LIPIDS

“Lipids are organic compounds that contain hydrogen, carbon, and oxygen atoms, which
forms the framework for the structure and function of living cells.”
What are Lipids?
These organic compounds are nonpolar molecules, which are soluble only in nonpolar solvents
and insoluble in water because water is polar molecules. In the human body, these molecules can
be synthesized in the liver and are and generally found in the oil, butter, whole milk, cheese,
fried foods, and also in some red meats.
Let us have a detailed look at the lipid structure, properties, types and classification of lipids.

Properties of Lipids
Lipids are a family of organic compounds, composed of fats and oils. These molecules yield high
energy and are responsible for different functions within the human body. Listed below are some
important characteristics of Lipids.
1. Lipids are oily or greasy nonpolar molecules, stored in the adipose tissue of the body.
2. Lipids are a heterogeneous group of compounds, mainly composed of hydrocarbon
chains.
3. Lipids are energy-rich organic molecules, which provide energy for different life
processes.
 4. Lipids are a class of compounds distinguished by their insolubility in water and solubility
in nonpolar solvents.
5. Lipids are important in biological systems because they form the cell membrane, a
mechanical barrier that divides a cell from the external environment.
Lipid Structure
Lipids are the polymers of fatty acids that contain a long, non-polar hydrocarbon chain with a
small polar region containing oxygen. The lipid structure is explained in the diagram below:

Lipid Structure – Saturated and Unsaturated Fatty Acids

Classification of Lipids
Lipids can be classified into two major classes:
 Nonsaponifiable lipids, and
 Saponifiable lipids.
Nonsaponifiable Lipids
A nonsaponifiable lipid cannot be broken up into smaller molecules by hydrolysis, which
includes triglycerides, waxes, phospholipids, and sphingolipids.
Saponifiable Lipids
 A saponifiable lipid contains one or more ester groups allowing it to undergo hydrolysis
in the presence of an acid, base, or enzymes.
 Nonsaponifiable lipids include steroids, prostaglandins, and terpenes.
  Each of these categories can be further broken down into non-polar and polar lipids.
 Nonpolar lipids, such as triglycerides, are used for energy storage and fuel.
 Polar lipids, which can form a barrier with an external water environment, are used in
membranes.
 Polar lipids include glycerophospholipids and sphingolipids.
Fatty acids are important components of all of these lipids.
Types of Lipids
Within these two major classes of lipids, there are several specific types of lipids important to
live, including fatty acids, triglycerides, glycerophospholipids, sphingolipids, and steroids. These
are broadly classified as simple lipids and complex lipids.
Simple Lipids
Esters of fatty acids with various alcohols.
1. Fats: Esters of fatty acids with glycerol. Oils are fats in the liquid state.
2. Waxes: Esters of fatty acids with higher molecular weight monohydric alcohols
Complex Lipids
Esters of fatty acids containing groups in addition to alcohol and a fatty acid.
1. Phospholipids: Lipids containing, in addition to fatty acids and alcohol, a phosphoric
acid residue. They frequently have nitrogen-containing bases and other substituents, eg,
in glycerophospholipids the alcohol is glycerol and in sphingophospholipids the alcohol
is sphingosine.
2. Glycolipids (glycosphingolipids): Lipids containing a fatty acid, sphingosine, and
carbohydrate.
3. Other complex lipids: Lipids such as sulfolipids and amino lipids. Lipoproteins may
also be placed in this category

