LDLkolesterol

LDLkolesterol, commonly referred to as LDL cholesterol, is a lipoprotein particle that transports cholesterol through the bloodstream. It is one of several lipoproteins that move lipids around the body. LDL particles deliver cholesterol to cells but can contribute to atherosclerosis when present at high levels.

LDL cholesterol is measured in milligrams per deciliter (mg/dL) or millimoles per liter (mmol/L). Levels are usually obtained from a fasting lipid panel. The Friedewald equation estimates LDL when triglycerides are not extremely high; direct measurement is available. Clinicians also consider non-HDL cholesterol and apoB as related markers.

Elevated LDL cholesterol is a major risk factor for atherosclerotic cardiovascular disease, including heart attack and stroke. LDL particles can infiltrate artery walls, become oxidized, and promote inflammation and plaque formation. Net risk depends on LDL level together with other factors such as blood pressure, diabetes, smoking, and age.

Several factors influence LDL levels, including diet (saturated and trans fats), body weight, physical activity, and genetics. Familial hypercholesterolemia causes very high LDL from a young age. Medications are often used when lifestyle changes are insufficient or cardiovascular risk is high.

Management emphasizes lifestyle changes and pharmacotherapy. First-line treatment is typically statin therapy to reduce LDL production in the liver. Other options include ezetimibe, PCSK9 inhibitors, bempedoic acid, and inclisiran. Target LDL levels vary by individual risk, with lower targets for those with established cardiovascular disease.