properties.

It is worth considering that preference is given to freshly squeezed vegetable juices, since fruit juices are more high in calories (high in glucose and fructose). Vegetable juices help fight high cholesterol, improve metabolism, and speed up metabolic processes.

Vegetable juice recipes:

1. Beet juice. Beetroot juice is drunk before meals, diluted with water in a concentration of one to one. For cooking, you need to wash the beets, peel, skip in a meat grinder, blender, best of all in a juicer. Place the resulting amount in the refrigerator for 1 - 1.5 hours, dilute. Take 1 tablespoon 3 times. Course 4 weeks.
2. Cucumber juice. For cooking, you need to chop 2 - 3 cucumbers in a blender, strain. Drink the amount received 4 times a day after meals. You can add honey or lemon. The course of admission is 6 - 8 weeks.
3. Zucchini juice. Skip half of the medium zucchini in a juicer, strain. Drink 4 times a day between meals. Course 5 weeks.
4. Tomato juice. Tomato juice contains the substance lycopene, a natural antioxidant that has a positive effect on lipid metabolism. For cooking, you need to grind 4 - 5 fresh tomatoes in a juicer and take on an empty stomach 1 time per day for a month.
5. Pumpkin juice. Pumpkin contains a large amount of pectin, which has a good effect on digestion and reduces the level of "bad" cholesterol. Due to the high content of potassium and magnesium, pumpkin strengthens the heart muscle. To prepare pumpkin juice, you need to take 150 - 200 grams of peeled pumpkin, skip it in a meat grinder, strain. Drink 100 ml 2 times a day. Course 1 month.

Prevention

Prevention of an increased coefficient of atherogenicity is:

1. In a healthy and rational diet, with the exception of all "harmful" products, on which the amount of cholesterol in the blood directly depends (semi-finished products, smoked meats, fatty fish and meat, all confectionery and flour products, sweet drinks).
2. In the use of a sufficient amount of plain, clean water (at least 1.5 liters per day).
3. Quitting smoking and minimizing alcohol intake.
4. The need for daily dosed physical activity.

It is mandatory to undergo periodic medical examinations.

Forecast for life

With a change in lifestyle, taking into account the risk factors for atherosclerosis, timely diagnosis and treatment of an increased atherogenic coefficient, the prognosis for life is favorable.

Along with inorganic elements (sodium, potassium, calcium, iron, magnesium, etc.), there are four large classes of organic substances present in the body and in food. These are carbohydrates, proteins, nucleic acids and lipids (fats). Lipids in human blood are conditionally divided into “good” and “bad”, and a lot depends on their balance. The coefficient of atherogenicity will show which of them prevails in the body, and will also answer the question - is the patient at high risk of developing atherosclerosis.

General concepts

The atherogenic coefficient (atherogenic index, CA, IA) is one of the indicators of a biochemical blood test, reflecting the ratio of "good" and "bad" lipids in the human body and helping to assess the risk of developing cardiovascular diseases associated with atherosclerosis.

Determination of the coefficient of atherogenicity is prescribed in combination with other analyzes for an expanded lipid spectrum.

Who needs to take this test?

Determination of the atherogenic coefficient is important for many patients, including:

• having close relatives with a disturbed lipid spectrum;
• survivors of myocardial infarction, suffering from cardiovascular diseases:
  • IHD (ischemic heart disease);
  • arterial hypertension;
  • atherosclerosis of various localizations (in the carotid arteries, cardiac and renal arteries, leg arteries).
• those suffering from kidney disease:
  • glomerulonephritis;
  • nephrotic syndrome;
  • chronic renal failure.
• with thyroid disease:
  • hypothyroidism;
  • hyperthyroidism.
• with diabetes mellitus type 1 and 2;
• suffering from pathology of the gastrointestinal tract:
  • chronic pancreatitis;
  • pancreatic cancer;
  • cirrhosis of the liver.
• with obesity;
• suffering from anorexia;
• with burn disease;
• with gout;
• with blood diseases
  • megaloblastic anemia;
  • myeloma;
  • sepsis.
• long-term use of oral contraceptives;
• suffering from alcoholism;
• smokers.

