High ldl-p and apob

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MarcR
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Re: High ldl-p and apob

Post by MarcR »

Thanks for directing me to this, Quantifier. I was not aware of it.

I just spent an hour looking at the twitter thread and the Google Drive folder containing the analysis. Perhaps I'm missing it, but I don't see an upper limit to exclude people with familial hypercholesterolemia. In general, that's the biggest issue with quintile analyses of LDL. The median LDL-C for q1-q5 is 85, 106, 122, 140, and 169, but q5 appears to include members of the 0.4% who have that genetic disorder. A cutoff of 190 would exclude them.

I think there should be a cutoff on the low end also - notwithstanding the Hadza, the elevation of risk in q1 might disappear with a cutoff of 50 to exclude people with hypolipidemia due to disease or genetic disorders.

If LDL actually causes premature mortality, I would expect to see a rising dose-response line for the bounded middle quintiles (q2-q4), but that's not in evidence either with HR 1.00, 0.88, 1.05, respectively.
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Re: High ldl-p and apob

Post by pberry »

My cardiologist included Lp-PLA2 activity in my blood panel as a measure of inflammation in the arteries. I’ve seen articles stating that this metric may have the potential to identify CVD risk in otherwise healthy individuals. The description from the Boston Heart lab report states:

Lp-PLA2 Activity measures vascular-specific inflammation. When cholesterol enters and gets trapped in the vessel wall, inflammation occurs. Lp-PLA2 Activity may identify active cholesterol build-up inside the vessel wall and the progression of cardiovascular disease.

Perhaps you could discuss with your doctor if this metric would be helpful to understand your true risk.
anne from california
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Re: High ldl-p and apob

Post by anne from california »

EB4129 wrote: Wed Mar 15, 2023 3:20 pm Hi there. First time poster, intermittent lurker.
Just hoping for some advice regarding ldl-p and apob. I am a 38 y/o female APOe 3/4 who struggles with elevated ldl p and apob. I am insulin sensitive and not overweight. My current particle number is 2045 but I have gotten it as low as 1200 in the past eating a very low saturated fat diet. The thing is a super low saturated fat diet is not sustainable for me. I tend to need a lot of food and animal protein makes me feel better. My apob is also always elevated :80’s-120. My Lpa is low (24), my hdl is high 80-90’s, trigs are 60-100. My main area of modification seems to be ldl p and apob. Other than a very low sat fat diet (which is not sustainable for me) I am thinking the only thing to bring down my numbers is a statin. I am thinking of taking a statin 3 days per week. I’d appreciate anyone’s advice or thoughts. I don’t have a family history of heart disease but I do have a grandmother with early onset Alzheimer’s. Also I have read the primer before.
Thanks!!
EB4129, I have similar numbers, but am older and postmenopausal with a family history of postmenopausal high cholesterol. My ApoB is the number that has gotten my attention more than anything else: 114. Because no one ever tested it, I don't know if it has risen with my LDL, which is now 145. Particle number was 1604 last time tested (about a year ago). Trigs low at 57. HDL at 75. No coronary artery disease in the family, but dementia among women--mother has been cognitively impaired since about age 78, grandmother from her mid-80s, great-grandmother from her later 80s. (Old bones in my family--great-grandmother died at 90, grandmother at 94, mother still living at 87, father still living at 92 (and taking care of mother). Not sure if it's related, but my mother's cognition took a nosedive around the time she started a statin. She also had insulin insensitivity and abused alcohol, so it's hard to say what may or may not have contributed to her cognitive decline. So I have no answers, but wanted to pop in and commiserate and say that I, too, find a low saturated fat diet hard to maintain. I have osteoporosis and am low body mass, so I need lots of protein, and I exercise a lot. Greek yogurt helps me keep my calcium and protein counts up, and while I don't seem to have an issues with dairy, trying to follow Bredesen's recommendation for A2 grassfed leaves me with full-fat options only. I also eat eggs, but can't stand them without a little bit of cheese. And, of course, staying out the dark chocolate is always a challenge. :)
60 years old, ApoE 3/3, mother and grandmother have/had late-onset dementia, eager to save brain and optimize health.
Thank you all for sharing your knowledge!
JD2020
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Re: High ldl-p and apob

Post by JD2020 »

anne from california wrote: Sun Apr 16, 2023 5:46 pm trying to follow Bredesen's recommendation for A2 grassfed leaves me with full-fat options only.
I live in the Bay Area, and this milk is available at the local Whole Foods. It is so good! Organic, 2%, A2/A2. The description refers to 365 days of grass.