Precursor and Derived Lipids

These include fatty acids, glycerol, steroids, other alcohols, fatty aldehydes, and ketone bodies,
hydrocarbons, lipid-soluble vitamins, and hormones. Because they are uncharged, acylglycerols
(glycerides), cholesterol, and cholesteryl esters are termed neutral lipids. These compounds are
produced by the hydrolysis of simple and complex lipids.
Some of the different types of lipids are described below in detail.
Fatty Acids
Fatty acids are carboxylic acids (or organic acid), often with long aliphatic tails (long chains),
either saturated or unsaturated.
 Saturated fatty acids
When a fatty acid is saturated it is an indication that there are no carbon-carbon double bonds.
The saturated fatty acids have higher melting points than unsaturated acids of the corresponding
size due to their ability to pack their molecules together thus leading to a straight rod-like shape.
 Unsaturated fatty acids
If a fatty acid has more than one double bond then this is an indication that it is an unsaturated
fatty acid.
“Most naturally occurring fatty acids contain an even number of carbon atoms and are
unbranched.”
Unsaturated fatty acids, on the other hand, have a cis-double bond(s) that create a kink in their
structure which doesn’t allow them to group their molecules in straight rod-like shape.
Role of Fats
Fats play several major roles in our body. Some of the important roles of fats are mentioned
below:
 Fats incorrect amounts are necessary for the proper functioning of our body.
 Many fat-soluble vitamins need to be associated with fats in order to be effectively
absorbed by the body.
 They also provide insulation to the body.
 They are an efficient way to store energy for longer periods.
Waxes
Waxes are “esters” (an organic compound made by replacing the hydrogen with acid by an alkyl
or another organic group) formed from long-chain carboxylic acids and long-alcohols.
Waxes are seen all over in nature. The leaves and fruits of many plants have waxy coatings,
which may protect them from dehydration and small predators.
The feathers of birds and the fur of some animals have similar coatings which serve as a water
repellent.
Carnauba wax is valued for its toughness and water resistance (great for car wax).
Phospholipids

Membranes are chiefly made of phospholipids which are Phosphoacylglycerols.

Triacylglycerols and phosphoacylglycerols are similar however the terminal OH group of the
phosphoacylglycerol is esterified with phosphoric acid instead of fatty acid which leads to the
formation of phosphatidic acid.
The name phospholipid comes from the fact that phosphoacylglycerols are lipids that contain a
phosphate group.
Steroids

The chemical messengers in our bodies are known as hormones which are organic compounds
synthesized in glands and delivered by the bloodstream to certain tissues in order to stimulate or
inhibit the desired process.
Steroids are a type of hormone which is usually recognized by their tetracyclic skeleton,
consisting of three fused six-membered and one five-membered ring, as shown in the diagram
above. The four rings are designated as A, B, C & D as noted in blue, and the numbers in red
represent the carbons.

CHOLESTEROL
 Cholesterol is waxy like substance, found only in animal source foods. Triglycerides, LDL,
HDL, VLDL are different types of cholesterol found in the blood cells.
 Cholesterol is an important lipid found in the cell membrane. It is a sterol, which means that
cholesterol is a combination of steroid and alcohol. In the human body, cholesterol is
synthesized in the liver.
 These compounds are biosynthesized by all living cells and are essential for the structural
component of the cell membrane.
 In the cell membrane, the steroid ring structure of cholesterol provides a rigid hydrophobic
structure that helps boost the rigidity of the cell membrane. Without cholesterol, the cell
membrane would be too fluid.
 It is an important component of cell membranes and is also the basis for the synthesis of
other steroids, including the sex hormones estradiol and testosterone, as well as other
steroids such as cortisone and vitamin D.

