{"id":188,"date":"2026-06-03T05:33:52","date_gmt":"2026-06-03T05:33:52","guid":{"rendered":"https:\/\/patrickwahlberg.com\/?p=188"},"modified":"2026-11-07T09:08:37","modified_gmt":"2026-11-07T09:08:37","slug":"kolesterol-lipoproteiner","status":"publish","type":"post","link":"https:\/\/patrickwahlberg.com\/sv\/kolesterol-lipoproteiner","title":{"rendered":"Kolesterol, lipoproteiner och varf\u00f6r riskbed\u00f6mning \u00e4r mer komplex \u00e4n \u201dbra\u201d och \u201dd\u00e5ligt\u201d"},"content":{"rendered":"\n<figure class=\"wp-block-image size-large pw-article-opening-image\"><img loading=\"lazy\" decoding=\"async\" width=\"1500\" height=\"1000\" src=\"https:\/\/patrickwahlberg.com\/wp-content\/uploads\/2026\/11\/pw-blog-cholesterol-blood-tests.jpg\" alt=\"Laboratory blood samples\" class=\"wp-image-714\" srcset=\"https:\/\/patrickwahlberg.com\/wp-content\/uploads\/2026\/11\/pw-blog-cholesterol-blood-tests.jpg 1500w, https:\/\/patrickwahlberg.com\/wp-content\/uploads\/2026\/11\/pw-blog-cholesterol-blood-tests-300x200.jpg 300w, https:\/\/patrickwahlberg.com\/wp-content\/uploads\/2026\/11\/pw-blog-cholesterol-blood-tests-1024x683.jpg 1024w, https:\/\/patrickwahlberg.com\/wp-content\/uploads\/2026\/11\/pw-blog-cholesterol-blood-tests-768x512.jpg 768w, https:\/\/patrickwahlberg.com\/wp-content\/uploads\/2026\/11\/pw-blog-cholesterol-blood-tests-18x12.jpg 18w\" sizes=\"auto, (max-width: 1500px) 100vw, 1500px\" \/><\/figure>\n\n\n\n<style>\nbody.single-post .entry-content>.pw-blog-section-title{box-sizing:border-box!important;width:100%!important;max-width:800px!important;margin:48px auto 19px!important;padding:0 0 12px!important;border-bottom:1px solid #e3e3e0!important;color:#171717!important;font-family:Arial,Helvetica,sans-serif!important;font-weight:750!important;font-size:29px!important;line-height:1.26!important;letter-spacing:-.025em!important;}\nbody.single-post .entry-content>h2:not(.pw-blog-section-title){max-width:800px!important;margin:55px auto 20px!important;font-family:Arial,Helvetica,sans-serif!important;font-weight:750!important;font-size:29px!important;line-height:1.26!important;}\nbody.single-post .entry-content>h3{max-width:800px!important;margin:35px auto 15px!important;font-size:23px!important;line-height:1.3!important;}\nbody.single-post .entry-content>p,body.single-post .entry-content>ul,body.single-post .entry-content>ol{max-width:800px!important;margin-left:auto!important;margin-right:auto!important;line-height:1.82!important;}\nbody.single-post .entry-content>figure.pw-article-opening-image{max-width:1040px!important;margin:15px auto 35px!important;}\nbody.single-post .entry-content>figure.pw-article-opening-image img{display:block!important;width:100%!important;max-height:470px!important;height:auto!important;object-fit:cover!important;border-radius:5px!important;}\n.pw-post-en{display:inline!important}.pw-post-sv{display:none!important}html[lang^=\"sv\"] .pw-post-en{display:none!important}html[lang^=\"sv\"] .pw-post-sv{display:inline!important}\n@media(max-width:720px){body.single-post .entry-content>.pw-blog-section-title,body.single-post .entry-content>h2:not(.pw-blog-section-title){font-size:24px!important;margin-top:36px!important}body.single-post .entry-content>h3{font-size:20px!important}body.single-post .entry-content>p{line-height:1.75!important}}\n<\/style>\n\n\n>\n\n\n<h2 class=\"wp-block-heading pw-blog-section-title\"><span class=\"pw-post-en\" lang=\"en\" translate=\"no\">Understanding Cholesterol and Lipoproteins<\/span><span class=\"pw-post-sv\" lang=\"sv\" translate=\"no\">F\u00f6rst\u00e5 kolesterol och lipoproteiner<\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">When doctors discuss lipid levels, they usually mean the fats circulating in the blood, primarily triglycerides and cholesterol. Cholesterol is a yellowish-white, waxy molecule found in every cell membrane and used to produce steroid hormones, vitamin D and bile acids. Because cholesterol does not dissolve in water, it travels through the bloodstream in lipoproteins\u2014particles that carry fatty substances through a water-based environment.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">This is where the simplified story of \u201cgood\u201d HDL and \u201cbad\u201d LDL becomes inadequate. HDL and LDL are not cholesterol themselves; they are particles that transport it. There are also several classes of lipoproteins, including chylomicrons, VLDL, IDL, LDL and HDL, with different sizes, densities and biological functions. Reducing lipid assessment to \u201chigh LDL is bad\u201d and \u201chigh HDL is good\u201d therefore gives an incomplete picture of cardiovascular risk.