Calculation of the coefficient of atherogenicity

The atherogenic coefficient can be calculated using the following formula: (Total cholesterol - HDL) / HDL, where HDL is high density lipoprotein. Total cholesterol is the sum of high, low density (LDL) and very low density (VLDL) lipoproteins.

Calculation example: in a patient with a cholesterol index of 6.19 and HDL of 1.06, the atherogenic coefficient will be 4.8.

Preparing the patient for a blood test

2-3 weeks before the study, the patient should not break the diet. If a person has suffered a serious illness (for example, myocardial infarction) or a major operation, then the test is postponed for 3 months - unless the blood was taken within 12 hours after the attack. It is postponed for 2-3 weeks after mild illnesses.

24 hours before the test, you can not drink alcohol, 12 hours before donating blood - eat, 30 minutes - smoke. The patient must be well-rested and sit for 5-10 minutes before the procedure, otherwise the test result may be distorted.

CA values ​​are normal - table

Normal values ​​of the coefficient of atherogenicity range from 2 to 2.5, but not more than 3.2 for women and 3.5 for men. A value above 3 means that “bad” cholesterol begins to predominate in the body - there is a possibility of developing atherosclerosis.

The reduced coefficient of atherogenicity has no practical significance. There is no need to take any steps to increase it.

Throughout life, the ratio changes. It has a minimum value in infancy and is equal to one, although this test is not intended for children, therefore, high numbers of the atherogenic index do not carry a semantic load during this period. With age, the coefficient increases, but even for older people it should not go beyond the limits indicated in the table.

Any factors that affect blood lipid levels will also affect the final ratio. Main reasons:

1. Smoking. Smoking affects the level of lipids in the blood and contributes to damage to the walls of blood vessels, in places where atherosclerotic plaques begin to develop.
2. Unhealthy food. Eating fatty and fried foods, foods that are rich in simple carbohydrates (sweets, baked goods, honey, sugary drinks, etc.).
3. Obesity. Firstly, people suffering from this disease lead a sedentary lifestyle, which is also a risk factor. And secondly, they often eat sweet and fatty foods.
4. Diabetes. People with this pathology automatically fall into the risk group for the development of atherosclerosis, since a high level of blood glucose damages the walls of blood vessels, where atherosclerotic plaques begin to join.
5. Increased blood pressure. Since the walls of blood vessels have a certain margin of safety, with a constantly high level of blood pressure, they are damaged, which leads to the development of atherosclerosis in this place.
6. Hunger for a long period of time.
7. Reception:
   • oral contraceptives;
   • anabolic steroids;
   • glucocorticoids (Prednisolone, Dexomethasone).
8. Pregnancy.
9. Relatives with high cholesterol. Sometimes there is a genetically inherent elevated level of lipids and, accordingly, a high level of atherogenic coefficient.
10. Alcohol consumption. Currently, one of the important factors in the development of atherosclerotic vascular lesions.

Features of the increased coefficient of atherogenicity

An increased atherogenic coefficient is associated with an increased risk of developing a variety of diseases:

1. With damage to the vessels of the heart: coronary heart disease, often manifested by retrosternal pain, which can spread to the left arm, left side of the neck. These attacks disappear after the use of nitrates.
2. With damage to the vessels of the kidneys - chronic renal failure (CRF).
3. With damage to the intestinal vessels - "abdominal toad", which includes pain and distension in the abdomen after eating.
4. With damage to the vessels of the legs - intermittent claudication (Lerish syndrome), a symptom of which is a forced stop of a person after a certain distance due to unbearable pain in the lower extremities.
5. With damage to the vessels of the brain:
   • encephalopathy, which is manifested by sleep disturbances, headaches, irritability;
   • transient ischemic attacks (TIAs), which come on and off suddenly and have stroke-like symptoms.
   • directly acute disorders of cerebral circulation (strokes, stroke) - with deeply advanced atherosclerosis.

Normalization of the level of atherogenicity

Non-drug ways to reduce the atherogenic coefficient include methods such as:

• adherence to a rational diet with a decrease in the amount of food containing fast carbohydrates (sweet carbonated drinks, juices, jams, pastries, honey, sweets) and fats (butter, lard, fatty meat, margarine, fatty dairy products). Thermal processing of food should exclude frying. Boiling, baking, steaming is recommended;
• normalization of excess weight;
• increase in physical activity during the day - with a sedentary lifestyle;
• reduction in alcohol intake and smoking cessation - provokers of the development of atherosclerosis.

