Got my oxidized LDL results

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Julie G
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Re: Got my oxidized LDL results

Post by Julie G »

Good questions, Circ. I tracked down a link that succinctly defines the two tests:
http://medlabdx.com/Cardiovascular.html
Myeloperoxidase (MPO) is a marker that measures the body’s response to a damaged endothelium,
or the lining of the arteries, that has become thin, cracked and ultimately unstable due to cholesterol accumulation and inflammation. The risk for a heart attack increases as MPO levels increase.

Oxidized LDL (OxLDL) is a marker that measures the amount of LDL (or “bad”) cholesterol in your blood that has been damaged due to oxidation. Poor lifestyle habits may increase OxLDL levels and increase the risk for metabolic syndrome.
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RichardS
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Re: Got my oxidized LDL results

Post by RichardS »

I wonder how myeloperoxidase compares to LP-PLA2 testing. I tested LP-PLA2 last year and was found to be well within the normal range. :)

Earlier in this thread, I was writing about the high correlation of oxLDL and Lp(a) which for me has been mostly well above lab cutoffs. I found this paper ("Oxidized Phospholipids, Lp(a) Lipoprotein, and Coronary Artery Disease" N Engl J Med 2005;353:46-57) and was very interested to find this is the discussion:
This study shows an association between the oxidized
phospholipid:apo B-100 ratio in plasma and
the presence and extent of angiographically documented
coronary artery disease. The association is
independent of all clinical and lipid-related risk
factors, except one, Lp(a) lipoprotein, which also
has a strong association with angiographically documented
coronary artery disease. The odds ratios
for angiographically documented coronary artery
disease associated with the Lp(a) lipoprotein level
were nearly identical with those associated with the
oxidized phospholipid:apo B-100 ratio. However,
among patients younger than 60 years of age, the
oxidized phospholipid:apo B-100 ratio remained
an independent predictor of obstructive coronary
artery disease. There was a strong correlation between
levels of Lp(a) lipoprotein and the oxidized
phospholipid:apo B-100 ratio. These observations,
in conjunction with previous studies from our laboratory
showing that in plasma such oxidized phospholipids
are predominantly physically present on
Lp(a) lipoprotein, 5-7,9 as opposed to other lipoproteins,
lend strong support to the hypothesis that, in
the setting of enhanced oxidative stress, proinflammatory
oxidized phospholipids may, in part, mediate
the atherogenicity of Lp(a) lipoprotein.
It seems they are arguing that high Lp(a) may not be such a big deal if oxLDL is normal. If so, that would be sweet news to me, especially since I have not been able to locate any published data showing lowering Lp(a) provides clinical benefits.

ETA: This line of thinking is reinforcing for me that oxidation and inflammation are probably my two primary battles to fight for brain and heart health given my existing coronary calcium scores and autoimmune issues.
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Re: Got my oxidized LDL results

Post by circular »

oxLDL vs sdLDL as oxidized cholesterol markers?

Just doing a fly-by while focused on something else ...
ApoE 3/4 > Thanks in advance for any responses made to my posts.
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Julie G
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Re: Got my oxidized LDL results

Post by Julie G »

I see where you're going with this, Circ... If you ask Dr. Gundry, he would suggest that sdLDL is a surrogate marker for oxLDL, BUT I suspect it's not as clear cut as that. At this point, it might be safer to say that there is a STRONG association between sdLDL and CHD via oxLDL. A brand new paper below highlights the strength of this association even in the presence of normal cholesterol levels:

Small dense low-density lipoprotein-cholesterol concentrations predict risk for coronary heart disease: the Atherosclerosis Risk In Communities (ARIC) study.
http://europepmc.org/articles/PMC3999643
Conclusions
In summary, our results showed that sdLDL-C was highly correlated with an atherogenic lipid profile and, in contrast to lbLDL-C, predicted future CHD events in ARIC participants. Furthermore, sdLDL-C predicted risk for incident CHD even in individuals who would be considered at low cardiovascular risk based on their LDL-C level. This new homogenous sdLDL-C assay could be readily implemented in most routine clinical chemistry laboratories, provided that its clinical value can be confirmed in future studies.
From my understanding Myeloperoxidase (MPO) is the closest surrogate marker for oxLDL. It may even be superior in that it is supposedly a direct measure of arterial damage. Here's a nice description of the test below:
http://www.lifeextension.com/Magazine/2 ... age-01?p=1
circular
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Re: Got my oxidized LDL results

Post by circular »

Thanks Julie. Dr. Gundry also tests MPO, so it would be interesting to see what specific value he attributes to each. When I asked his what markers indicate oxidized cholesterol he only mentioned sdLDL, but maybe he thought we should move on due to time constraints and didn't know just how interested I am in the details. My MPO has come down but I'm not sure why. It's still elevated though :shock:
ApoE 3/4 > Thanks in advance for any responses made to my posts.
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Julie G
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Re: Got my oxidized LDL results

Post by Julie G »

I'm not surprised that Dr. Gundry uses sdLDL as a surrogate marker for oxLDL. The association is very strong. But, do we have actual evidence that smaller particles are more easily oxidized? I'm truly curious about this.