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Ancel Keys and the Cholesterol Hypothesis<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Ancel Keys had a profound influence on how cholesterol and cardiovascular disease were understood in the twentieth century. His work helped establish the diet\u2013heart hypothesis, which identified saturated fat and cholesterol as major drivers of heart disease. It was an influential model, but one subsequently criticised for being overly simplistic and for failing to capture the full complexity of metabolism, insulin resistance, inflammation, particle size and lifestyle.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The important point is not that everything Keys said was wrong, but that his model was long used as though it explained the whole picture. Modern lipidology shows that risk is not just about how much cholesterol is in the blood; it also concerns how lipids are transported, how many particles are circulating, their size and the metabolic environment in which they occur.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Why Total Cholesterol Is Not Enough<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Total cholesterol is a crude measure. It tells us how much cholesterol is in the blood but little about how it is distributed among lipoproteins or how many atherogenic particles are actually circulating. Two people can have the same total cholesterol but very different risk profiles depending on triglycerides, LDL particle number, HDL levels, apoB and lipoprotein(a).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">That is why many experts consider total cholesterol, and even LDL-C, insufficient as stand-alone risk markers. LDL-C measures the amount of cholesterol carried in LDL particles, not the number of LDL particles themselves. LDL-P, which measures particle number, can therefore provide additional information when LDL-C and particle number are discordant.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Why Ratios Matter<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Ratios can provide a more informative picture of lipid metabolism than isolated results. Common examples include:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>The triglyceride-to-HDL ratio.<\/li>\n\n\n<li>The total cholesterol-to-HDL ratio.<\/li>\n\n\n<li>The LDL-to-HDL ratio.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">These ratios are used because they reflect relationships between different lipid fractions rather than absolute levels alone. An unfavourable ratio can reflect insulin resistance, a higher particle burden and a more atherogenic metabolic profile, even when an individual result does not appear dramatically abnormal. A low ratio, by contrast, is often consistent with a more favourable metabolic state.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The triglyceride-to-HDL ratio, in particular, is often used as an indirect marker of metabolic health. High triglycerides combined with low HDL are common in insulin resistance, overweight and type 2 diabetes. The ratio cannot establish a diagnosis on its own, but it can provide useful context.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">LDL-C, LDL-P and Particle Size<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">A key distinction in modern lipidology is the difference between LDL-C and LDL-P. LDL-C measures the cholesterol within LDL particles, while LDL-P measures how many LDL particles are circulating. These values can sometimes tell different stories. One person may have relatively large, cholesterol-rich LDL particles and therefore fewer particles at a given LDL-C level, while another may have small, cholesterol-poor particles and more particles despite having the same LDL-C.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">This matters because the number of atherogenic particles often better reflects the risk of cholesterol entering the arterial wall. Pattern B, characterised by smaller, denser LDL particles, is often associated with higher risk and metabolic conditions such as insulin resistance, high triglycerides and diabetes. Pattern A, involving larger, more buoyant particles, is generally considered less unfavourable.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Is High Cholesterol Unhealthy?<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">High cholesterol cannot automatically be labelled unhealthy. Context is crucial. Elevated lipid values can occur in people with good metabolic health, but also in those with underlying illness, malnutrition or other medical conditions. Results must therefore be interpreted alongside the wider picture: symptoms, body composition, inflammation, thyroid function, liver health, insulin status and lifestyle.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The point is not that low levels are always good or always bad, but that simple conclusions cannot be drawn without context. Lipid values are biomarkers, not moral judgements. They must be considered alongside other factors to be meaningful.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">What Should Actually Be Measured?