Metabolism of fats (lipid metabolism) in the body. Lipid metabolism - its disorders, causes, symptoms and treatment

lipid metabolism is the process by which fatty acids are digested, broken down to generate energy or stored in the body as a source of energy for future use. Fatty acids are components of triglycerides, which make up most of the fats consumed by humans in foods such as vegetable oils and animal products. Triglycerides are found in blood vessels or stored for future use as an energy source in adipose tissue cells, better known as body fat, and also in liver cells.

Although carbohydrates are the main source of energy, when their reserves are depleted, the breakdown and use of fatty acids in triglycerides as a reserve energy source begins. For example, the body draws energy from fat during exercise when glycogen stores (or a form of carbohydrate-derived glucose that can be stored) are low, or when there is not enough carbohydrate in the diet to meet the body's energy needs.

Remember, fat itself is not excreted from the body ...

Triglycerides, also known as lipids or fats, are a good source of energy because each gram contains 9 calories (37 kilojoules), while carbohydrates have only 4 calories (17 kilojoules) per gram.

Since calories are units of energy, fats are considered energy-dense nutrients. Triglycerides are made up of three fatty acid chains linked to a hydrogen-containing compound called glycerol. When the body requires additional calories, these fatty acids are released during fat metabolism.

Where does fat metabolism begin in the body ...

The first step in fat metabolism is the consumption and absorption of triglycerides, which are found in both plant foods such as olives, nuts and avocados and animal foods such as meat, eggs and dairy products.

These fats enter the intestine through the digestive tract, but they cannot be absorbed in it in the form of triglycerides. Therefore, they are broken down by an enzyme called lipase into fatty acids, most often monoglycerides, which are a single chain of fatty acids connected to glycerol. The broken down triglycerides are then absorbed into the body via the intestines and revert to their original form before being transported to the lymphatic system via chylomicrons, a type of cholesterol-like substance known as lipoproteins.

From the lymphatic system, triglycerides enter the bloodstream, where the process of fat metabolism can be completed in one of three ways - triglycerides are either transported to the liver, or to muscle cells, or to fat cells, where they are either stored or used as an energy source. If they enter the liver cells, they are converted into "bad" cholesterol, known as very low density lipoproteins, and released into the bloodstream, where they transport other lipids. Triglycerides that enter muscle cells can be oxidized in the mitochondria of those cells and used for energy production, while those that end up in fat cells are stored until they are needed later. This leads to an increase in the size of fat cells, which manifests itself as more body fat.

Violations and their causes in alphabetical order:

lipid metabolism disorders

A number of diseases are caused lipid metabolism disorder. The most important among them are atherosclerosis and obesity. Diseases of the cardiovascular system, as a result of atherosclerosis, occupy the first place in the structure of mortality in the world. One of the most common manifestations of atherosclerosis is damage to the coronary vessels of the heart. The accumulation of cholesterol in the walls of blood vessels leads to the formation of atherosclerotic plaques. They, increasing in size over time, can block the lumen of the vessel and interfere with normal blood flow. If, as a result, the blood flow is disturbed in the coronary arteries, then there is angina pectoris or myocardial infarction. Predisposition to atherosclerosis depends on the concentration of transport forms of blood lipids - plasma alpha-lipoproteins.

What diseases cause a violation of lipid metabolism:

Accumulation of cholesterol (CS) in the vascular wall occurs due to an imbalance between its entry into the intima of the vessels and its exit. As a result of this imbalance, cholesterol accumulates there. In the centers of accumulation of cholesterol, structures are formed - atheromas. There are two most well-known factors that cause lipid metabolism disorders.

1. Firstly, these are changes in LDL particles (glycosylation, lipid peroxidation, phospholipid hydrolysis, apo B oxidation). Therefore, they are captured by special cells - "scavengers" (mainly macrophages). The capture of lipoprotein particles with the help of "junk" receptors proceeds uncontrollably. Unlike apo B/E - mediated endocytosis, this does not cause regulatory effects aimed at reducing the entry of cholesterol into the cell, described above. As a result, macrophages become overwhelmed with lipids, lose their waste-absorbing function, and turn into foam cells. The latter linger in the wall of blood vessels and begin to secrete growth factors that accelerate cell division. Atherosclerotic cell proliferation occurs.