I'm trying to be open-minded by noting that connection (between sdLDL & oxLDL) is only a correlation. Remember MichaelR's assertion that particle size is irrelevant? I think the East Coast take on this is that small particle size is an innocent tag along to oxLDL, MetS, IR. viewtopic.php?f=5&t=651&hilit=MESA&start=50
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Re: Got my oxidized LDL results

Post by circular »

Haven't had time to delve but I've had this stashed away and dug it out:

"Atherosclerosis: Evolving Vascular Biology and Clinical Implications
Atherogenic Lipoprotein Particles in Atherosclerosis"

It's aaaaaaallllllllllllllll the way back in 2004 though.

http://circ.ahajournals.org/content/109 ... III-2.full

I gather atherogenic and oxidized are two different things but compound the effects of each other?
ApoE 3/4 > Thanks in advance for any responses made to my posts.
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Re: Got my oxidized LDL results

Post by Riley »

It's hard to read this stuff with all the paleo/ Atkins stuff mixed in - once any subject starts getting any type of junk science mixed in it can be very hard to root it out .
I've seen this occur on any number of dozens of topics.
This is very unfortunate ..
I've seen the results of high fat and high refined sugar diets in 100s of patients a day for 20 years. I've written papers on it , studied it, seen it in myself and seen it in just about every patient population from Alaska to Mexico. I mean seriously ? Not enough fat ? Fat and refined sugar are both bad but like with everything when you get a part of the truth an ideaological dichotomy seems to develop.
The idea that anyone eating the western diet is ever not getting enough fat is so preposterous. Even as a strict vegan I can't help but get it from everywhere - it's just ubiquitous in our society from vegetable oils and butter used to cook vegetables to bacon grease in the healthy beans.
But even more than this is I haven't read any discussion yet on the pro inflammatory markers in meat and dairy. Dead bacteria , dead edotoxins, large undigestable proteins that cause thousands of immune responses in the body.
This is a very very serious subject.
At least the APOe4 community seems to be sorting it out, from what I can read in the latest posts.
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SusanJ
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Re: Got my oxidized LDL results

Post by SusanJ »

Diet is probably the toughest nut to crack for e4s. Think we'd all like a definitive study, but without it, we're all an N=1. So each of us have landed on different solutions to feel better and optimize our labs, and many are still tweaking. Since not everyone on the forum is a scientist, we do tend to have wide-ranging discussions. But, I don't think anyone has said that anyone eating a high fat SAD diet is on the right track.

I do find it interesting that on a higher fat (without the high sugar/carb component), some folks on this forum have noted a cognitive benefit while keeping lipids in reasonable ranges. Where fat is coming from plant sources like EVOO, avocado or fish and seafood, but not so much the saturated fats in red meat and refined oils like on SAD. These are folks who also eat a ton of greens and veggies.

Curious though, what types of diets were you recommending to your patients? And did you ever know the e4 status in your patients to see if there were different effects?
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Stavia
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Re: Got my oxidized LDL results

Post by Stavia »

Riley have a look at my summary of possible strategies on the newcomers forum. Currently we do not think that high saturated fat is a good idea for us. However with the mitochondrial insufficiency mild ketosis might be a very good idea. Some of us try a balance this seesaw by limiting saturated fat (I keep mine under 7-10 grams a day) and increasing other fats derived from fatty fish, olive oil, nuts, avocados. Because I believe that saturated fat is not our friend (see citations in my summary) I hardly ever eat red meat or dairy products.
So no we are not advocating Atkins or high red meat/dairy paleo. I made this very mistake in interpretation when I first joined the forum. You can see my intro on my first thread. I was horrified at what I wrongly interpreted. Sorry guys.....
So I guess we havent gone into the proinflamammatory effects of red meat or dairy because many of us don't eat a lot of it, if at all.
We also avoid high omega 6 veggie oils because of the 3-6 balance appearing to be extremely significant for us. Again in my summary.
Most of us dissect our diets obsessively. All of us base our main bulk of our food on veggies and salads. Currently we are wondering about limiting lectins and focusing on lower lectin plants. Most of us use extra virgin olive oil exclusively and avoid commercial omega 6 oils. Many of us are worried about adverse effects of coconut oil on our lipids. Many of us eat mainly fish or seafood, less often pastured chicken. Eggs appear to be safe as far as we know and possibly beneficial due to the phosphatidyl choline Others do eat grass fed beef or New Zealand lamb but occasionally. We eat nuts. Some of us eat occasional dairy, others more.
Thats our high fat diet we are talking about - hugely different to the standard American diet. Its also not Atkins by any means. It probably is a variation of paleo but not mainstream paleo either.
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