Detailed Explanation of Five Blood Lipid Indicators: Clinical Significance and Treatment Guidelines

Let's look at the clinical significance of each blood lipid test item:

Triglycerides:
Clinical Significance: While elevated triglycerides are less damaging to blood vessels than cholesterol, long-term elevation can still lead to atherosclerosis, and severe elevation can induce acute pancreatitis.

Diagnosis and Treatment: The reference range for triglycerides on a lab report is 0.4–1.8 mmol/L. However, hypertriglyceridemia is diagnosed only when triglycerides are >2.3 mmol/L. For mildly elevated triglycerides, a light diet, regular exercise, and limiting oily and sweet foods are recommended, along with regular checkups. If triglycerides cannot be reduced to the normal range, statins can be used for treatment. When triglycerides are >5.6 mmol/L, acute pancreatitis is easily induced, and fibrates should be administered immediately.

Total Cholesterol:
Clinical Significance: Cholesterol is a "killer" of arterial health and a major cause of cardiovascular disease.

Diagnosis and Treatment: The reference range for total cholesterol on a lab report is 2.4–5.7 mmol/L. It's a mistake to assume you're healthy just because your cholesterol test results are within the "normal range." For diabetic patients, a total cholesterol level >3.1 mmol/L indicates a high risk of myocardial infarction or cerebral infarction (from a professional perspective, this group is considered high-risk for cardiovascular events) and requires immediate treatment. Additionally, healthy individuals without any diseases should also begin medication if their total cholesterol level >7.2 mmol/L.

Low-Density Lipoprotein Cholesterol (LDL-C):

Clinical Significance: Among all lipid indicators, LDL-C is the most important because higher LDL-C levels are associated with a higher risk of myocardial infarction and cerebral infarction, while significantly lower LDL-C levels reduce the probability of cardiovascular events.

Diagnosis and Treatment: The normal range for LDL-C on a lab report is 2.07–3.1 mmol/L. This reference range is not only useless but also potentially harmful. Some patients, seeing their test results within the normal range, stop taking medication or refuse to take it altogether. In fact, many patients should receive immediate treatment. According to the *Guidelines for the Prevention and Treatment of Dyslipidemia in Chinese Adults*, patients with coronary heart disease require treatment when their LDL cholesterol is >1.8 mmol/L; diabetic patients over 40 years of age require treatment when their LDL cholesterol is >2.6 mmol/L. The 2016 *European Guidelines for the Management of Dyslipidemia* recommends that patients with extremely high overall cardiovascular disease risk should have their LDL cholesterol levels controlled below 1.8 mmol/L; for patients with recurrent atherosclerotic cardiovascular disease, it is recommended to lower LDL cholesterol to below 1.0 mmol/L.

Lipoprotein(a): Clinical significance: Lipoprotein(a) is a type of blood lipid. When lipoprotein(a) >30 mg/dL, it is diagnosed as hyperlipoprotein(a)emia. The 2010 European Atherosclerosis Society (EAS) expert consensus on lipoprotein(a) states that elevated lipoprotein(a) is a definite risk factor for cardiovascular disease, and the ideal lipoprotein(a) level should be below 50 mg/dL.

Diagnosis and Treatment: Numerous studies show that lipoprotein(a) levels are primarily related to genetics and are not affected by lifestyle habits (such as regular physical exercise or a light diet). Currently, there are no approved drug treatments for lowering lipoprotein(a) concentration and reducing the risk of atherosclerotic disease. Therefore, do not believe any folk remedies claiming to control lipoprotein(a).

High-Density Lipoprotein Cholesterol (HDL-C):

Clinical Significance: HDL-C has long been considered "good" cholesterol, transporting cholesterol from peripheral tissues to the liver for breakdown. Besides genetics, factors such as obesity, smoking, lack of exercise, and hepatitis can also affect HDL-C; people with these habits or symptoms often have lower HDL-C levels.

Diagnosis and Treatment: Aerobic exercise, weight loss, quitting smoking, and limiting alcohol consumption are all methods to increase HDL-C.

Therefore, when seeking medical advice, one should not solely rely on the normal reference range on a lab report. Medication should always be taken under the guidance of a doctor to minimize cardiovascular damage.