On Tue, 29 May 2001, Chuck Spindler wrote:

> Update on her numbers -- she called the doc and was given the full
> scoop:
>
> Total chol. - 300
> HDL - 85
> LDL - 208
> VLDL - 7
> Triglyceride - 36
>
> So, now I'm even more perplexed.  It seems to me that there is a clear
> contradiction between the high total cholesterol and LDL readings, and
> the fact that she has a very high HDL, very low triglyceride, and an
> extremely low VLDL.  Isn't VLDL the "really" bad stuff that we should be
> most worried about?

Some of us believe that the thing to watch is the TG:HDL ratio,
which should be as low as possible.  In your mother's case this
ratio is about .4, which is very, very good.  Anything below 2.0
is considered good, and below 1.0 is excellent.

The reason for this is that there is evidence that what's "bad"
about LDL cholesterol is the fraction of small-dense LDL
particles, rather than the total LDL number.  Normal lab tests
don't measure small-dense LDL (in fact, they don't even measure
LDL directly), but it is known that the small-dense LDL is
strongly correlated with TG.  So, with such a very low TG reading
there is probably very little small-dense LDL present, despite
the high total LDL number.

If you want to read more about small-dense LDL and atherogenesis,
see
http://www.cabi.org/catalog/JOURNALS/samples/pns/html/pns58163.htm

Most people with high LDL have elevated TG as well, and that
appears to be the reason why there is *some* statistical
correlation between LDL and heart disease.  But the correlation
is weak.  In 1997 Gaziano did a prospective study that showed a
much stronger predictive value for TG:HDL than for other numbers.
That is, he took a bunch of blood samples, froze them, and then
recorded cardiovascular problems over a period of years, without
looking at the blood samples at all.  Only afterwards did he
analyze the blood samples to see who had what.

I hope that helps.

Todd Moody
[log in to unmask]