Lp-PLA2 and cardiovascular disease and APOE4

[Sandraz]

Hi. I was looking around at articles about inflammation markers and AD but found this article about Lp-PLA2 & apoe4's and CAD risk.

"In conclusion, this is one of the first studies to demonstrate an association between apoE genotype and Lp-PLA2, an emerging marker of vascular inflammation. The Lp-PLA2 index, an integrated measure of Lp-PLA2 mass and activity was higher in apo E4 carriers irrespective of ethnicity. The findings underscore the importance of assessing the relationship between genetic predisposition and phenotypic characteristics, such as presence of inflammation, in the assessment of cardiovascular disease risk."

"Apolipoprotein E (apoE) has been implicated as conveying increased risk for coronary artery disease (CAD). We hypothesized that the presence of apo E4 is associated with an increased inflammatory burden in subjects with CAD as compared to subjects without CAD. The presence of the apo E4 isoform was associated with a higher level of Lp-PLA2 index, a marker of vascular inflammation. Our results suggest that genetic variation at the apoE locus may impact cardiovascular disease risk through enhanced vascular inflammation."

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3389284/

When I looked at my numbers from February, my hs-crp was 0.5 (low) & Lp-PLA2 was 185 (low) in spite of my 4,4 genes.
These numbers were good in spite of being under tremendous stress at work, following HFLC (but cheating a bit bc of stress) plus my exercise had dropped off a lot bc of exhaustion from said stress. I theorize my low inflammation markers are due to HFLC and am being retested end of July.

Since then, I have stabilized my diet (AM BS reading are 75-83 down from mid to upper 90's) and am exercising more, and stress at work has declined. Am hoping to see those numbers maybe even go down IF they are reflective of diet and stress and excercise. Of course that is several variables.. but not going to stop exercising and (somehow) increase stress at work to test only for HFLC changes.

Sandra Z

[Ski]

Sandra
Through my own testing and seeing other presentations of patients results, Ive come to realize that one cannot rely on one marker.

Ive seen examples of tests in patients with heart diseases where every marker is good and really low (LDL_P, APOB, hsCRP, Lp(a), Lp-PLA2) and then 2 markers may stand out like HbA1C and Cardiac Myeloperoxidase.

I wish there was one test we could rely on, but there really isnt IMO.

[Julie G]

...but NO reason not to monitor the bio-markers we ARE aware of, right?

FWIW, here's a direct to consumer site that will conduct that test: http://requestatest.com/heart-health-testing My Framingham risk score is less than 1% and my lipidologist sees no need for further testing

Congrats on your many improvements, Sandra!!! You are an inspiration to me & many of us. Thanks also for sharing the amazing research you're uncovering. I'm learning a lot.

[SpunkyPup]

"I theorize my low inflammation markers are due to HFLC and am being retested end of July. "

not so quickly with the assumptions there...I'm not a fat lover and also have good markers and it is let us say a controversial marker but there are other markers that also will give a more definite overall picture.

high fat is not good for E4's moderate fat is better..

I would only consider high fat if you are in ketosis so you need a ketone meter before I will believe anyone here saying they are high fat as that is the definition commonly accepted in the low carb high fat community and elsewhere.
just because you eat what you think is high fat does not make it so and is potentially misleading and one should also be fat adapted. this I have seen E3/4's trying to do and not succeeding.

[Sandraz]

Spunky, I hear you. I have just read Russ's post about his CT scan results. I am dismayed about what I should do.
I am scared of eating too much fat and that leading to deposits and blockages. But when I add many carbs back in, or even more protein, my BS goes up. Recently, though, my hunger has gone down and looks like calorie intake is dropping naturally.
Although I know I could wake up tomorrow starving and want to eat everything in sight.
I am focusing on low carb veggies, EVOO, and trying to keep SF low (25 grams/day). Recently my AM blood sugars have been 70, lowest I have seen. Also working on exercising more. The keto strips show I am in ketosis, but I have not been using blood ketone meter recently bc strips so expensive, but urine strips show in moderate range. I feel kind of freakish bc I am always testing something a couple times a day.

Skybike, you are surely right about not relying on one marker and especially about the markers of inflammation, some of which are lower in APOE4's, that don't necessarily correlate to lower risk. You guys know so much here on this forum and I have such a steep learning curve ahead of me.

Tomorrow AM I am going for NMR bloodwork. Won't know results till end of July bc that was my docs next open appt.
Last test in Feb showed Myeloperoxidase of 206 (low). I didn't even know that test had been run. I am hoping my insulin level and A1C will have dropped bc they weren't great ... Insulin 6 and HbA1C 5.6.

And Julie. My Framingham risk of heart attack in 10 yrs is 1% but somehow don't feel like that nifty chart is taking everything into account...too many other risk factors that they don't even mention... Guess I am feeling kind of overwhelmed by all of this tonight.

This forum and all of you and all the discussions are so appreciated

Thanks!
Sandra Z

[Julie G]

Sandra, I hear you re. Russ's results. I think they've frightened all of us. I passed on eggs this AM, and had a protein shake instead- with my avocado and EVOO. Keep in mind that Russ was eating higher fat, with higher carbs- not what you're doing. My guess is THAT ratio of fats:carbs makes a BIG difference. I have my fingers crossed that you'll get amazing results.

[Tincup]

Sandra,

Here is a reason A1C tests may not match with your own serum glucose readings http://chriskresser.com/why-hemoglobin-a1c-is-not-a-reliable-marker

The main problem is that there is actually a wide variation in how long red blood cells survive in different people. This study, for example, shows that red blood cells live longer than average at normal blood sugars. Researchers found that the lifetime of hemoglobin cells of diabetics turned over in as few as 81 days, while they lived as long as 146 days in non-diabetics.

This proves that the assumption that everyone’s red blood cells live for three months is false, and that hemoglobin A1c can’t be relied upon as a blood sugar marker. In a person with normal blood sugar, hemoglobin will be around for a lot longer, which means it will accumulate more sugar. This will drive up the A1c test result – but it doesn’t mean that person had too much sugar in their blood. It just means their hemoglobin lived longer and thus accumulated more sugar. The result is that people with normal blood sugar often test with unexpectedly high A1c levels.

I've long had this problem. Fasting sugars in the 70's & 80's, post meal spikes to 100 and A1C's of 5.4-5.8. There is no way my average blood sugar is as correlated with the A1C.