Prohibited products in the photo

Diet for atherosclerosis - video

Medical methods of treatment:

1. Omega-3 polyunsaturated fatty acids (such as fish oil supplements). They help to normalize the level of cholesterol in the blood, thereby affecting the atherogenic coefficient.
2. Statins (Simvastatin, Rosuvastatin). At the moment, these are the main drugs prescribed for violations of lipid metabolism in the body. You need to drink such pills throughout your life. They not only lower cholesterol levels, but also affect existing atherosclerotic plaques, reducing them. Also, the discovery of recent years is their anti-inflammatory effect, the mechanism of which is still being studied.
3. Fibrates (Gemfibrozil, Fenofibrate). Drugs that increase the level of "good" blood lipids, thereby reducing the atherogenic coefficient.
4. Bile acid sequestrants (colestyramine). The drugs form insoluble compounds with cholesterol and bile acids, thereby reducing their blood levels.

The atherogenic coefficient is a unique tool in our hands that allows us to assess the likelihood of developing atherosclerosis in a patient, prevent its complications and select individual therapy for all those who need it. Every person who cares about their health should be attentive to this indicator in order to identify its changes as early as possible and stop the progression of the disease in the early stages.

It is difficult to meet a person who does not know about the dangers of cholesterol, dangerous diseases caused by an excess of this element in the body. From here, people, seeing inflated cholesterol levels in the results of a blood test, begin to exhaust themselves with various diets, restrict food and, worse, prescribe medication for themselves. But we must remember one thing - cholesterol is divided into harmful and useful. The latter is simply necessary for the life of our body. How much your level of "bad" cholesterol is exceeded helps to find out the atherogenic index, which is calculated according to the results of a biochemical blood test.

What is atherogenic?

This is such a ratio of harmful and beneficial cholesterol for the body, where its "bad" fraction predominates. For what purpose is calculated To assess the risk of atherosclerosis in a patient.

As we already mentioned, the calculations are based on the results of a biochemical study of a patient's blood sample.

Cholesterol and lipoproteins

In order for you to understand the calculation of the atherogenic index, we will present a little theory. What is cholesterol? These are soluble complex compounds in the blood. Cholesterol is not alone here - it is in conjunction with protein. This compound is called lipoprotein (lipoprotein).

The latter are inhomogeneous. There are groups:

• High molecular weight lipoproteins (HDL). They are distinguished by high density.
• Low molecular weight lipoproteins (LDL). Differ in low density.
• Very low molecular weight lipoproteins (VLDL). Compounds of the lowest density.

Hence, to present a complete picture, calculate the atherogenic index, the doctor needs a lipidogram with information about the total cholesterol content in the blood, each of its fractions presented above, as well as data on triglyceride (refers to fats - a product of 3-atomic alcohol glycerol and carboxylic acids).

"Good" and "bad" lipoproteins

Cholesterol is present in the body as follows:

• 80% of its total mass is produced by the liver, intestinal tract, kidney system, gonads, adrenal glands. Then cholesterol interacts with proteins, forming LDL, HDL.
• 20% enters the body with food. In this case, cholesterol is present in the chylomicron, which is formed in the intestine. Next, the compound enters the bloodstream.

The further path of formations is as follows:

• LDL will be transported from the liver to body tissues.
• HDL, on the other hand, moves to the liver.
• Chylomicrons travel to peripheral tissues and the liver.

High molecular weight lipoproteins will be produced by the liver. Chylomicrons in it are divided into LDL and HDL - it all depends on the apoliprotein with which the cholesterol is combined.

"Harmful" here will be considered low-density lipoproteins. They are called atherogenic. The more of them, the more fatty acids enter the tissues. The latter will be removed from the cells by binding to "good" high-density lipoproteins. Once in the liver, cholesterol is completely hydrolyzed.

The high molecular weight lipoproteins we need are synthesized only by the liver. They do not enter the body with products. But the category of polyunsaturated fats, which belong to the omega-3 group, can contribute to an increase in this fraction in the blood. In particular, they are present in fatty fish products.

But the formation of "bad" cholesterol just provokes food - excessively fatty foods, an unbalanced diet. This disrupts lipid metabolism in the body. The result is the production of a large amount of LDL.

