Total Cholesterol/HDL Ratio

Lipid Panel

A healthy result should fall into the range 0 - 5 Ratio.

The total cholesterol /HDL ratio is the proportion of one type of cholesterol to all the other cholesterol in the blood. Total cholesterol includes three substances HDL, LDL, and VLDL. 

HDL stands for high density lipoprotein, LDL stands for low density lipoprotein and, VLDL stands for very low density lipoprotein. LDL is known as “bad” cholesterol and HDL is known as “good” cholesterol. VLDL is not necessarily “good” either, but there is a lot less of it in the blood than the other two types. VLDL is made up mostly of triglycerides. LDL and VLDL are thought of as bad because high levels of these substances cause heart disease and blood vessel disease. People with high levels of LDL and VLDL are at higher risk of heart attack and stroke. People with higher levels of HDL are less likely to have heart attack and stroke. People can improve their total cholesterol /HDL ratio by getting more aerobic exercise and reducing the amount of saturated fat they eat, and taking certain types of cholesterol-lowering medications.  

Normal Ranges for Total Cholesterol /HDL Ratio:

Men: Less than 4.5

Women: Less than 4.0

Children to up 18 years of age: Less than 4.0

Critical Range: 5 or higher 

 

Sources:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2747394/

http://www.uptodate.com/contents/lipoprotein-classification-metabolism-and-role-in-atherosclerosis

https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/expert-answers/cholesterol-ratio/faq-20058006

https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=167&ContentID=lipid_panel_hdl_ratio

https://www.medicalnewstoday.com/articles/316173.php

www.merckmanuals.com/professional/endocrine-and-metabolic-disorders/lipid-disorders/hypolipidemia

http://press.endocrine.org/doi/abs/10.1210/jcem.85.12.7027 

www.merckmanuals.com/professional/endocrine-and-metabolic-disorders/lipid-disorders/dyslipidemia

https://www.uptodate.com/contents/hypertriglyceridemia?source=see_link#H3

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What does it mean if your Total Cholesterol/HDL Ratio result is too low?

The total cholesterol /HDL ratio cannot be too low. However, total cholesterol may be very low or HDL can become very high. Most people do not have any symptoms when these things occur. When cholesterol levels are very low, people may experience confusion and memory problems. In rare cases, the person may have a genetic condition that is causing low cholesterol. It is also possible that they are experiencing a severe disease such as cancer or severe anemia. Cholesterol medications can also lower the total cholesterol /HDL ratio.

Some specific causes of a low total cholesterol /HDL cholesterol ratio are:

  • Cholesteryl ester transfer protein deficiency
  • Familial hyperalphalipoproteinemia
  • Abetalipoproteinemia
  • Hypobetalipoproteinemia
  • Chylomicron retention disease
  • Anorexia
  • Undernutrition
  • Malabsorption
  • Advanced, non-cholestatic liver disease
  • Malignant cancer
  • Drugs
    • Statins
    • Bile acid sequestrants
    • Ezetimibe

What does it mean if your Total Cholesterol/HDL Ratio result is too high?

If your total cholesterol /HDL ratio is too high, it means your total cholesterol is too high, your HDL is too low, or both. Most people do not have any symptoms when total cholesterol /HDL ratio is too high. When cholesterol levels are very high, however, people may notice collections of cholesterol under the skin of the hands and around the eyes. 

Some specific causes of a high total cholesterol /HDL cholesterol ratio are: 

  • Obesity 
  • Sedentary lifestyle 
  • Alcohol overuse
  • Diabetes mellitus 
  • Hypothyroidism
  • Cholestatic liver diseases
  • Chronic kidney disease
  • Certain drugs such as:
    • Thiazides
    • Beta-blockers
    • Retinoids
    • Glucocorticoids
    • Highly active antiretroviral agents
    • Oral estrogens
    • Antirejection drugs
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