Cholesterol and Triglyceride Changes in Health Checkups

Q: Cholesterol and Triglyceride Changes in Health Checkups

Hello： The main factors affecting triglycerides include a high-fat, high-calorie diet, overweight and increased waist circumference, diabetes, alcohol consumption, and the use of female hormones. <br>The sources of cholesterol come partly from synthesis and metabolism in the live

Health check report: Elevated cholesterol levels, but decreased triglycerides?

Hello, doctor.
Three years ago, my health check report showed a height of 156 cm and weight of 48.3 kg, with total cholesterol at 202 mg/dL, HDL at 85 mg/dL, LDL at 107 mg/dL, and triglycerides at 50 mg/dL.
This year's health check report indicates a height of 156 cm and weight of 43.6 kg, with total cholesterol at 219 mg/dL, HDL at 82 mg/dL, LDL at 129 mg/dL, and triglycerides at 41 mg/dL.
Normally, since I have lost nearly 5 kg, my total cholesterol should have decreased as well.
I would like to ask why my triglycerides have decreased but my cholesterol has increased? Is this normal? What could explain this situation?

wander, 30~39 year old female. Ask Date: 2021/06/05

Dr. Lin Jianliang reply Internal Medicine

Hello: The main factors affecting triglycerides include a high-fat, high-calorie diet, overweight and increased waist circumference, diabetes, alcohol consumption, and the use of female hormones.
The sources of cholesterol come partly from synthesis and metabolism in the liver and partly from diet.
Consuming foods or products high in cholesterol and being overweight can also increase cholesterol levels.
It is important to note that hypercholesterolemia is not exclusively associated with obesity; individuals with normal or even low body weight can also have elevated cholesterol levels.
Additionally, some individuals with familial hypercholesterolemia or genetic abnormalities may also experience high cholesterol levels.
Furthermore, conditions such as hypothyroidism and nephrotic syndrome are also commonly associated with hypercholesterolemia.

Reply Date: 2021/06/05

More Info

Understanding the changes in cholesterol and triglyceride levels during health checkups can be complex, especially when considering factors such as weight loss, diet, and metabolic changes. In your case, you have experienced a weight loss of nearly 5 kg, yet your total cholesterol has increased from 202 mg/dL to 219 mg/dL, while your triglycerides have decreased slightly from 50 mg/dL to 41 mg/dL. This situation raises valid questions about the relationship between weight, cholesterol levels, and overall health.

Firstly, it is important to understand that cholesterol and triglycerides are both types of lipids found in the blood, but they serve different functions. Cholesterol is essential for building cell membranes and producing hormones, while triglycerides are primarily used for energy. The body regulates these lipids through a complex interplay of diet, metabolism, and hormonal influences.

Your weight loss could suggest improvements in certain health markers, but it does not automatically guarantee a decrease in cholesterol levels. Several factors could explain why your total cholesterol has increased despite weight loss:
1. Dietary Changes: Even if you have lost weight, the composition of your diet plays a crucial role in lipid levels. If your diet has included more saturated fats or trans fats, this could lead to an increase in LDL (low-density lipoprotein) cholesterol, which is often referred to as "bad" cholesterol. Conversely, a diet rich in healthy fats (like those from fish, nuts, and avocados) can help improve HDL (high-density lipoprotein) cholesterol levels.

2. Genetic Factors: Genetics can significantly influence cholesterol metabolism. Some individuals may have a genetic predisposition to higher cholesterol levels, regardless of weight or diet. Conditions such as familial hypercholesterolemia can lead to elevated cholesterol levels even in otherwise healthy individuals.

3. Hormonal Changes: Hormones, particularly those related to thyroid function and insulin sensitivity, can affect lipid metabolism. Weight loss can sometimes lead to changes in hormone levels that might influence how your body processes cholesterol and triglycerides.

4. Physical Activity: Regular exercise can improve lipid profiles by increasing HDL cholesterol and lowering triglycerides. If your physical activity level has changed alongside your weight loss, this could also impact your cholesterol levels.

5. Body Composition: Weight loss does not always equate to fat loss; it can also include muscle loss or changes in body composition that affect metabolism. If your body composition has shifted, it could influence how your body processes lipids.

In your case, while your triglycerides have decreased, which is generally a positive sign, the increase in total cholesterol warrants further investigation. It would be beneficial to look at the breakdown of your cholesterol levels, specifically the LDL and HDL levels, to assess your cardiovascular risk more accurately.
Additionally, consider discussing your dietary habits with a healthcare provider or a registered dietitian. They can help identify any potential dietary factors contributing to your cholesterol levels and suggest modifications to improve your lipid profile. Regular monitoring of your cholesterol levels, along with lifestyle modifications such as a balanced diet and regular exercise, can help manage your lipid levels effectively.

In summary, while weight loss is typically associated with improved health markers, the relationship between weight, cholesterol, and triglycerides is multifaceted. It is essential to consider dietary habits, genetic predispositions, hormonal influences, and lifestyle factors when interpreting changes in lipid levels. Regular follow-ups with your healthcare provider will help ensure that you maintain a healthy lipid profile and overall well-being.

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