2. Secondly, this is the inefficient release of cholesterol from the endothelium of the vascular wall by HDL circulating in the blood.

Factors affecting elevated LDL levels in humans

Gender - higher in men than in premenopausal women and lower than in postmenopausal women
- Aging
- Saturated fats in the diet
- High cholesterol intake
- Diet low in coarse fibrous foods
- Alcohol consumption
- Pregnancy
- Obesity
- Diabetes
- Hypothyroidism
- Cushing's disease
- Uremia
- Nephrosis
- Hereditary hyperlipidemias

Disorders of lipid metabolism (dyslipidemia), characterized primarily by elevated levels of cholesterol and triglycerides in the blood, are the most important risk factors for atherosclerosis and related diseases of the cardiovascular system. Plasma concentration of total cholesterol (CH) or its fractions closely correlates with morbidity and mortality from coronary artery disease and other complications of atherosclerosis. Therefore, the characterization of lipid metabolism disorders is a prerequisite for effective prevention of cardiovascular diseases.

Lipid metabolism disorders can be primary and secondary and are characterized only by an increase in cholesterol (isolated hypercholesterolemia), triglycerides (isolated hypertriglyceridemia), triglycerides and cholesterol (mixed hyperlipidemia).

The primary lipid metabolism disorder is determined by single or multiple mutations of the corresponding genes, which result in overproduction or impaired utilization of triglycerides and LDL cholesterol or overproduction and impaired HDL clearance.

Primary lipid disorders can be diagnosed in patients with clinical symptoms of these disorders, with early onset of atherosclerosis (before 60 years), in individuals with a family history of atherosclerosis, or with an increase in serum cholesterol > 240 mg / dl (> 6.2 mmol / l) .

Secondary lipid metabolism disorder occurs, as a rule, in the population of developed countries as a result of a sedentary lifestyle, consumption of food containing a large amount of cholesterol, saturated fatty acids.

Other causes of secondary lipid metabolism disorders can be:
1. Diabetes.
2. Alcohol abuse.
3. Chronic renal failure.
4. Hyperthyroidism.
5. Primary biliary cirrhosis.
6. Taking certain drugs (beta-blockers, antiretroviral drugs, estrogens, progestins, glucocorticoids).

Hereditary disorders of lipid metabolism:

A small number of people have hereditary disorders of lipoprotein metabolism, manifested in hyper- or hypolipoproteinemia. Their cause is a violation of the synthesis, transport or cleavage of lipoproteins.

In accordance with the generally accepted classification, there are 5 types of hyperlipoproteinemia.

1. The existence of type 1 is due to insufficient activity of LPL. As a result, chylomicrons are very slowly removed from the bloodstream. They accumulate in the blood, and the level of VLDL is also higher than normal.
2. Hyperlipoproteinemia type 2 is divided into two subtypes: 2a, characterized by high levels of LDL in the blood, and 2b (increased LDL and VLDL). Type 2 hyperlipoproteinemia is manifested by high, and in some cases very high, hypercholesterolemia with the development of atherosclerosis and coronary heart disease. The content of triacylglycerols in the blood is within the normal range (type 2a) or moderately elevated (type 2b). Hyperlipoproteinemia type 2 is characteristic of a serious disease - hereditary hypercholesterolemia, affecting young people. In the case of the homozygous form, it ends in death at a young age from myocardial infarctions, strokes and other complications of atherosclerosis. Type 2 hyperlipoproteinemia is widespread.
3. With type 3 hyperlipoproteinemia (dysbetalipoproteinemia), the conversion of VLDL to LDL is disrupted, and pathological floating LDL or VLDL appear in the blood. In the blood, the content of cholesterol and triacylglycerols is increased. This type is quite rare.
4. With type 4 hyperlipoproteinemia, the main change is an increase in VLDL. As a result, the content of triacylglycerols in the blood serum is significantly increased. It is combined with atherosclerosis of coronary vessels, obesity, diabetes mellitus. It develops mainly in adults and is very common.
5. Type 5 hyperlipoproteinemia - an increase in the serum content of HM and VLDL, associated with a moderately reduced activity of lipoprotein lipase. The concentration of LDL and HDL is below normal. The content of triacylglycerols in the blood is increased, while the concentration of cholesterol is within the normal range or moderately elevated. It occurs in adults, but is not widespread.
Typing of hyperlipoproteinemias is carried out in the laboratory on the basis of a study of the blood levels of various classes of lipoproteins by photometric methods.

