3

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My doctor questions whether particle size matters. Your opinions?

Answered on August 19, 2014
Created March 21, 2011 at 2:58 PM

He says that the research is "back and forth" on the issue. The guy is quite bright and keeps up with things, so I'm not about to dismiss what he says outright.

THIS ABSTRACT is very recent and seems to give credence to what he says.

Your opinions?

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on March 21, 2011
at 05:48 PM

I think the data on sdLDL is pretty damn compelling. Andmost MDs have to deal with this because there are many patients they want to statinize who they cant because of side effects....so they are on Niacin Fish oil and dietary modifications in place of it. I find that the PCPswho have the most patients with side effect are the one whose eyes open to the statin issue quickly because of how well those patients with statin side effects do on so called "second line therapy" Me.....I just dont think lipid levels matter. Particle size to me does matter alot for PAD, CAD, and inflammatory levels

Af1d286f0fd5c3949f59b4edf4d892f5

(18472)

on March 21, 2011
at 04:13 PM

I was typing up something similar to this, minus the unique ice cream causes drownings example. ut it's true, this study does not even discuss particle size, only ratios.

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1 Answers

10
E8022f05c250e19a65b92207dd1630ca

on March 21, 2011
at 04:11 PM

As far as I can tell (only from the abstract though) this study is simply saying that the ratio of LDL/HDL didn't show much difference than a simple TC/HDL measurement in terms of predicting a coronary event. Keep in mind this is a cohort study meaning that it is observational and not a randomized controlled trial. This leaves it vulnerable to bias and uncontrolled variables. You can only really detect correlation rather than causation. For example, you find ice-cream sales are associated with increases in outdoor temperature. During periods of increased outdoor temperature there has also been found to be an increase in drownings. From this observation, you could hypothesize that increases in ice cream sales are associated with increases in drownings. In this paper higher TC/HDL and HDL/LDL ratios are both associated with increased risk of a coronary event. It doesn't say that LDL particle does not.

Check these studies out and give them to your doc: http://www.ncbi.nlm.nih.gov/pubmed/18503219 http://www.ncbi.nlm.nih.gov/pubmed/21392724 This is a study out of Berkeley talking about how pattern B LDL vs Pattern A is more dangerous (meaning small dense LDL vs normal larger LDL):http://www.lbl.gov/Science-Articles/Archive/cholesterol-particles.html

MD's are usually skeptical of anything that they cannot influence with drug therapy. There is no drug that can make your LDL particle size change, so they do not put any value there even if the research points otherwise.

Af1d286f0fd5c3949f59b4edf4d892f5

(18472)

on March 21, 2011
at 04:13 PM

I was typing up something similar to this, minus the unique ice cream causes drownings example. ut it's true, this study does not even discuss particle size, only ratios.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on March 21, 2011
at 05:48 PM

I think the data on sdLDL is pretty damn compelling. Andmost MDs have to deal with this because there are many patients they want to statinize who they cant because of side effects....so they are on Niacin Fish oil and dietary modifications in place of it. I find that the PCPswho have the most patients with side effect are the one whose eyes open to the statin issue quickly because of how well those patients with statin side effects do on so called "second line therapy" Me.....I just dont think lipid levels matter. Particle size to me does matter alot for PAD, CAD, and inflammatory levels

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