Lipids & Sat Fat Question

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mb00
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Lipids & Sat Fat Question

Postby mb00 » Thu Dec 27, 2018 8:35 pm

Hello - As recently posted in my intro I'm a newbie here on the forum who's an Apoe3/4. I've been doing some digging on this site as well as listening to Peter Attia's podcasts which are a wealth of information but often fly way over my head and had several questions. Thank you all in advance for this wonderful forum!

1) With regards to the concern of Saturated Fat (which I know is not settled and I tend to eat a decent amount). Is the concern purely from the cardiovascular side? IE if one has great lipid and lipoprotein markers would it be safe to say that the concern from Saturated Fat would be removed? Or does Saturated Fat have other mechanisms by which us APOE 4s need to be concerned about with regards to AD.

2) On the lipids side from what I've heard from Attia's podcasts the main items to be concerned about at LDL-P, ApoB, Trigs, and some inflammation markers such as oxLDL. From my understanding LDL-P and Apo B should track very closely to each other and are oftentimes used interchangeably by Dr. Attia to evaluate atherogenic risk. However, in some of my recent labs the two have diverged quite a bit with my Apo B at 80 mg/dL and LDL-P at 1348 nmol/L. Was wondering which if any do people here give preference to.

3) Lastly, I had a question regarding desmosterol. I found a discussion from 2015 on this board that had Julie, stavia, russ, and plenty others discussing a Dr. Dayspring lecture about it. As evidenced below I have optimal sterol absorption markets, but incredibly high sterol syntheisis markers and was wondering what if anything I should be doing about this. I've read that high desmosterol and desmosterol ratio is actually good for cognition but at these levels am I running other risks?

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Julie G
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Re: Lipids & Sat Fat Question

Postby Julie G » Fri Dec 28, 2018 10:18 am

Welcome, mb00! You ask a lot of great questions, many of which have unsettled answers.

1.) Yep, that's my understanding, based upon Attia who's a good representative of mainstream medicine.

2.) I think I heard Attia and Dayspring say that they give precedence to LDL-P over ApoB.

3.) Yes, it looks like your body is synthesizing an above average amount of desmosterol. I don't think you have to do anything in response to this. It's a part of a clinical picture to help you understand why might veer towards higher lipids. Without seeing your entire lipid panel, it's hard to comment. And, YES, a higher desmosterol level is correlated with protection against cognitive decline.

Nice to have you join the conversation!

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Stavia
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Re: Lipids & Sat Fat Question

Postby Stavia » Fri Dec 28, 2018 11:40 am

Hi mb00 and welcome.
ApoB assay is a chemical method which measures the number of apoB molecules in a unit volume. Each LDL particle has one.
LDLp assay is done with the serum going into a little MRI machine, and uses a surrogate measure of resonance to calculate the number of LDL particles.

Obviously in any test there is an error rate.
Either method will give a range of results. Which is all that really matters, it is not clinically useful to know more than "low/medium/high" . Small differences in numbers are irrelevant.

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Julie G
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Re: Lipids & Sat Fat Question

Postby Julie G » Fri Dec 28, 2018 5:18 pm

Good info, Stavia. Here's a paper that discusses discordance between ApoB and LDL-P.
Results
ApoB and LDL-PNMR values were highly correlated (R2 = 0.79), although substantial discordance was observed. Similar numbers of patients were identified as at-risk by LDL-PNMR when apoB levels were < 69 mg/dL (5%-6%) and by apoB values when LDL-PNMR was < 1073 nmol/L (6%-7%). Discordance (LDL-PNMR > apoB) was associated with insulin resistance, smaller LDL particle size, increased systemic inflammation, and low circulating levels of “traditional” lipids, whereas discordance (apoB > LDL-PNMR) was associated with larger LDL particle size, and elevated levels of lipoprotein(a) and lipoprotein-associated phospholipase A2 (Lp-PLA2).
Conclusion
Discordance between apoB and LDL-PNMR in routine clinical practice is more widespread than currently recognized and may be associated with insulin resistance.

mb00
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Re: Lipids & Sat Fat Question

Postby mb00 » Fri Dec 28, 2018 5:32 pm

Thanks for the quick and informative responses Julie and Stavia.

Julie the paper you posted about IR being linked to discordance for my situation may explain why. While my Glycemic control is fine I'm fairly certain that I have mild IR and am working on that. I plan on buying a dexcom g6 next year in order to optimize that.

One thing that's a bit irritating about the True Health Diagnostic labs is that while they do a great job bucketing your lab results into optimal medium or high risk they don't present the lab ranges. Several times I've heard that on a couple key labs you should be in X quartile of the lab range and without their ranges your left blind relying on their bucketing.

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Re: Lipids & Sat Fat Question

Postby Bettylacy » Wed Jan 02, 2019 12:04 am

Welcome mb00,
If you are interested in checking out an IR formula, I refer clients to use this link:
http://www.thebloodcode.com/homa-ir-calculator/
Keep in mind many of us APOE 4 sisters and brothers are following Dr. Bredesen's recommendation for lower glycemic markers than conventional/mainstream medicine.
APOe 3/4

mb00
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Re: Lipids & Sat Fat Question

Postby mb00 » Sat Jan 05, 2019 5:17 pm

Ah great thanks Betty. Based on the formula I had a 1.4 score at the same time as my lipids testing was done. Based on the website it appears I do have mild IR then as optimal is sub 1.

Thanks!


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