Total cholesterol 5.23 means total serum cholesterol 5.23 mmol/L and HDL cholesterol 1.86 means HDL 1.86 mmol/L. The above values are high compared to normal levels. This may be due to physiological factors such as poor diet, or to diseases such as obstructive jaundice and chronic liver disease. Total cholesterol and HDL cholesterol are important indicators in the four clinical lipid tests, in which the total cholesterol index of the normal population should be lower than 5.17mmol/L, and the HDL cholesterol level of men should be between 1.16~1.42mmol/L, and women should be between 1.29~1.55mmol/L. The patient’s examination suggests that the total cholesterol index is 5.23mmol/L and the HDL cholesterol index is 1.86mmol/L, both of which are on the high side, and the reasons for this are more complex. First of all, the causes of total cholesterol increase are dietary factors, if the patient often consume duck heart, pig liver and other high cholesterol content of animal offal food, then the serum total cholesterol will be high. Secondly, diseases such as obstructive jaundice, cirrhosis, and severe hepatitis can also lead to elevated serum total cholesterol in patients. And high HDL cholesterol in patients may be due to recent excessive alcohol consumption or more exercise, or it may be due to chronic liver diseases such as chronic hepatitis B. To summarize, there are many reasons for high serum total cholesterol and HDL cholesterol, and it is recommended that patients consult a doctor as soon as possible to clarify the specific cause of the disease.