Atherogenic index - what does it mean? This is the ratio of harmful LDL to beneficial HDL in the human body. Accordingly, if the volume of low-density lipoproteins is higher, then the patient has a risk of atherosclerosis.

What does total cholesterol mean?

How to decipher blood test results? OH - this will be the name of the column with the total level of cholesterol in the blood. Someone here will have 7, and someone will have 4. But this figure does not affect the likelihood of developing atherosclerosis in a patient!

The fact is that OH shows the total volume of lipoproteins in the blood - both HDL and LDL. Let's look at what can increase the level of OH:

• In the patient's blood, a large amount of HDL, that is, the necessary high-molecular lipoproteins. They are the useful elements that transport fats from cells for further processing in the liver. A high level of HDL will indicate anti-atherogenicity.
• In the patient's blood, on the contrary, the volume of low molecular weight lipoproteins is overestimated, and the number of HDL is low. This already indicates a high atherogenicity.
• The risk of atherosclerosis will not only be in a person with an elevated level of LDL in the blood. High atherogenicity persists if the number of lipoproteins of the low molecular weight group is normal, and the volume of HDL is underestimated.

Now you know that it is the analysis of the atherogenic index that is required to determine the risk of diagnosing atherosclerosis. OH cannot be the only starting point.

Index indicators

Imagine the general norm of the atherogenic index, deviations from it:

• Up to 3 - normal limits.
• Up to 4 is already an increased figure. However, it will help to reduce special diets, physical activity.
• Over 4 is an alarming sign, indicating the imminent development of atherosclerosis. The patient needs special treatment.

What are the high scores talking about?

If the index is elevated (more than 3 mmol / l), then cholesterol is already beginning to be deposited on the vascular walls. The higher this indicator, the more active the process is.

The result is the formation of cholesterol plaques on the vascular walls. Over time, such deposits grow, narrowing the lumen of the vessels. In addition, calcium salts accumulate in plaques. And these elements pathologically affect the vessels - the latter lose their elasticity, dystrophic processes are observed in them.

Plaques can collapse, then transforming into blood clots. This contributes to the development of thromboembolism - a rather dangerous disease that can result in sudden death due to blockage of blood vessels by blood clots.

Causes of atherosclerosis

It is important for everyone to know what it means - the atherogenic index. After all, the main cause of atherosclerosis is an increased level of LDL in the blood. However, the disease can additionally be provoked by related factors:

• Age changes.
• Wrong way of life.
• Infectious diseases.
• A number of certain diseases.

In addition, individuals are identified who will be a "risk group" - they have a high probability of developing atherosclerosis. Here the main factors will be:

• Heredity.
• Age over 60 years.
• Floor. Men suffer from the disease more often than women.
• Increased body weight.
• Hypertension.
• Diabetes.
• Smoking.
• Infectious diseases - herpes, cytomegalovirus, chlamydia.

Norms for a woman

We have analyzed in general what it means - the atherogenic index. In women, its indicators are lower than in men. This is due to the hormone estrogen, which is present in the fair sex. The element has a positive effect on the vascular walls, additionally providing them with elasticity. But only until the "golden" anniversary. After menopause, estrogen can no longer protect the walls of blood vessels.

Consider the indicators of the norm of the atherogenic index in women:

• Up to 30 years - up to 2.2 mmol / l.
• After 30 years - up to 3.2 mol / l.
• After 50 years - must be calculated as for men.

Other normal indicators of the level of lipoproteins up to 50 years:

• OH - 3.6-5.2 mmol / l.
• High density LP - 0.86-2.28 mmol / l.
• Low density LP - 1.95-4.51 mmol / l.

Norms of triglyceride compounds:

• 1.78-2.2 mmol / l is a normal indicator.
• 2.2-5.6 mmol / l - overestimated figures.
• More than 5.6 is a concentration dangerous to health.

Reasons for the increase

What does this mean in women - the atherogenic index, we already know. What are the reasons for its increase? There are several of them:

• The very first is an improper, unbalanced diet. A woman eats a lot of fatty foods - pork, sour cream, butter, and so on.
• Insufficient physical activity.
• Smoking is a bad habit that slows down fat metabolism in the body.
• hereditary factor.
• Infections - chlamydia, cytomegalovirus.
• Hypertension.
• Diabetes.
• The onset of menopause.

