Re: Question for Quentin (cholesterol ratios)

x-no-archive: yes

TigerLily wrote:
for a diabetic, they want our LDL levels to be
below 75 now

That's a very controversial recommendation; I believe the "they" involved are the statin manufacturers. In fact, LDL readings alone are a poor predictor of CVD risk.

Ann Epidemiol. 2005 May;15(5):405-13.
Related Articles, Links


A comparison of lipid variables as predictors of cardiovascular disease in the Asia Pacific region.

Barzi F, Patel A, Woodward M, Lawes CM, Ohkubo T, Gu D, Lam TH, Ueshima H; Asia Pacific Cohort Studies Collaboration.

The George Institute for International Health, University of Sydney, Camperdown, NSW 2050, Australia. fbarzi@xxxxxxxxxxxxxxxxxxxxxx

PURPOSE: Many guidelines advocate measurement of total or low density lipoprotein cholesterol (LDL), high density lipoprotein cholesterol (HDL), and triglycerides (TG) to determine treatment recommendations for preventing coronary heart disease (CHD) and cardiovascular disease (CVD). This analysis is a comparison of lipid variables as predictors of cardiovascular disease. METHODS: Hazard ratios for coronary and cardiovascular deaths by fourths of total cholesterol (TC), LDL, HDL, TG, non-HDL, TC/HDL, and TG/HDL values, and for a one standard deviation change in these variables, were derived in an individual participant data meta-analysis of 32 cohort studies conducted in the Asia-Pacific region. The predictive value of each lipid variable was assessed using the likelihood ratio statistic. RESULTS: Adjusting for confounders and regression dilution, each lipid variable had a positive (negative for HDL) log-linear association with fatal CHD and CVD. Individuals in the highest fourth of each lipid variable had approximately twice the risk of CHD compared with those with lowest levels.

*******TG and HDL were each better predictors of CHD and CVD risk compared with TC alone, with test statistics similar to TC/HDL and TG/HDL ratios. Calculated LDL was a relatively poor predictor.*******

CONCLUSIONS: While LDL reduction remains the main target of intervention for lipid-lowering, these data support the potential use of TG or lipid ratios for CHD risk prediction.

PMID: 15840555 [PubMed - indexed for MEDLINE]




you have good ratios, but that's not enough

Lots of doctors and scientists believe it's what matters most.

Susan
.

Relevant Pages

  • Re: Lifelong Reduction in LDL Cholesterol Markedly Cuts Risk of Coronary Events
    ... he's selling diet books and prepared foods with a marketing plan that depends on making you believe that lowering LDL is critical. ... A comparison of lipid variables as predictors of cardiovascular disease in the Asia Pacific region. ... Adjusting for confounders and regression dilution, each lipid variable had a positive log-linear association with fatal CHD and CVD. ...
    (alt.support.diabetes)
  • LDL poor predictor of CHD and CVD risk
    ... This is why risking the side effects of a statin for LDL lowering to proposed targets is not worthwhile. ... A comparison of lipid variables as predictors of cardiovascular disease in the Asia Pacific region. ... Adjusting for confounders and regression dilution, each lipid variable had a positive log-linear association with fatal CHD and CVD. ...
    (alt.support.diabetes)
  • Re: doc wants me on Zocor
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    (alt.support.diabetes)
  • Re: describing logistic regression results for clinicians
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  • From another ng, re: LDL and CVD risk
    ... This is consistent with other research that shows elevated TGLs and TGL/HDL ratios as much more predictive of CVD. ... The only ones profiting from a focus on LDL lowering are the statin manufacturers, ... A comparison of lipid variables as predictors of cardiovascular ...
    (alt.support.diabetes)