As a predictor of atherosclerotic lesions of the coronary vessels, the indicator of cholesterol in the composition of HDL is more informative. Even more informative is the coefficient reflecting the ratio of atherogenic drugs to anti-atherogenic drugs.

The higher this coefficient, the greater the risk of the onset and progression of the disease. In healthy individuals, it does not exceed 3-3.5 (in men it is higher than in women). In patients with coronary artery disease, it reaches 5-6 or more units.

Is diabetes a lipid metabolism disease?

The manifestations of lipid metabolism disorders are so pronounced in diabetes that diabetes is often referred to as a disease of lipid rather than carbohydrate metabolism. The main disorders of lipid metabolism in diabetes are an increase in lipid breakdown, an increase in the formation of ketone bodies and a decrease in the synthesis of fatty acids and triacylglycerols.

In a healthy person, usually 50% of the incoming glucose breaks down CO2 and H2O; about 5% is converted to glycogen, and the rest is converted to lipids in fat depots. In diabetes, only 5% of glucose is converted into lipids, while the amount of glucose decomposing into CO2 and H2O also decreases, and the amount converted into glycogen changes slightly. The result of impaired glucose intake is an increase in blood glucose levels and its removal in the urine. Intracellular glucose deficiency leads to a decrease in the synthesis of fatty acids.

In untreated patients, an increase in plasma levels of triacylglycerols and chylomicrons is observed, and the plasma is often lipemic. An increase in the level of these components causes a decrease in lipolysis in fat depots. The decrease in lipoprotein lipase activity further contributes to the reduction in lipolysis.

lipid peroxidation

A feature of cell membrane lipids is their significant unsaturation. Unsaturated fatty acids are easily subjected to peroxide degradation - LPO (lipid peroxidation). The membrane's response to damage is therefore called "peroxide stress".

LPO is based on a free radical mechanism.
Free radical pathology is smoking, cancer, ischemia, hyperoxia, aging, diabetes, i.e. in almost all diseases, uncontrolled formation of free oxygen radicals and intensification of lipid peroxidation take place.
The cell has a system of protection against free radical damage. The antioxidant system of cells and tissues of the body includes 2 links: enzymatic and non-enzymatic.

Enzymatic antioxidants:
- SOD (superoxide dismutase) and ceruloplasmin involved in the neutralization of oxygen free radicals;
- catalase catalyzing the decomposition of hydrogen peroxide; glutathione system providing catabolism of lipid peroxides, peroxide modified nucleotides and steroids.
Even a short-term lack of non-enzymatic antioxidants, especially antioxidant vitamins (tocopherol, retinol, ascorbate), leads to persistent and irreversible damage to cell membranes.

Which doctors to contact if there is a violation of lipid metabolism:

Have you noticed a violation of lipid metabolism? Do you want to know more detailed information or do you need an inspection? You can book an appointment with a doctor– clinic Eurolaboratory always at your service! The best doctors will examine you, study the external signs and help identify the disease by symptoms, advise you and provide the necessary assistance. you also can call a doctor at home. Clinic Eurolaboratory open for you around the clock.symptoms of diseases and do not realize that these diseases can be life-threatening. There are many diseases that at first do not manifest themselves in our body, but in the end it turns out that, unfortunately, it is too late to treat them. Each disease has its own specific signs, characteristic external manifestations - the so-called disease symptoms. Identifying symptoms is the first step in diagnosing diseases in general. To do this, you just need to several times a year be examined by a doctor not only to prevent a terrible disease, but also to maintain a healthy spirit in the body and the body as a whole.

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It's time to move on to a finer adjustment of the athlete's nutrition. Understanding all the nuances of metabolism is the key to sports achievements. Fine-tuning allows you to move away from classic dietary formulas and tailor nutrition to your individual needs, achieving the fastest and most lasting results in training and competition. So, let's study the most controversial aspect of modern nutrition - fat metabolism.

General information

Scientific fact: fats are digested and broken down in our body very selectively. So, in the human digestive tract there are simply no enzymes capable of digesting trans fats. Liver infiltrate simply seeks to remove them from the body in the shortest possible way. Perhaps everyone knows that if you eat a lot of fatty foods, it causes nausea.

