Large HDL (High-Density Lipoprotein) refers to a subtype of HDL cholesterol, often categorized based on particle size. HDL is known as 'good cholesterol' because it helps remove other forms of cholesterol from the bloodstream, transporting it to the liver for excretion.
The classification into 'large' HDL is based on the size of these particles. Large HDL molecules can transport greater quantities of bad cholesterol to the liver, making them more beneficial to cardiovascular health. In contrast, smaller particles do not provide added cardiovascular protection.
This test helps assess cardiovascular disease (CVD) risk in patients with intermediate or high risk based on traditional or emerging risk factors, including:
- Existing health conditions: diabetes, high blood pressure, or atherosclerosis
- A family history of heart disease
- Smoking
- Age: Men >45 and women >55 years of age
This test is also used to assess a patient's response to lipid-lowering therapy.
Abnormal Large HDL Particle Levels
Low Large HDL Particle Levels - Causes
Low levels may increase the risk of cardiovascular disease, as there is less HDL available to remove cholesterol from the arteries.
- Diet: High intake of trans fats and refined sugars or carbohydrates can lower HDL levels.
- Sedentary lifestyle: Lack of physical activity can reduce the levels of large HDL particles.
- Obesity: Excess body weight can lower HDL levels, especially large HDL particles.
- Type 2 diabetes, and metabolic syndrome: These conditions can reduce the size and number of HDL particles.
- Smoking: Smoking is associated with lower HDL levels, including large HDL particles.
- Genetics: Some individuals have naturally lower HDL levels.
- Certain medications: Some medications, like beta-blockers or anabolic steroids, can lower HDL levels.
- Type 2 diabetes, and metabolic syndrome: These conditions can reduce the size and number of HDL particles.
Low Large HDL Particle Levels - Symptoms
- Generally asymptomatic
- Low levels are associated with an increased risk of cardiovascular disease. Symptoms related to cardiovascular issues might include chest pain, shortness of breath, or fatigue.
Elevated Large HDL Particle Levels - Causes
Elevated levels are typically not a cause for concern. While having high HDL levels is generally considered beneficial, excessively high levels may be associated with certain health issues.
- Genetics: Some individuals naturally have higher HDL levels.
- Medications: Certain drugs, such as niacin and fibrates, can elevate HDL.
- Estrogen: Hormone replacement therapy or higher estrogen levels in women can increase HDL, particularly large HDL particles.
Elevated Large HDL Particle Levels - Symptoms
- Generally asymptomatic
- Considered protective against cardiovascular disease.
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