Thursday, 27 February 2014

Cholesterol Testing

Eggs are a rich source of cholesterol but do not raise plasma levels of cholesterol in healthy people. 

Cholesterol testing involves measuring the amount of various plasma lipoproteins in the blood that are used for carrying cholesterol. Cholesterol testing in a research setting is valid because studies often use detailed analysis to identify individuals lipoprotein subgroups. Cholesterol testing in the clinical setting for the general population is however a scam because it is simplified to a level that makes the results of no real clinical prognostic value.

Total Cholesterol: Meaningless

Cholesterol tests will often report on your total cholesterol levels in blood. Forty years ago when less was understood about plasma cholesterol, it was believed that high levels of total cholesterol were bad. However, total cholesterol is actually a general catch all term for a number of different cholesterol lipoproteins that are known to have different effects. As some of these cholesterol carrying lipoproteins are beneficial, total cholesterol is a pointless measurement.

Low Density Lipoprotein

The low density lipoprotein carries cholesterol from the liver to the tissues. There are two types of LDL particle. These are the small dense and large buoyant particles. Only elevated levels of the small dense LDL is a risk factor for cardiovascular disease. Elevated levels of the large buoyant LDL particle are not. Tests that report on total LDL without doing a subgroup analysis are therefore a waste of time because they are not a true reflection of risk.

High Density Lipoprotein (HDL)

The high density lipoprotein particle transports cholesterol from the tissues to the liver for metabolism and excretion. There are two HDL particles named the HDL2 and HDL3 particles. High levels of HDL are protective of cardiovascular. The fact that elevated levels of HDL are protective highlights the absurdity of measuring total cholesterol levels. In addition, a high levels of LDL is not detrimental if the HDL levels is also elevated similarly.

Lipoprotein(a)

Lipoprotein(a) is a lipoprotein particle identical to the LDL particle but with an additional protein. Lipoprotein(a) is highly atherogenic which means it is strongly associated with atherosclotic plaques. It has been suggested by some that because of its similarity to the LDL particle, the normal testing procedure lumps lipoprotein(a) in with the normal LDL fraction of lipoproteins. This further calls into question the value of the LDL measurement.

Very Low Density Lipoprotein (VLDL)

The VLDL lipoprotein particle transports newly synthesised triglycerides from the liver to the tissues, including the adipose tissue. High levels of triglycerides are a risk factor for cardiovascular disease because they are associated with insulin resistance. Of all the tests this is possibly the most relevant to health as it reflects the presence of the metabolic syndrome and blood sugar disorders such as glucose intolerance and diabetes.
RdB

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