Blood Lipids
 Lipid logistics: transport of triglycerides and cholesterol in organisms in form of lipoproteins
as chylomicrons, VLDL, LDL, IDL, HDL.
 As an isolated molecule, cholesterol is only minimally soluble in water, or hydrophilic.
 Because of this, it dissolves in blood at exceedingly small concentrations.
 To be transported effectively, cholesterol is instead packaged within lipoproteins,
complex discoidal particles with exterior amphiphilic proteins and lipids, whose outward-
facing surfaces are water-soluble and inward-facing surfaces are lipid-soluble.
 This allows it to travel through the blood via emulsification.
 Unbound cholesterol, being amphipathic, is transported in the monolayer surface of the
lipoprotein particle along with phospholipids and proteins.
 Cholesterol esters bound to fatty acid, on the other hand, are transported within the fatty
hydrophilic core of the lipoprotein, along with triglyceride.
 There are several types of lipoproteins in the blood. In order of increasing density, they
are chylomicrons, very-low-density lipoprotein (VLDL), intermediate-density
lipoprotein (IDL), low-density lipoprotein (LDL), and high-density lipoprotein (HDL).
 HDL is known as “good cholesterol” because it transports cholesterol to your liver to be
expelled from your body. HDL helps rid your body of excess cholesterol so it’s less likely to
end up in your arteries.
 LDL is called “bad cholesterol” because it takes cholesterol to your arteries, where it may
collect in artery walls. Too much cholesterol in your arteries may lead to a buildup of plaque
known as atherosclerosis. This can increase the risk of blood clots in your arteries. If a blood
clot breaks away and blocks an artery in your heart or brain, you may have a stroke or heart
attack.
 Plaque buildup may also reduce blood flow and oxygen to major organs. Oxygen deprivation
to your organs or arteries may lead to kidney disease or peripheral arterial disease, in addition
to a heart attack or stroke.
 Lower protein/lipid ratios make for less dense lipoproteins. Cholesterol within different
lipoproteins is identical, although some is carried as its native "free" alcohol form (the
cholesterol-OH group facing the water surrounding the particles), while others as fatty acyl
esters, known also as cholesterol esters, within the particles
The only way to find out if your cholesterol is high is through a blood test that measures
cholesterol in milligrams per deciliter of blood (mg/dL).
 The fate of cholesterol in the blood is highly determined by its constitution of lipoproteins,
 When you get your cholesterol numbers checked, you’ll receive results for:
 Total blood cholesterol: This includes your HDL, LDL, and 20% of your total
triglycerides. Should be below 200mg/dl
 Triglycerides: This number should be below 150 mg/dL. Triglycerides are a common
type of fat. If your triglycerides are high and your LDL is also high or your HDL is low,
you’re at risk of developing atherosclerosis.
 HDL: The higher this number, the better. It should be at least higher than 55 mg/dL for
females and 45 mg/dL for males.
  LDL: The lower this number, the better. It should be no more than 130 mg/dL if you
don’t have heart disease, blood vessel disease, or diabetes. It should be no more than 100
mg/dL if you have any of those conditions or high total cholesterol.

NB: Triglycerides and cholesterol are both fatty substances known as lipids.
But, triglycerides are fats; cholesterol is not.
Triglycerides store unused calories and provide your body with energy
Cholesterol is used to build cells and certain hormones.

Functions of cholesterol in the body

Cholesterol is essential for making the cell membrane and cell structures and is vital for
synthesis of hormones, vitamin D and other substances.
 Cell membrane synthesis – Cholesterol helps to regulate membrane fluidity over the range
of physiological temperatures. It has a hydroxyl group that interacts with the polar head
groups of the membrane phospholipids and sphingolipids. These exist along with nonpolar
fatty acid chain of the other lipids. Cholesterol also prevents the passage of protons
(positive hydrogen ions) and sodium ions across the plasma membranes.
 Cell transporters and signaling molecules – The cholesterol molecules exist as transporters
and signaling molecules along the membrane. Cholesterol also helps in nerve conduction.
Also associated with endocytosis. Endocytosis means engulfing of foreign molecules by
the cell. Cholesterols help in cell signaling by assisting in the formation of lipid rafts in the
plasma membrane.
 Cholesterol in the myelin sheaths – The nerve cells are covered with a protective layer or
myelin sheath. The myelin sheath is rich in cholesterol. This is because it is derived from
compacted layers of Schwann cell membrane. It helps in providing protection, insulation
and allows more efficient conduction of nerve impulses.
 Role inside the cells – Within the cells, cholesterol is the precursor molecule in several
biochemical pathways. For example, in the liver, cholesterol is converted to bile, which is
then stored in the gallbladder. Bile is made up of bile salts. This helps in making the fats
more soluble and helps in their absorption. Bile salts also aid in absorption of fat soluble
vitamins like Vitamins A, D, E and K.
  Hormones and Vitamin D - Cholesterol is an important precursor molecule for the
synthesis of Vitamin D and the steroid hormones like Corticosteroids, Sex-steroids (Sex
hormones like Estrogen, Progesterone and Testosterone etc.)

