blank! said:
your LDL is awfully high.
What alot of people don't realize is it isn't as simple as high and low LDL. There are different forms of LDL. LDL isn't a horrible thing if it is the right LDL.
In recent years it has become clear that
some patients with normal cholesterol develop severe vascular disease, whereas others with high cholesterol do not have damage. It is important to understand that LDL cholesterol is the lipoprotein carrier of the "bad" cholesterol that gets absorbed into the vessel wall, and leads to fatty plaques in the arteries. The HDL, "good" cholesterol, is the lipoprotein carrier of the bad cholesterol
away from the vessel wall. We now know that there are dense and fluffy LDL's, and that the
dense LDL particles can penetrate the vessel wall and do damage, while the
fluffy LDL's tend to bounce off the wall, and get taken back to the liver. Thus we really want to know the LDL particle count, not the LDL cholesterol level, and also the particle size. One can have a moderately high LDL, but if the particles are large, the particle number is smaller, and the damage potential for each particle is smaller. The HDL carrier is also more effective at being a good carrier if it is large. Until recently, testing for particle size and number was not readily available. A lab in North Carolina,
Liposciences, has patented an NMR Spectrophotometry evaluation of lipoproteins which promises to revolutionize the way we look at serum lipids. Triglycerides also seem to take on a much bigger role in lipid related damage and is better measured by measuring VLDL, the transporting carrier, and how that is cleared by the liver. We are excited to be using this test, which generally costs about $140, and is not offered, by any of the standard labs. Liposciences is allowing us to use this test on our patients for a few months, in an effort to help spread the word on its importance. See their website:
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