Norms for males

Imagine the norm of the atherogenic index in men:

• Up to 30 years - 2.5 mmol / l.
• After 30 years - 3.5 mmol / l.

• OH - 3.5-6 mmol / l.
• High molecular weight lipoproteins - 0.7-1.76 mmol / l.
• LP of the low molecular weight group - 2.21-4.81 mmol / l.

Accordingly, after reaching the age of 50-60, the normal indicators of these values ​​will grow upwards, which is associated with age-related changes in the body.

Reasons for the increase

We analyzed the atherogenic index in men. Imagine now, because of which its indicators can be overestimated in the stronger sex:

• Violation of protein, fat metabolism in the body is a consequence of the oversaturation of the system with animal fats.
• Wrong way of life.
• Inactive work.
• Lack of active leisure, sports.
• Stress.
• Insufficient physical activity.
• Smoking.

How to calculate the index?

The formula for the atherogenic index is simple. Based on the results of a biochemical study, not only a specialist, but also a non-professional can calculate its value.

It is presented like this:

And \u003d (OH - HDL) / HDL.

Here is the breakdown of the abbreviations:

• And - the result of calculations, namely, the atherogenic index.
• OH - total cholesterol in the blood mass.
• HDL - the number of high molecular weight lipoproteins.

Treatment of the condition

The atherogenic index is increased - what does this mean? Do not be afraid - not always the consequence will be the rapid development of atherosclerosis and its complications. First of all, the treating specialist determines the reason for the increase in performance. This may be a temporary failure caused by pregnancy, hormonal changes.

Treatment, both medication and diet, is prescribed only by a doctor! Someone is prescribed hormonal drugs, for some patients it is enough to follow the instructions of a nutritionist.

An abrupt change in nutrition, for example, a severe restriction of the body in incoming fats, will not always have a positive effect. This can, on the contrary, lead to increased production of lipids by the body, which provokes stress from their lack. Hence, catering should be competent - only with the approval of a specialist.

Useful and harmful products

The atherogenic index is increased. What does it mean? You should gradually change your diet:

• Reduce to moderate amounts of foods that contain animal fat.
• Give up fat, fatty lamb and pork, sour cream, creamy meat, egg yolks.
• Eliminate trans fats from your diet. They contain margarine, spread and a number of similar products.

And now a list of what will be useful for your diet:

• Sea fish are predominantly fatty varieties.
• Nuts. The biggest benefit is in walnuts.
• Vegetable oil. Flaxseed, sunflower or olive.
• Freshly squeezed juices.
• Fresh fruits and vegetables.
• Purified drinking water in large quantities - up to 1.5 liters per day.

Medical and mechanical therapy

When the atherogenic index is much increased, it is already difficult to manage with one diet. In such cases, the doctor prescribes a special treatment for the patient:

• Medical therapy. These are satins (drugs that artificially reduce the production of cholesterol), cation exchangers (aimed at binding bile acids in the intestines), drugs with omega-3 fats (drugs lower LDL levels).
• mechanical therapy. This is extracorporeal hemocorrection. In other words, mechanical purification of the blood mass. To do this, blood is taken from the patient's vein, it is purified through special filters, and then injected back.

What creates a low index?

What needs to be done so that the atherogenic index is lower at the next analysis? It is enough to follow a few simple rules:

• Assume the correct position when taking a blood sample. As a rule, the patient should lie down, be calm and relaxed. This affects the accuracy of the results.
• Work with a professional dietitian to develop a diet that reduces/eliminates animal fats.
• Direct your attention to a healthy lifestyle - choose your favorite sports direction or other physical activities (hiking, tourist routes, etc.)
• Take special drugs - but only those prescribed by your doctor. These are satins, clofibrate, antifungal agents, colchicine, drugs containing estrogens. It is also important to observe the frequency of administration and dosage. If, against the background of a decrease in the total cholesterol volume, the volume of high-molecular-weight lipoproteins also decreases, then the treatment is immediately stopped.

Thus, low or high TC values ​​will not tell you anything about the risk of diagnosing atherosclerosis and its consequences. It is worth paying attention only to the atherogenic index. Its low values ​​specifically for your gender and age are an indicator that everything is in order with the vessels!