5 Steps to prevent Heart Disease

Wednesday, January 13, 2016

Official guidelines for LDLp and apoB seem a little high to me

My comment in purple. 
In my book The Tubby Theory from Topeka written at the end of 2009,  I advised that non-HDL-C be called the Tubby Factor as it is easier to remember to ask your Doctor, what is my Tubby Factor?
Non-HDL-C is more accurate than the LDL-C.  

More accurate than both of those is the particle number 
 (don't get bogged down with particle size, HDLc or Triglycerides). 
 ApoB and LDLp are the best tests. 
 LDLp Ion method done by Quest lab does not use the numbers in this chart.  
The apoB by Quest is the same range as this chart. 

"Dr Sniderman: The first thing I do is measure apoB to determine whether treatment is necessary or not.
If apoB is elevated, then all things being equal, treatment needs to be seriously considered. Treatment is a collaborative process between the patient and the physician and involves diet, exercise, and lifestyle as well as pharmacologic agents if indicated.
For the majority, my target for LDL-lowering therapy is an apoB < 75 mg/dL.

For those at very high risk, my target is an apoB < 65 mg/dL.

These are the equivalent population levels to the LDL-C and non–HDL-C targets chosen by many recent guideline groups. The apoB targets chosen by many of the guideline groups are much too high. It seems that once 1 group selected values, the others just repeated them."

Above quote from Lipid Round table article 

My 6 CIMTs show atheroma regression with low LDLp 

This chart shows LDLc 70 in same row as Non-HDLc  83 and LDLp 720 and apoB 54. 2008

In high risk patients I try to get(in my book from 2009):
 Tubby Factor (Non-HDLc )less than 80.  INEXPENSIVE
apo B less than 60 (immunoassay) PARTICLE COUNT
LDLp less than 750 (done by Liposcience NMR) PARTICLE COUNT-  BEST TEST MY OPINION

The 2014 American Diabetic guidelines are still using the old LDLc. 
Diabetics often have discordance between LDLc and Tubby Factor and Particle number.

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