Cholesterol concerns

[Robert Santana]

In the setting of normal triglycerides, direct and calculated LDL are likely to be quite close, or at least in the same ballpark so as to not change your conclusions about what to do.

I’m curious about the oxidized LDL, though, haven’t seen that tested. I know that oxidized is presumed to be the more pathological subtype of LDL. Is there any evidence that measuring it in addition to or in lieu of “vanilla” LDL adds to the risk determination? I would think it likely that oxidized LDL is generally a fairly fixed percentage of total LDL, and you could spare the expense of the fancy test. Do you have any references on this?

I'm suggesting he retest it because he has no trending to verify that this was even a valid test. He should not take it at face value with no prior data.

You know that there are references.

[CommanderFun]

I could try and dig up the old test results from 5-10 years ago. I was actually much less healthy then though. I would be surprised if the numbers weren't higher then than now. Little to no exercise of any kind, lotta fast food, and so on.

[jfsully]

I'm suggesting he retest it because he has no trending to verify that this was even a valid test. He should not take it at face value with no prior data.

You know that there are references.

I can’t find anything about the relationship of oxidized to total LDL, was wondering if you had something on that specifically. It would have bearing on whether spending the extra $$ to test oxidized has value over just LDL.

[Robert Santana]

I could try and dig up the old test results from 5-10 years ago. I was actually much less healthy then though. I would be surprised if the numbers weren't higher then than now. Little to no exercise of any kind, lotta fast food, and so on.

If you can find them that would be great. I still think you should retest before conceding to these numbers though.

I can’t find anything about the relationship of oxidized to total LDL, was wondering if you had something on that specifically. It would have bearing on whether spending the extra $$ to test oxidized has value over just LDL.

If he doesn't want to spend the money then he doesn't have to spend the money. There are plenty of MIs that occur independent of LDL values so relying on that metric to determine health risk is already silly. If he's worried about it I provided him with an additional metric to look at. There are plenty of research articles on PubMed reporting independent associations between oxidized LDL and cardiovascular disease risk, hemoglobin a1c, and diabetes. You are welcome to search for them. I have no interest in arguing over professional research. The man wanted some practical advice and he received. If he doesn't want to pay for it he doesn't have to but he most certainly should get retested.

[CommanderFun]

I've found some information about different types of LDL particles, patterns A and B. B pattern seems to be the one with the big risk for arterial buildup from what I've read. I've also read that pattern A seems to be more prevalent when blood triglycerides are lower, while pattern B seems to be more prevalent when the triglycerides are high. Thoughts on this?

[jfsully]

Believe it or not, I didn’t want to argue about it, I was just trying to learn something.

[Robert Santana]

I've found some information about different types of LDL particles, patterns A and B. B pattern seems to be the one with the big risk for arterial buildup from what I've read. I've also read that pattern A seems to be more prevalent when blood triglycerides are lower, while pattern B seems to be more prevalent when the triglycerides are high. Thoughts on this?

This is correct. Small dense LDL also tends to be more atherogenic. Unfortunately, particle size is not easy to measure.

Believe it or not, I didn’t want to argue about it, I was just trying to learn something.

Did you learn something?

[jfsully]

This is correct. Small dense LDL also tends to be more atherogenic. Unfortunately, particle size is not easy to measure.




Did you learn something?

Always do.

[Robert Santana]

Glad to hear it. Always happy to help.

[mdavis6890]

At the risk of getting hammered here - If you care about your cholesterol levels and want to improve them, cardio will yield quick results.