 NB: The average amount of blood cholesterol varies with age, typically rising gradually until
one is about 60 years old. There appear to be seasonal variations in cholesterol levels in
humans, more, on average, in winter.

Clinical significance
Hypercholesterolemia
Main articles: Hypercholesterolemia and Lipid hypothesis
According to the lipid hypothesis, elevated levels of cholesterol in the blood lead
to atherosclerosis which may increase the risk of:-
 Heart attack,
 stroke, and
 Peripheral vascular disease.
Causes of high cholesterol
Lifestyle factors that may cause high cholesterol are:
 Obesity
 A diet high in red meat, full-fat dairy products, saturated fats, trans fats, and processed
foods
 A large waist circumference (over 40 inches for men or over 35 inches for women)
 Lack of regular exercise
 Smokers typically have lower HDL cholesterol than nonsmokers. Research shows
quitting smoking can increase HDL. If you smoke, talk to your doctor about smoking
cessation programs or other methods you can use to quit smoking.
 Unmanaged stress may lead to behaviors that can increase LDL and total cholesterol such
as overeating fatty foods, inactivity, and increased smoking.
 In some cases, high LDL is inherited. This condition is called familial
hypercholesterolemia (FH). FH is caused by a genetic mutation that affects the ability of
 a person’s liver to get rid of extra LDL cholesterol. This may lead to high LDL levels and
an increased risk of heart attack and stroke at a young age.
 Diabetes tends to lower "good" cholesterol levels and raise triglyceride and "bad"
cholesterol levels, which increases the risk for heart disease and stroke.
 This common condition is called diabetic dyslipidemia.
 Diabetic dyslipidemia means your lipid profile is going in the wrong direction. It's a
deadly combination that puts patients at risk for premature coronary heart
disease and atherosclerosis.
 Studies show a link between insulin resistance, which is a precursor to type 2
diabetes, and diabetic dyslipidemia, atherosclerosis and blood vessel disease. These
conditions can develop even before diabetes is diagnosed.

How to treat high cholesterol

To treat high cholesterol, doctors often recommend these lifestyle changes:
 stopping smoking
 eating a healthy diet
 exercising regularly
 reducing stress
Sometimes lifestyle changes aren’t enough, especially if you have FH. You may need one or
more medications such as:
 Statins to help your liver get rid of cholesterol
 Bile-acid-binding medications to help your body use extra cholesterol to produce bile
 Cholesterol absorption inhibitors to prevent your small intestines from absorbing
cholesterol and releasing it into your bloodstream
 Injectable medications that cause your liver to absorb more LDL cholesterol
Medications and supplements to reduce triglyceride levels may also be used such as niacin
(Niacor), omega-3 fatty acids, and fibrates.
DIABETES
Diabetes is a disease that occurs when your blood glucose, also called blood sugar, is too high.
Blood glucose is your main source of energy and comes from the food you eat. Insulin,
a hormone made by the pancreas, helps glucose from food get into your cells to be used for
energy. Sometimes your body doesn’t make enough—or any—insulin or doesn’t use insulin
well. Glucose then stays in your blood and doesn’t reach your cells.

Over time, having too much glucose in your blood can cause health problems. Although diabetes
has no cure, you can take steps to manage your diabetes and stay healthy.

Sometimes people call diabetes “a touch of sugar” or “borderline diabetes.” These terms suggest
that someone doesn’t really have diabetes or has a less serious case, but every case of diabetes is
serious.