A constant excess of fat leads to such consequences as:

• diarrhea;
• indigestion;
• pancreatitis;
• rashes on the face;
• apathy, weakness and fatigue;
• the so-called "fat hangover".

On the other hand, the balance of fatty acids in the body is extremely important for achieving athletic performance - in particular in terms of increasing endurance and strength. In the process of lipid metabolism, all body systems are regulated, including hormonal and genetic ones.

Let's take a closer look at which fats are good for our body, and how to use them so that they help achieve the desired result.

Types of fats

The main types of fatty acids that enter our body:

• simple;
• complex;
• arbitrary.

According to another classification, fats are divided into monounsaturated and polyunsaturated (for example, here in detail about) fatty acids. These are healthy fats. There are also saturated fatty acids, as well as trans fats: these are harmful compounds that prevent the absorption of essential fatty acids, impede the transport of amino acids, and stimulate catabolic processes. In other words, neither athletes nor ordinary people need such fats.

Simple

To begin with, consider the most dangerous but, at the same time, – The most common fats that enter our body are simple fatty acids.

What is their peculiarity: they decompose under the influence of any external acid, including gastric juice, into ethyl alcohol and unsaturated fatty acids.

In addition, it is these fats that become a source of cheap energy in the body. They are formed as a result of the conversion of carbohydrates in the liver. This process develops in two directions - either towards the synthesis of glycogen, or towards the growth of adipose tissue. Such tissue is almost entirely composed of oxidized glucose, so that in a critical situation the body can quickly synthesize energy from it.

Simple fats are most dangerous for an athlete:

1. The simple structure of fats practically does not load the gastrointestinal tract and the hormonal system. As a result, a person easily receives an excess load of calories, which leads to weight gain.
2. When they break down, alcohol poisoning the body is released, which is hardly metabolized and leads to a deterioration in overall well-being.
3. They are transported without the help of additional transport proteins, which means they can stick to the walls of blood vessels, which is fraught with the formation of cholesterol plaques.

For more information on foods that are metabolized to simple fats, see the Food Table section.

Complex

Complex fats of animal origin, with proper nutrition, are part of the muscle tissue. Unlike their predecessors, these are multimolecular compounds.

We list the main features of complex fats in terms of their effect on the athlete's body:

• Complex fats are practically not metabolized without the help of free transport proteins.
• With proper fat balance in the body, complex fats are metabolized with the release of useful cholesterol.
• They are practically not deposited in the form of cholesterol plaques on the walls of blood vessels.
• With complex fats, it is impossible to get an excess of calories - if complex fats are metabolized in the body without insulin opening the transport depot, which causes a decrease in blood glucose.
• Complex fats stress the liver cells, which can lead to intestinal imbalance and dysbacteriosis.
• The process of splitting complex fats leads to an increase in acidity, which negatively affects the general condition of the gastrointestinal tract and is fraught with the development of gastritis and peptic ulcer.

At the same time, fatty acids with a multimolecular structure contain radicals linked by lipid bonds, which means that they can be denatured to the state of free radicals under the influence of temperature. In moderation, complex fats are good for the athlete, but don't overcook them. In this case, they are metabolized into simple fats with the release of a huge amount of free radicals (potential carcinogens).

Arbitrary

Voluntary fats are fats with a hybrid structure. For an athlete, these are the most beneficial fats.

In most cases, the body is able to convert complex fats into arbitrary ones on its own. However, in the process of lipid reformulation, alcohols and free radicals are released.

Consuming arbitrary fats:

• reduces the likelihood of free radical formation;
• reduces the likelihood of cholesterol plaques;
• positively affects the synthesis of beneficial hormones;
• practically does not load the digestive system;
• does not lead to an excess of calories;
• do not cause an influx of additional acid.

Despite the many useful properties, polyunsaturated acids (in fact, these are arbitrary fats) are easily metabolized into simple fats, and complex structures that lack molecules are easily metabolized into free radicals, obtaining a complete structure from glucose molecules.

What does an athlete need to know?

And now let's move on to what an athlete needs to know about lipid metabolism in the body from the entire course of biochemistry:

Paragraph 1. Classical nutrition, not adapted for sports needs, contains many simple fatty acid molecules. This is bad. Conclusion: drastically reduce the intake of fatty acids and stop frying in oil.

