Great question. Knowing what we know about cholesterol and the completely weak link to CVD, almost all the values are worthless; I don't know if they even use blood serum homocysteine levels in gauging CVD risk.
It's a more accurate value as an indicator of overall CVD risk; you can have two people with elevated LDL, and only one will develop cardiovascular disease. There's actually 7 different subclasses of LDL, based on size and density; VLDL being the smallest and most dense. As a visual analogy, think of VLDL as small bits of sand, and LDL as large fluffy balloons.
VLDL and IDL are more atherogenic based on three theories: 1) smaller LDL particles can more easily infiltrate damaged areas of an artery wall and form plaques, 2) smaller, dense LDL particles stay in the blood stream longer than large, fluffy LDL, therefore they have more opportunity to initiate more damage, and 3) VLDL and IDL oxides more easily. The .pdf that Xtrainer posted explains this nicely, and I touch on it in the fish oil guide.. Personally, this one makes the most sense to me, as the link between CVD and inflammation is rock solid, but the link between CVD and (total)cholesterol levels is laughable at best.
The fucked up thing is, we've been able to test for the various subclasses of LDL for well over 20 years:
<dl class="AbstractPlusReport"><dt class="head">
Circulation. 1981 Dec;64(6):1174-84.<script language="**********1.2"><!-- var Menu7296792 = [ ["UseLocalConfig", "jsmenu3Config", "", ""], ["Compound (MeSH Keyword)" , "window.top.location='/sites/entrez?Db=pccompound&DbFrom=pubmed&Cmd=Link&LinkName=pubmed_pccompound_mesh&LinkReadableName=Compound%20(MeSH%20Keyword)&IdsFromResult=7296792&ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus' ", "", ""], ["Substance (MeSH Keyword)" , "window.top.location='/sites/entrez?Db=pcsubstance&DbFrom=pubmed&Cmd=Link&LinkName=pubmed_pcsubstance_mesh&LinkReadableName=Substance%20(MeSH%20Keyword)&IdsFromResult=7296792&ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus' ", "", ""], ["Cited in PMC" , "window.top.location='http://www.pubmedcentral.gov/tocrender.fcgi?action=cited&tool=pubmed&pubmedid=7296792&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus&ordinalpos=1' ", "", ""], ["LinkOut", "window.top.location='/sites/entrez?Cmd=ShowLinkOut&Db=pubmed&TermToSearch=7296792&ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus' ", "", ""] ] --></script>
Links
</dt><dd class="abstract">
Intermediate-density lipoprotein and cholesterol-rich very low density lipoprotein in angiographically determined coronary artery disease.
<!--AuthorList-->
Tatami R,
Mabuchi H,
Ueda K,
Ueda R,
Haba T,
Ka****ni T,
Ito S,
Koizumi J,
Ohta M,
Miyamoto S,
Nakayama A,
Kanaya H,
Oiwake H,
Genda A,
Takeda R.
The relationship between the concentrations of intermediate-density lipoprotein (IDL) and other lipoproteins and the extent of coronary artery disease (CAD) was studied in 182 consecutive patients evaluated by selective coronary cineangiography. On univariate analysis, the extent of CAD correlated significantly and positively with very low density lipoprotein (VLDL) cholesterol, IDL cholesterol and low-density lipoprotein (LDL) cholesterol, and negatively with high-density lipoprotein (HDL) cholesterol. Analysis of four subgroups divided by IDL cholesterol and LDL cholesterol levels indicated that moderately increased levels of IDL cholesterol were closely associated with a high frequency of CAD. Moreover, multi-variate regression analysis demonstrated that IDL cholesterol for men, LDL cholesterol for men and women and HDL cholesterol for men were significant variables of use in the final weighting procedure. IDL cholesterol was closely associated with cholesterol-rich VLDL.
This study shows that IDL and cholesterol-rich VLDL combine to contribute to the development of CAD.
</dd></dl>
Old thread, but a classic. BFNM was an elite poster here, as well as Terumo. Learned alot from those guys.