https://alexandrefamilyfarm.com/product ... d-fat-milk
anne from california
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Re: High ldl-p and apob

Post by anne from california »

JD2020 wrote: Mon Apr 17, 2023 12:44 pm
anne from california wrote: Sun Apr 16, 2023 5:46 pm trying to follow Bredesen's recommendation for A2 grassfed leaves me with full-fat options only.
I live in the Bay Area, and this milk is available at the local Whole Foods. It is so good! Organic, 2%, A2/A2. The description refers to 365 days of grass.

https://alexandrefamilyfarm.com/product ... d-fat-milk
Thanks, JD2020. We have some Alexandre Farms products in our area, but not that one. Just the extra-fat ones.
60 years old, ApoE 3/3, mother and grandmother have/had late-onset dementia, eager to save brain and optimize health.
Thank you all for sharing your knowledge!
OfficeSpace
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Re: High ldl-p and apob

Post by OfficeSpace »

Quantifier wrote: Sun Mar 19, 2023 10:17 pm If you want data from lean, active individuals, how about the hunter-gatherers in Hunter-gatherers as models in public health?
The Hadza of Tanzania are very active, have low lipids (some too low to measure with the field equipment used, so the values assigned were likely higher than actual ones). You won't find your lean, healthy people with high LDL-C there.
How about the Tsimane forager-farmers of Bolivia?

APOE4 is associated with elevated blood lipids and lower levels of innate immune biomarkers in a tropical Amerindian subsistence population
Abstract: In post-industrial settings, apolipoprotein E4 (APOE4) is associated with increased cardiovascular and neurological disease risk. However, the majority of human evolutionary history occurred in environments with higher pathogenic diversity and low cardiovascular risk. We hypothesize that in high-pathogen and energy-limited contexts, the APOE4 allele confers benefits by reducing innate inflammation when uninfected, while maintaining higher lipid levels that buffer costs of immune activation during infection. Among Tsimane forager-farmers of Bolivia (N = 1266, 50% female), APOE4 is associated with 30% lower C-reactive protein, and higher total cholesterol and oxidized LDL. Blood lipids were either not associated, or negatively associated with inflammatory biomarkers, except for associations of oxidized LDL and inflammation which were limited to obese adults. Further, APOE4 carriers maintain higher levels of total and LDL cholesterol at low body mass indices (BMIs). These results suggest that the relationship between APOE4 and lipids may be beneficial for pathogen-driven immune responses and unlikely to increase cardiovascular risk in an active subsistence population.
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Re: High ldl-p and apob

Post by OfficeSpace »

JD2020 wrote: Mon Apr 17, 2023 12:44 pm
anne from california wrote: Sun Apr 16, 2023 5:46 pm trying to follow Bredesen's recommendation for A2 grassfed leaves me with full-fat options only.
I live in the Bay Area, and this milk is available at the local Whole Foods. It is so good! Organic, 2%, A2/A2. The description refers to 365 days of grass.

https://alexandrefamilyfarm.com/product ... d-fat-milk
Whole Foods on the opposite coast (Maryland) also carries Alexandre Family Farm products... the lowfat kefir is expensive but delicious!
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Re: High ldl-p and apob

Post by NataliaReyn »

OfficeSpace wrote: Wed Aug 09, 2023 7:48 am
JD2020 wrote: Mon Apr 17, 2023 12:44 pm
anne from california wrote: Sun Apr 16, 2023 5:46 pm trying to follow Bredesen's recommendation for A2 grassfed leaves me with full-fat options only.
I live in the Bay Area, and this milk is available at the local Whole Foods. It is so good! Organic, 2%, A2/A2. The description refers to 365 days of grass.

https://alexandrefamilyfarm.com/product ... d-fat-milk
Whole Foods on the opposite coast (Maryland) also carries Alexandre Family Farm products... the lowfat kefir is expensive but delicious!
Hello, OfficeSpace!

My name is Natalia. I am one of the Support Team Interns here on the site and I wanted to officially welcome you to our community here since it looks like you have joined us recently.

If you would like to explore the site in more detail, I can share several tools/resources to help you get the most out of your experience.
The Primer is a detailed and informative resource written by a practicing M.D. with ApoE4/4. It includes information about the biochemistry of the ApoE4 gene and offers a variety of research-based prevention strategies.

Feel free to explore our WIKI if you haven't already for various topics that may be on interest to you WIKI Main Page .

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