Point 2. Under the influence of heat treatment, polyunsaturated acids break down into simple fats. Conclusion: replace fried food with baked food. The main source of fats should be vegetable oils - fill salads with them.

Point 3. Do not consume fatty acids along with carbohydrates. Under the influence of insulin, fats, practically without the influence of transport proteins in their complete structure, enter the lipid depot. In the future, even with fat burning processes, they will release ethyl alcohol, and this is an additional blow to metabolism.

And now about the benefits of fats:

• Fats must be consumed necessarily, as they lubricate the joints and ligaments.
• In the process of fat metabolism, the synthesis of basic hormones occurs.
• To create a positive anabolic background, you need to maintain a balance of polyunsaturated omega 3, omega 6 and omega 9 fats in the body.

To achieve the right balance, you need to limit your total calorie intake from fat to 20% in relation to your overall meal plan. At the same time, it is important to take them in conjunction with protein products, and not with carbohydrates. In this case, transport, which will be synthesized in the acidic environment of gastric juice, will be able to metabolize excess fat almost immediately, removing it from the circulatory system and digesting it to the end product of the body's vital activity.

Product table

Outcome

So, the recommendation of all times and peoples to “eat less fat” is only partly true. Some fatty acids are simply irreplaceable and must be included in the diet of an athlete. To properly understand how an athlete consumes fats, here is a story:

A young athlete approaches the trainer and asks: how to eat fats correctly? The coach replies: don't eat fat. After that, the athlete understands that fats are harmful to the body and learns to plan his diet without lipids. Then he finds loopholes where the use of lipids is justified. He is learning how to create the perfect meal plan with variable fats. And when he becomes a coach himself, and a young athlete comes up to him and asks how to eat fats, he also answers: do not eat fats.

What is fat metabolism and what role does it play in the body? Fat metabolism plays an important role in ensuring the vital activity of the body. When the metabolism of fats is disturbed, this can become a factor for the development of various pathologies in the body. Therefore, everyone needs to know what fat metabolism is and how it affects a person.

Usually, many metabolic processes take place in the body. With the help of enzymes, salts, proteins, fats and carbohydrates are broken down. The most important in this process is the metabolism of fats.

It affects not only the harmony of the body, but also the general state of health. With the help of fats, the body replenishes its energy, which it spends on the functioning of systems.

When fat metabolism is disturbed, this can cause rapid weight gain. And also cause hormonal problems. The hormone will no longer properly regulate the processes in the body, which will lead to the manifestation of various diseases.

Today, lipid metabolism indicators can be diagnosed in the clinic. With the help of instrumental methods, it is also possible to track how the hormone behaves in the body. Based on testinglipid metabolism, the doctor can accurately diagnose and start the right therapy.

Hormones are responsible for the metabolism of fats in humans. There is more than one hormone in the human body. There are a large number of them. Each hormone is responsible for a specific metabolic process. Other diagnostic methods can be used to assess the work of lipid metabolism. You can view the effectiveness of the system using a lipidogram.

About what a hormone and fat metabolism are, as well as what role they play in ensuring life, read in this article below.

Lipid metabolism: what is it? Doctors say that the concept of the metabolic process of fats is a combined one. A large number of elements are involved in this process. When identifying failures in the system, attention is primarily drawn to such of them:

• Fat intake.
• Split.
• Suction.
• Exchange.
• Metabolism.
• Construction.
• Education.

It is according to the presented scheme that lipid metabolism occurs in humans. Each of these stages has its own norms and values. When there is a violation of at least one of them, it negatively affects the health of any person.

Process features

Each of the above processes contributes to the organization of the body's work. Each hormone also plays an important role here. It is not important for an ordinary person to know all the nuances and essence of the system. But you need to have a general idea of ​​​​its work.

Before that, you should know the basic concepts:

• Lipids. They come with food and can be used to replenish the energy spent by a person.
• Lipoproteins. Consists of protein and fat.
• Phosphorolipids. Combination of phosphorus and fat. Participate in metabolic processes in cells.
• Steroids. Belong to the sex hormones and take part in the work of hormones.