Types of diabetes
The most common types of diabetes are type 1, type 2, and gestational diabetes.
Type 1 Diabetes
 Type 1 diabetes is also called insulin-dependent diabetes. It used to be called juvenile-onset
diabetes, because it often begins in childhood.
 It’s an autoimmune condition. It's caused by the body attacking its own pancreas with
antibodies. In people with type 1 diabetes, the damaged pancreas doesn't make insulin.
 This type of diabetes may be caused by a genetic predisposition. It could also be the result of
faulty beta cells in the pancreas that normally produce insulin.
 A number of medical risks are associated with type 1 diabetes. Many of them stem from
damage to the tiny blood vessels in your eyes (called diabetic retinopathy), nerves (diabetic
neuropathy), and kidneys (diabetic nephropathy). Even more serious is the increased risk
of heart disease and stroke.
 Treatment for type 1 diabetes involves taking insulin, which needs to be injected through
the skin into the fatty tissue below. The methods of injecting insulin include:
  A periodic test called the A1C blood test estimates glucose levels in your blood over the
previous three months. It's used to help identify overall glucose level control and the risk of
complications from diabetes, including organ damage.
 Having type 1 diabetes does require significant lifestyle changes that include:
 Frequent testing of your blood sugar levels
 Careful meal planning
 Daily exercise
 Taking insulin and other medications as needed
People with type 1 diabetes can lead long, active lives if they carefully monitor their glucose,
make the needed lifestyle changes, and adhere to the treatment plan.

Type 2 Diabetes
 With type 2 diabetes, the pancreas usually makes some insulin. But either the amount made
isn’t enough for the body's needs, or the body's cells resist it.
 Insulin resistance, or lack of sensitivity to insulin, happens mainly in fat, liver, and muscle
cells.
 By far, the most common form of diabetes is type 2 diabetes, accounting for 95% of diabetes
cases in adults. Some 26 million American adults have been diagnosed with the disease.
 Type 2 diabetes used to be called adult-onset diabetes, but with the epidemic
of obese and overweight kids, more teenagers are now developing type 2 diabetes. Type 2
diabetes was also called non-insulin-dependent diabetes.
 Type 2 diabetes is often a milder form of diabetes than type 1. Nevertheless, type 2 diabetes can
still cause major health complications, particularly in the smallest blood vessels in the body that
nourish the kidneys, nerves, and eyes. Type 2 diabetes also increases your risk of heart
disease and stroke
 With Type 2 diabetes, the pancreas usually produces some insulin. But either the amount
produced is not enough for the body's needs, or the body's cells are resistant to it.
 Insulin resistance, or lack of sensitivity to insulin, happens primarily in fat, liver, and muscle
cells.
 People who are obese -- more than 20% over their ideal body weight for their height -- are at
particularly high risk of developing type 2 diabetes and its related medical problems.
 people have insulin resistance.
 With insulin resistance, the pancreas has to work overly hard to produce more insulin. But even
then, there is not enough insulin to keep sugars normal.
 There is no cure for diabetes.
 Type 2 diabetes can, however, be controlled with weight management, nutrition, and exercise.
Unfortunately, type 2 diabetes tends to progress, and diabetes medications are often needed.
 An A1C test is a blood test that estimates average glucose levels in your blood over the previous
three months.
 Periodic A1C testing may be advised to see how well diet, exercise, and medications are working
to control blood sugar and prevent organ damage. The A1C test is typically done a few times a
year
 Treatment during pregnancy includes working closely with your health care team and:
 Careful meal planning to ensure adequate pregnancy nutrients without excess fat and
calories
 Daily exercise
 Controlling pregnancy weight gain
 Taking diabetes insulin to control blood sugar levels if needed

HYPERGLYCEMIA
High blood sugar is a leading indicator of diabetes. If a person with diabetes does not manage the
sugar levels in their blood, they can develop a severe complication called diabetic ketoacidosis
(DKA).
If a person does not get treatment for ketoacidosis, they can fall into a diabetic coma, which a
dangerous complication of diabetes.
In this article, we look at how to recognize hyperglycemia, ways to treat it, and possible causes
and complications.

