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Member Forum >> Heart Health Forum >> Is LDL Particle Number and Size Relevant?
 Is LDL Particle Number and Size Relevant?
Malcolm

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Posted: 9/29/2019 12:45:44 PM
Edited: 9/29/2019 2:02:22 PM (1)
 
Here is a link to a 2003 article in JCEM that says LDL particle size ain’t that helpful in predicting CHD (coronary heart disease).

https://www.youtube.com/watch?v=DV9yQbNCE3E


https://academic.oup.com/jcem/article/88/10/4525/2845681 - EDIT! This is the correct link to the JCEM article.

Here are the conclusions of the article:

The burden of proof for any newly proposed risk factor is that it must add significantly to risk assessment by existing measurements, or that it is equivalent but more economical. LDL subtyping does not meet either of these expectations. Metabolic studies demonstrate that large and small LDL subtypes are atherogenic. In as much as any type of LDL is contained in the plasma total LDL concentration, the standard clinical measurement of risk, all LDL types should be viewed as harmful. The best indicator of response to lipid therapy is a reduction in the plasma concentration of atherogenic lipoproteins, as conventionally measured by LDL and triglycerides, but alternatively by non-HDL cholesterol or apo B (91).

This is the kind of article my cardiologist would probably love because it basically supports the merit of lowering your LDL, which would happen if you took a statin.

Statins would also lower your ApoB number, and the article says that lowering Apo B is protective. My cardiologist would smile favorably about this too.

The article says lowering triglycerides has merit. We all agree there.

And it says a good predictor of CHD is the Total Cholesterol/HDL ratio. Dr. Aseem Malhotra agrees with this based on a recent talk I watched. He likes the ratio to be 4.0 or less. I think Ivor Cummins likes this metric as well.

One strange point in the 2003 article is that if you have low HDL-C, then large LDL particles are more of a threat than small LDL particles.

They also have a comment about niacin in the article, which says it’s not particularly helpful.
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Bob Niland

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Posted: 9/29/2019 1:14:36 PM
 
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Malcolm

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Posted: 9/29/2019 2:05:25 PM
 
Bob:

Whoops! I have corrected my mistaken link. Thanks for checking.

Please refer to my original post once again.
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Bob Niland

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Posted: 9/29/2019 2:17:57 PM
 
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