Admission

Lipids enter the body with food, like other elements. But the peculiarity of fats is that they are difficult to digest. Therefore, when it enters the digestive tract, fats are initially oxidized. For this, stomach juice and enzymes are used.

When passing through all the organs of the gastrointestinal tract, there is a gradual breakdown of fats into simpler elements, which allows the body to better absorb them. As a result, fats break down into acids and glycerol.

Lipolysis

The duration of this stage can be about 10 hours. When fat is broken down, cholecystokinin, which is a hormone, is involved in this process. It regulates the work of the pancreas and bile, as a result of which they release enzymes and bile. These elements from fat release energy and glycerin.

Throughout this process, a person may feel a little tired and lethargic. If there is a violation of the process, then the person will not have an appetite and an intestinal disorder may occur. At this time, all energy processes also slow down. With pathology, rapid weight loss can also be observed, since the body will not have the right amount of calories.

Lipolysis can occur not only then. When fats are broken down. During the fasting period, it also starts, but at the same time, those fats that the body has been deposited “in reserve” are broken down.

Lipolysis breaks down fat into fiber. This allows the body to replenish the spent energy and water.

Suction

When the fats are broken down, the task of the body is to take them out of the digestive tract and use them to replenish energy. Since the cells are made of protein, the absorption of fats through them takes a long time. But the body found a way out of this situation. It clings to the cells of lipoproteins, which accelerate the process of absorption of fat into the blood.

When a person has a large body weight, this indicates that this process is disturbed in him. Lipoproteins in this case are able to absorb up to 90% of fats, when the norm is only 70%.

After the absorption process, lipids are carried with the blood throughout the body and supply tissues and cells, which gives them energy and allows them to continue to work at the proper level.

Exchange

The process is fast. It is based on delivering lipids to the organs that require them. These are muscles, cells and organs. There, fats undergo modification and begin to release energy.

Building

In the creation of substances from fat that the body needs, it is carried out with the participation of many factors. But their essence is the same - to break down fats and give energy. If there is at this stage some kind of violation in the system, then this negatively affects the hormonal background. In this case, cell growth will be slowed down. They also don't regenerate well.

Metabolism

This starts the process of metabolism of fats, which are used to meet the needs of the body. How much fat is needed for this depends on the person and his lifestyle.

With a slow metabolism, a person may feel weak during the process. He also has unsplit fat can be deposited on the tissues. All this becomes the reason that body weight begins to grow rapidly.

Lithogenesis

When a person has consumed a lot of fat and it is enough to fill all the needs of the body, then the remains of it begin to be deposited. Sometimes this can happen quite quickly, as a person consumes a lot of calories, but spends little of them.

Fat can be deposited both under the skin and on the organs. As a result, a person’s mass begins to grow, which causes obesity.

Spring metabolism of fats

In medicine, there is such a term. This exchange can happen to anyone and it is connected with the seasons. A person during the winter may not consume enough vitamins and carbohydrates. All this is due to the fact that rarely anyone eats fresh vegetables and fruits during such a period.

More fiber is consumed in winter, and therefore the lipid process slows down. Calories that the body has not used during this time are stored in fat. In the spring, when a person begins to eat fresh foods, the metabolism accelerates.

In spring, a person moves more, which has a positive effect on metabolism. Light clothing also allows you to burn calories faster. Even with a large weight in a person during this period, one can observe a slight decrease in body weight.

metabolism in obesity

This disease is one of the most common today. They suffer a lot of people on the planet. When a person is fat, this indicates that he has experienced a violation of one or more of the processes described above. Therefore, the body receives more fat than it consumes.

It is possible to determine violations in the work of the lipid process during the diagnosis. The examination must be carried out without fail, if the body weight is more than the norm by 25-30 kilograms.

You can also be examined not only with the appearance of pathology, but also for prevention. It is recommended to conduct testing in a special center where there is the necessary equipment and qualified specialists.

Diagnosis and treatment

To evaluate the operation of the system and identify violations in it, diagnostics are needed. As a result, the doctor will receive a lipid profile, according to which he will be able to track deviations in the system, if any. The standard testing procedure is to donate blood to check the amount of cholesterol in it.

It is possible to get rid of pathologies and bring the process back to normal only with complex treatment. You can also use non-drug methods. It's diet and exercise.