INSULIN
 Together, insulin and glucagon help maintain a state called homeostasis in which conditions
inside the body remain steady.
 When blood sugar is too high, the pancreas secretes more insulin.
 When blood sugar levels drop, the pancreas releases glucagon to raise them.
 This balance helps provide sufficient energy to the cells while preventing the nerve damage
that can result from consistently high levels of blood sugar.
 In this article, we explain the functions and processes of insulin and glucagon as well as
their effects on diabetes.

How insulin works

 The cells need glucose for energy. However, most of them are unable to use glucose without
the help of insulin.
 Insulin gives glucose access to the cells. It attaches to the insulin receptors on cells
throughout the body, instructing the cells to open up and grant entry to glucose.
 Low levels of insulin constantly circulate throughout the body. A spike in insulin signals to
the liver that blood glucose is also high. The liver absorbs glucose then changes it into a
storage molecule called glycogen.
 When blood sugar levels drop, glucagon instructs the liver to convert the glycogen back to
glucose, causing blood sugar levels to return to normal.
 Insulin also supports healing after an injury by delivering amino acids to the muscles.
 Amino acids help build the protein that is present in muscle tissue, so when insulin levels are
low, muscles may not heal properly.

How glucagon works

 The liver stores glucose to power the cells during periods of low blood sugar.
 Skipping meals and poor nutrition can lower blood sugar.
 By storing glucose, the liver makes sure that blood glucose levels remain steady between
meals and during sleep.
 When blood glucose falls, cells in the pancreas secrete glucagon.
 Glucagon instructs the liver to convert glycogen to glucose, making glucose more available
in the bloodstream.
 From there, insulin attaches to its receptors on the body's cells and ensures that they can
absorb glucose.
HYPOGLYCEMIA
Low blood sugar
Delays between meals, poor nutrition, some diabetes medications, and certain medical conditions
can cause low blood sugar.
The symptoms of low blood sugar include:
 Dizziness
 Rapid heartbeat
 Weakness
 Tingling, particularly in the tongue, lips, arms, or legs
 Hunger alongside nausea
 Fainting
 Confusion and difficulty concentrating
 Irritability
Without treatment, low blood sugar can lead to seizures or loss of consciousness.

IDEAL BLOOD SUGAR LEVELS

A range of factors, including insulin resistance, diabetes, and an unbalanced diet, can cause
blood sugar levels to spike or plummet.
The standard measurement units for blood sugar levels are milligrams per deciliter (mg/dl).
Ideal blood sugar ranges are as follows:

Timing Blood glucose level (mg/dL)

Person without diabetes: 100 mg/dL

Before breakfast
Person with diabetes: 70–13

Person without diabetes: Less than 140 mg/dL

2 hours after a meal
Person with diabetes: Less than 180 mg/dL

Person without diabetes: 120 mg/dL

Bedtime
Person with diabetes: 90–150 mg/dL
  A1C is a measurement that gives a picture of average glucose levels over an extended
period.
 A1C readings should be under 7 percent for people with diabetes and less than 6 percent
for those without diabetes.

The symptoms of high blood sugar include:

 Urinating more often than usual: The kidneys respond to high blood sugar by trying to
get rid of excess glucose.
 Excessive thirst that accompanies frequent urination: The kidneys can
cause dehydration and feelings of intense thirst when trying to regulate blood sugar.
 Feeling excessively hungry: High blood sugar does not directly cause feelings of hunger.
However, a drop in insulin often causes hunger when it accompanies high blood sugar.

Over time, extremely high blood sugar may lead to the following symptoms:
 Unexplained weight loss
 Slow healing
 Itchy, dry skin
 Increased likelihood of infections
 Headaches
 Fatigue or difficulty concentrating
 Blurred vision
 Constipation, diarrhea, or both
 Erectile dysfunction