I was looking into healthy cholesterol levels because of another post, and I came across an interesting interview that discussed why someone’s HDL may be too high: https://www.healthcentral.com/article/can-my-hdl-be-too-high. Made me think of this thread.
"HDL can become damaged or “spent” at which point it no longer does any of these good things and instead actually contributes to cardiovascular disease, even winding up with LDL in plaque. There are three main reasons this happens.
-The failure to provide adequate nutrition to re-energize HDL after it has been out working. This leads to a lack of apoA-I and an HDL cell membrane that has lost functionality.
-Oxidative damage to apoA-I, caused by inflamed and overheated immune cells. This means individuals with inflammatory health issues will have poor quality HDL. The greater the inflammation, the worse the HDL quality.
-Sugar glycation of HDL, rendering it “cemented” so that it can’t work. The more uncontrolled the blood sugar, the worse the HDL problem."
I thought it was interesting, so I figured I’d share. I think I might ask for an expanded lipid profile next time I go to the doctor. Maybe they can determine if I have “good” HDL or “bad” HDL. My HDL levels are decently high at 84.
Definition of hyperlipidemia may vary depending on the country. I’m sharing the article below because I have a relative in Taiwan and I was inquiring as to whether his doctor recommended statins or any other cholesterol lowering medication. He is a type 2 diabetic. This article appears to define hyperlipidemia as total cholesterol greater than or equal to 240. (It’s a long article)
Just got my lab referal (after hoops I’ll not even get into) from my new primary doc
Only thing I’m not familiar with is “apo-b” which after some googling means Apolipoprotein B which apparently is associated with lipids and cardiac risk hand in hand with lipids…
That’s all I know about it and it’s from a 19 second Google endeavor. Do any of you have this checked, does it factor into decisions? Has it been explained to you by your doctor to your satisfaction?
It is just another marker, more specific that just the general LDL level.
A general LDL number does not reflect how many of the LDL particles are small and dense. Those are the ones that are more likely to cause cardiac problems by building up plaque in the artery walls.
The thing you want in your total LDL number are big fluffy particles, and fewer of the small dense particles.
The ApoB level helps indicate that.
It might be one of those things where your doctor did it because you are a diabetic over X years of age. Or it might be because of previous results.
It is a useful test. It is another thing to look at and consider in the overall picture of heart health.
If he tells you that it needs to be lowered, we can talk about things you can work on.
Here is a nice reference that sums it up in the first few sentences and also in the summary sentence.
Abstract
Small dense low-density lipoprotein (sd LDL) is more atherogenic [tending to promote the formation of fatty plaques in the arteries] than large buoyant (lb) LDL, which is relatively high in particle number (as estimated by apolipoprotein [apo] B) and poor in cholesterol (C) content. Because recent epidemiological studies have shown that serum apo B is a stronger predictor of the risk of coronary heart disease (CHD) than LDL-C, we assumed that this strong predictive power of apo B for CHD is attributable to a close association with sd LDL concentration.
…
These results suggest that apo B is superior to non-HDL-C in reflecting a potent atherogenic lipoprotein, sd-LDL, which may explain a potent predictive power of apo B for CHD.
I’ve never had this test before this summer, but did have it checked then. My result was actually slightly below the lower end of the reference range, which I assume is good. My doctor seemed to think it was a great result.