Therapy begins with the fact that all risk factors are initially eliminated. During this period, it is worth giving up alcohol and tobacco. Great for sports therapy.

There are also special methods of treatment with drugs. They resort to the help of this method in the case when all other methods were not effective. In acute forms of the disorder, drug therapy is also commonly used.

The main classes of drugs that can be used for treatment are:

1. fibrates.
2. Statins.
3. Derivatives of nicotinic acid.
4. Antioxidants.

The effectiveness of therapy mainly depends on the state of health of the patient and the presence of other pathologies in the body. Also, the patient himself can influence the correction of the process. For this, only his desire is needed.

He must change his old lifestyle, eat right and exercise. It is also worth undergoing a constant examination in the clinic.

To maintain a normal lipid process, you should use the following recommendations from doctors:

• Do not consume more fat per day.
• Eliminate saturated fats from your diet.
• Eat more unsaturated fats.
• There is fatty until 16.00.
• Give periodic loads on the body.
• To do yoga.
• Enough time to rest and sleep.
• Avoid alcohol, tobacco and drugs.

Doctors recommend that lipid metabolism be given sufficient attention throughout life. To do this, you can simply follow the above recommendations and constantly visit a doctor for an examination. This must be done at least twice a year.

How is fat formed in the human body?

The human body is able to form lipids or triglycerides not only from dietary fats, but also from carbohydrates and proteins. Fats with incoming food enter the gastrointestinal tract, are absorbed in the small intestine, undergo a transformation process and break down into fatty acids and glycerol. There are also internal, endogenous fats that are synthesized in the liver. Fatty acids are a source of a large amount of energy, being a kind of organismic "fuel".

They are absorbed into the blood and, with the help of special transport forms - lipoproteins, chylomicrons, are carried to various organs and tissues. Fatty acids can be used again for the synthesis of triglycerides, fat, and in their excess, stored in the liver and in adipose tissue cells - adipocytes. It is adipocytes with a large supply of triglycerides that create discomfort for a person and are manifested by excess deposits of subcutaneous fat and excess weight. Body fat can also be formed from carbohydrates.

Glucose, fructose, entering the bloodstream with the help of the hormone insulin, can be deposited as triglycerides in the liver and cells. Dietary proteins are also able to transform into triglycerides through a cascade of transformations: split proteins to amino acids are absorbed into the blood, enter the liver, are converted into glucose and, under the action of insulin, become triglycerides stored in adipocytes. So it is very simplified to imagine the process of lipid formation in the human body.

2 Functions of lipids in the body

The role of fats in the human body is difficult to overestimate. They are:

• the main energy source in the body;
• building material for cell membranes, organelles, a number of hormones and enzymes;
• protective "cushion" for the internal organs.

Fat cells carry out thermoregulation, increase the body's resistance to infection, secrete hormone-like substances - cytokines, and also regulate metabolic processes.

3 How are fats used?

Triglycerides deposited “in reserve” can leave adipocytes and be used for the needs of cells when they receive insufficient energy or require structural material to build membranes. Body hormones that have a lipolytic effect - adrenaline, glucagon, somatotropin, cortisol, thyroid hormones, give a signal to adipocytes - lipolysis or the process of fat breakdown occurs.

Having received “instructions” from hormones, triglycerides are broken down into fatty acids and glycerol. Fatty acids are transported into the blood by carriers called lipoproteins. Lipoproteins in the blood interact with cell receptors, which break down lipoproteins and take away fatty acids for further oxidation and use: building membranes or generating energy. Lipolysis can be activated during stress, excessive physical exertion.

4 Why is lipid metabolism disturbed?

Dyslipidemia or a violation of lipid metabolism is a condition in which, for various reasons, there is a change in the content of lipids in the blood (increase or decrease), or the appearance of pathological lipoproteins. The condition is caused by pathological processes in the synthesis, breakdown of fats or their incomplete removal from the blood. Malfunctions in lipid metabolism can lead to an excess of fats in the blood - hyperlipidemia.

According to studies, this condition is typical for 40% of the adult population, and occurs even in childhood.

Violation of lipid metabolism can be triggered by a number of factors that trigger pathological processes of unbalancing the intake and utilization of lipids. Risk factors include:

• hypodynamia or a sedentary lifestyle,
• smoking,
• alcohol abuse,
• increased activity of thyroid hormones,
• overweight,
• diseases that provoke metabolic disorders of lipids.

