LifeCare Chiropractic

The Best Chiropractic Care in Mesa, Arizona

VLDL

Other Markers Outside of Cholesterol – (11-12-00)

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VLDL, Apolipoproteins B, CIII, and E, and Risk of Coronary Events

More evidence pointing to the fact that just measuring lipid levels in patients is rather archaic, and other markers in the blood are much more specific and should prove to be a much more effective measure of cardiovascular risk.

Circulation — Abstracts: Sacks et al. 102 (16): 1886

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PREDICTION OF CORONARY HEART DISEASE IN MEN – (12-19-05)

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non-HDL cholesterol High-Density Lipoprotein Cholesterol and Apolipoprotein B in the Prediction of Coronary Heart Disease in Men

ApoB is the protein component of a lipid molecule that carries around the cholesterol. This study compared which was a better marker for coronary heart disease–non HDL cholesterol (the amount of LDL and VLDL cholesterol together) vs ApoB. Elevated ApoB was the best predictor of risk at 4.18 times the risk. Above and beyond “traditional” risk factors.

This is not the first study to come to this conclusion, and yet it’s use is still few and far between in clinical practice.

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JUST CHECKING CHOLESTEROL DOES NOT GIVE A GOOD PICTURE OF HEART DISEASE – (02-21-05)

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Insulin resistance, adiposity influence lipoprotein size, subclass concentrations

This study really demonstrates how behind the research most clinicians are.  Just checking cholesterol really does not give us a good picture of where the patient is as far as their risk for heart disease.

This study evaluated subclasses of LDL (small, intermediate, large), VLDL (very low density lipoprotein) and HDL.  Worsening insulin resistance did not affect LDL levels.  However, strong changes were seen in the subclasses–decrease in the large LDL offset increases in the other sizes of LDL.

So, if one just looks at straight LDL, you just missed the fact that the real picture is one of worsening risk (larger LDL and larger HDL particles are generally considered protective).  Subfractioning of the cholesterol molecules is looking more and more like a good idea…

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RISKS OF CHOLESTEROL IN CORONARY HEART DISEASE – (04-30-07)

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Non–High-Density Lipoprotein and Very-Low-Density Lipoprotein Cholesterol and their Risk Predictive Values in Coronary Heart Disease

Invariably, when I give a presentation to a group in the community, maybe 1 out of 20 know their lipids outside of total cholesterol. The reality is, you absolutely, positively CANNOT appropriately manage elevated lipids without knowing where your HDL, VLDL and triglycerides are. And yet PCP and Internists still look at lipids with blinders on and will aggressively treat patients based on total cholesterol alone.

And yet here, researchers found NO association between elevated LDL and CVD risk. Good thing the only bad thing that happens from statin drug use is fatal rhabdomyolysis.

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WHY DOESN’T CHOLESTEROL MATTER TO MY HEART?

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MY DOCTOR TELLS ME MY CHOLESTEROL IS HIGH…WHY DOESN’T THIS MATTER TO MY HEART?  To really understand this, you need to understand how the body processes fats through the liver.  Basically, our body uses proteins to carry fats around the body.

In general, the more protein (thus more dense) one of these carrier molecules has, the safer it is for our blood vessels and heart.  The more fat (and less dense) in the molecule the more it can damage the vessels.  In someone who is prediabetic (and has high triglycerides), the liver makes more of the less dense molecules (VLDL attached to Apo C III).  It is a bad shift from dense HDL to very light VLDL and the use of the protein Apo C III.

Total cholesterol is merely one single value in a sea of these molecules, and what types of molecules we have floating in our blood is more of a reflection of how healthy we are rather than having a single value (like total cholesterol) as an indicator.

So, to REALLY get an idea of what our risk of heart disease is, we need an overall total picture of these molecules.  Looking at the single marker (total cholesterol) is the equivalent of looking through a telescope at the ground in front of you as you walk.  Really kind of pointless….

Read entire article here