Total Cholesterol

• Normal range : <200 mg/dl
• Boderline high : 200-240 mg/dl
• High risk : >240 mg/dl

For children and Adolescents:

• Acceptable : <170 mg/dl
• Boderline 170 -200 mg/dl
• High >200 mg/dl

• Cholesterol is an important normal body constituent used in the structure of cell membranes, synthesis of bile acids , and synthesis of steroid hormones . Since cholesterol is water insoluble, most serum cholesterol is carried by lipoproteins (Chylomicrons, VLDL,LDL and HDL) . 
• A small amount of Cholesterol circulates in the blood in complex particles called Lipo proteins. Each particle contains a combination of protein, cholesterol, triglyceride, and phospholipid molecules and the particles are classified by their density into HDL, LDL and VLDL.
• The body synthesizes 60- 80 % of its cholesterol , primarily in the liver and intestine , and delivers the reminder from diet. Although elevated cholesterol is linked to increased atherosclerosis, cholesterol also functions as a natural protector of cell membranes due to its free radical scavenging activity. The extra cholesterol in the blood may be deposited in plaques on the walls of blood vessels. Plaques can narrow or eventually block the opening of blood vessels, leading to Atherosclerosis and increased risk of numerous health problems. 
• The higher the serum cholesterol the more frequently associated heart disease is found.

• As a screening test for adults with no risk factors for heart disease
• When a person has one or more risk factors for heart disease( Cigarette smoking, Being overweight or Obese, old age , Pre existing heart disease, diabetes)

• Biliary cirrhosis
• Familial hyperlipidemia
• High cholesterol diet
• Hypothyroidism
• Nephritic syndrome
• Uncontrolled diabetes 
• pregnancy
• Oophorectomy may increase cholesterol levels 
• Drugs - ACTH, Anabolic steroids , Beta adrenergic blocking agents , Corticosteroids , Epinephrine, Oral contraceptives , Phenytoin , Sulphonamides , Diuretics and Vit D

• Hyperthyroidism
• Liver diseases
• Mal absorption
• Malnutrition
• Pernicious Anaemia
• Sepsis
• Drugs - Allopurinol, Androgens , Captopril, Colchicines , Lovastatin , Niacin, Nitrates