5 Primary disorders of lipid metabolism

All disorders of lipid metabolism are classified into primary and secondary. The primary ones are caused by genetic defects and are hereditary in nature. There are several forms of primary disorders in lipid metabolism, the most common being familial hypercholesterolemia. This condition is caused by a defect in the gene encoding the synthesis, the function of receptors that bind to certain lipoproteins. There are several forms of pathology (homo- and heterozygous), they are united by the hereditary nature of the disease, high cholesterol levels from the moment of birth, early development of atherosclerosis and coronary artery disease.

A doctor may suspect hereditary dyslipoproteinemia in a patient if:

• early myocardial infarction;
• significant damage to the vessels by the atherosclerotic process at a young age;
• available data on the incidence of coronary artery disease, cardiovascular accidents in close relatives at a young age.

6 Secondary disorders of lipid metabolism

These disorders of lipid metabolism develop as a consequence of many diseases, as well as as a result of the use of certain drugs.

Causes of elevated blood lipids:

• diabetes,
• obesity,
• hypothyroidism,
• medications: progesterone, thiazides, estrogens, glucocorticoids,
• chronic renal failure,
• stress.

Reasons for low lipid levels:

• malabsorption syndrome,
• undernutrition, malnutrition,
• tuberculosis,
• chronic liver disease,
• AIDS.

Secondary dyslipidaemia is very common in type 2 diabetes mellitus. It is always accompanied by atherosclerosis - a change in the walls of blood vessels with the deposition of “plaques” of excess cholesterol and other lipid fractions on them. Among patients with diabetes, the most common cause of death is coronary artery disease caused by atherosclerotic disorders.

7 Consequences of high blood lipids

Excessively “fatty” blood is enemy No. 1 for the body. An excessive amount of lipid fractions, as well as defects in their utilization, inevitably lead to the fact that “everything superfluous” settles on the vascular wall with the formation of atherosclerotic plaques. Metabolic lipid disorders lead to the development of atherosclerosis, which means that in such patients the risk of developing coronary heart disease, stroke, and heart rhythm disturbances increases many times over.

8 Signs indicating disorders of lipid metabolism

An experienced physician may suspect dyslipidaemia in a patient on examination. External signs indicating the existing running violations will be:

• multiple yellowish formations - xanthomas located on the trunk, abdomen, forehead skin, as well as xanthelasma - yellow spots on the eyelids;
• men may experience early graying of hair on the head and chest;
• frosted ring on the edge of the iris.

All external signs are a relative indication of a violation of lipid metabolism, and to confirm it, a complex of laboratory and instrumental studies is needed to confirm the doctor's assumptions.

9 Diagnosis of lipid metabolism disorders

There is a screening program to detect dyslipidemia, which includes:

• general analysis of blood, urine,
• BAC: determination of total cholesterol, TG, LDL cholesterol, VLDL, HDL, ASAT, ALAT, bilirubin, protein, protein fractions, urea, alkaline phosphatase,
• determination of blood glucose, and if there is a tendency to increase - a test for glucose tolerance,
• determination of abdominal circumference, Quetelet index,
• measurement of blood pressure,
• Examination of the vessels of the fundus,
• echocardiography,
• X-ray of the OGK.

This is a general list of studies, which, in case of lipid metabolism disorders, can be expanded and supplemented at the discretion of the doctor.

10 Treatment of lipid disorders

Therapy of secondary dyslipidemia is aimed primarily at eliminating the underlying disease that caused the lipid metabolism disorder. Correction of glucose levels in diabetes mellitus, normalization of body weight in obesity, treatment of malabsorption and in the gastrointestinal tract are guaranteed to improve lipid metabolism. Elimination of risk factors and a lipid-lowering diet in violation of lipid metabolism is the most important part on the path to recovery.

Patients should stop smoking, stop drinking alcohol, lead an active lifestyle and fight physical inactivity. The food should be enriched with PUFAs (they contain liquid vegetable oils, fish, seafood), the total intake of fats and foods containing saturated fats (butter, eggs, cream, animal fat) should be reduced. Drug therapy for lipid metabolism disorders includes the use of statins, fibrates, nicotinic acid, bile acid sequestrants, as indicated.