<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">To assess cardiovascular risk more thoroughly than with a standard lipid panel, the following markers may be informative:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Triglycerides.<\/li>\n\n\n<li>HDL.<\/li>\n\n\n<li>LDL-P or apoB, if available.<\/li>\n\n\n<li>Lipoprotein(a).<\/li>\n\n\n<li>Ratios such as triglycerides\/HDL.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">ApoB is often particularly useful because it reflects the number of atherogenic particles. In some circumstances, it is more directly associated with risk than the total amount of cholesterol. Lipoprotein(a) also matters because elevated levels are an established cardiovascular risk factor.<\/p>\n\n\n\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><thead><tr><th>Marker<\/th><th>Often desired target<\/th><th>Comment<\/th><\/tr><\/thead><tbody><tr><td>Triglycerides<\/td><td>Below 1.0 mmol\/L, ideally below 0.8<\/td><td>Lower values generally suggest a more favourable metabolic profile.<\/td><\/tr><tr><td>HDL<\/td><td>Above 1.2 mmol\/L, ideally above 1.5<\/td><td>Higher HDL often accompanies better metabolic health but must be interpreted alongside other markers.<\/td><\/tr><tr><td>ApoB<\/td><td>Often below 0.8 g\/L; lower with high risk<\/td><td>ApoB reflects atherogenic particle number better than LDL-C in many situations. It needs context and should not be the only factor driving decisions.<\/td><\/tr><tr><td>LDL-P<\/td><td>Preferably low, particularly when apoB is also elevated<\/td><td>A particle-number measure that can be more informative than LDL-C when results are discordant.<\/td><\/tr><tr><td>Triglycerides\/HDL<\/td><td>Below 1.0 when both values are in mmol\/L; clearly below this is often favourable<\/td><td>A low ratio is often favourable and may indicate better insulin sensitivity.<\/td><\/tr><tr><td>Lipoprotein(a)<\/td><td>As low as possible; often below 75 nmol\/L or 30 mg\/dL, depending on units and laboratory<\/td><td>Lp(a) is largely genetically determined and is an established risk marker.<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\">Conclusion<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Cholesterol is an essential molecule, not a poison. The issue is not the existence of cholesterol in the body, but how it is transported, which particles carry it and the metabolic environment in which it operates. The old idea that total cholesterol alone can explain cardiovascular risk is too simplistic. At the same time, it would be wrong to dismiss established lipid research or claim that low cholesterol is invariably healthy.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The most reasonable approach is therefore a nuanced one: assess risk using several markers, understand the ratios, examine particle number and metabolic context, and never allow a single number to tell the entire story.<\/p>\n\n","protected":false},"excerpt":{"rendered":"<p>When doctors discuss lipid levels, they usually mean the fats circulating in the blood, primarily triglycerides and cholesterol. Cholesterol is found in every cell membrane and is used to produce steroid hormones, vitamin D and bile acids.<\/p>","protected":false},"author":1,"featured_media":714,"comment_status":"closed","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_hide_featured_image":false,"_jetpack_featured_image_duplicate_dismissed":0,"_jetpack_feature_clip_id":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_post_was_ever_published":false},"categories":[33],"tags":[],"class_list":["post-188","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-metabolic-health"],"jetpack_sharing_enabled":true,"jetpack_featured_media_url":"https:\/\/patrickwahlberg.com\/wp-content\/uploads\/2026\/11\/pw-blog-cholesterol-blood-tests.jpg","_links":{"self":[{"href":"https:\/\/patrickwahlberg.com\/sv\/wp-json\/wp\/v2\/posts\/188","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/patrickwahlberg.com\/sv\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/patrickwahlberg.com\/sv\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/patrickwahlberg.com\/sv\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/patrickwahlberg.com\/sv\/wp-json\/wp\/v2\/comments?post=188"}],"version-history":[{"count":10,"href":"https:\/\/patrickwahlberg.com\/sv\/wp-json\/wp\/v2\/posts\/188\/revisions"}],"predecessor-version":[{"id":768,"href":"https:\/\/patrickwahlberg.com\/sv\/wp-json\/wp\/v2\/posts\/188\/revisions\/768"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/patrickwahlberg.com\/sv\/wp-json\/wp\/v2\/media\/714"}],"wp:attachment":[{"href":"https:\/\/patrickwahlberg.com\/sv\/wp-json\/wp\/v2\/media?parent=188"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/patrickwahlberg.com\/sv\/wp-json\/wp\/v2\/categories?post=188"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/patrickwahlberg.com\/sv\/wp-json\/wp\/v2\/tags?post=188"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}