Results 1 to 15 of 15
Particle size tests - VAP vs NMR LipoProfile
  1. #1
    Peabody Guest

    Default Particle size tests - VAP vs NMR LipoProfile

    These are the two tests available to me that might be useful in
    measuring particle size. Has anyone reviewed them and come to a
    conclusion as to which offers more useful and/or valid information?

    And a more basic question. My HDL is 72, and my triglycerides are
    44. But on the other side, I have a terrible family cardiac
    history, was a heavy smoker long ago, and am being treated for
    hypertension. So I was just trying to assess what my risk level
    might be, and whether I should be taking any meds beyond aspirin.
    But with a TG/HDL ratio of 0.61, is there really any chance that
    either test would show anything other than large/fluffy? In other
    words, would it be a waste of money to get either test?



  2. #2
    Susan Guest

    Default Re: Particle size tests - VAP vs NMR LipoProfile

    x-no-archive: yes

    On 4/17/2011 2:21 PM, Peabody wrote:
    > These are the two tests available to me that might be useful in
    > measuring particle size. Has anyone reviewed them and come to a
    > conclusion as to which offers more useful and/or valid information?


    I haven't asked for them because I don't consider them that important.

    >
    > And a more basic question. My HDL is 72, and my triglycerides are
    > 44. But on the other side, I have a terrible family cardiac
    > history, was a heavy smoker long ago, and am being treated for
    > hypertension. So I was just trying to assess what my risk level
    > might be, and whether I should be taking any meds beyond aspirin.
    > But with a TG/HDL ratio of 0.61, is there really any chance that
    > either test would show anything other than large/fluffy? In other
    > words, would it be a waste of money to get either test?


    I've recently been told that both my MIL and I have nothing to worry
    about with very high LDL because we have HDL over 70, each of us, and
    low TGLs.

    If it were me, I'd be more concerned about the reason for the ht, which
    is typically endocrine in origin... I don't recall if you've had renin/
    aldosterone testing. If you're severely restricting salt, you may find
    that trying some actually lowers your bp, as it does mine... someone
    recently explained to me that sodium is required in order to deliver
    potassium to cells, which lowers bp... You might also want other
    adrenal steroids tested for possible ht causes.

    Is that medicated lipids, btw, or diet induced?

    Susan

  3. #3
    Ozgirl Guest

    Default Re: Particle size tests - VAP vs NMR LipoProfile

    For peace of mind perhaps. Your profile looks good but we are not inside
    your body

    "Peabody" <waybackNO746SPAM44[email protected]> wrote in message
    news:[email protected]..
    > These are the two tests available to me that might be useful in
    > measuring particle size. Has anyone reviewed them and come to a
    > conclusion as to which offers more useful and/or valid information?
    >
    > And a more basic question. My HDL is 72, and my triglycerides are
    > 44. But on the other side, I have a terrible family cardiac
    > history, was a heavy smoker long ago, and am being treated for
    > hypertension. So I was just trying to assess what my risk level
    > might be, and whether I should be taking any meds beyond aspirin.
    > But with a TG/HDL ratio of 0.61, is there really any chance that
    > either test would show anything other than large/fluffy? In other
    > words, would it be a waste of money to get either test?
    >
    >


  4. #4
    [email protected] Guest

    Default Re: Particle size tests - VAP vs NMR LipoProfile

    On Apr 17, 1:21*pm, Peabody <waybackNO746SPA...@yahoo.com> wrote:
    > These are the two tests available to me that might be useful in
    > measuring particle size. *Has anyone reviewed them and come to a
    > conclusion as to which offers more useful and/or valid information?
    >
    > And a more basic question. *My HDL is 72, and my triglycerides are
    > 44. *But on the other side, I have a terrible family cardiac
    > history, was a heavy smoker long ago, and am being treated for
    > hypertension. *So I was just trying to assess what my risk level
    > might be, and whether I should be taking any meds beyond aspirin. *
    > But with a TG/HDL ratio of 0.61, is there really any chance that
    > either test would show anything other than large/fluffy? *In other
    > words, would it be a waste of money to get either test?


    Just for the record, LDL particle size has not shown to be an
    indicator or correlated with CVD. On the other hand LDL Particle
    Number has been shown to be an indicator of issues.
    Much of this of this research has been posted on ASD previously and
    can be found in the archieves.

    The issue was confused for quite a while because folks with small ldl
    particle sizes have high of ldl particle numbers. When you account for
    this association ldl particle size is factored out as an indicator.
    I'll dig up the references again if any wants to see it, but thats the
    most recent view by real scientiests just interested in science.

    This "large LDL is harmless" notion is carried on by a subset of low
    carb folks that like to rationalize their high LDL levels (due to high
    saturated fat intake), but its not supported by science.

    Regards
    Randy

  5. #5
    [email protected] Guest

    Default Re: Particle size tests - VAP vs NMR LipoProfile

    On Apr 17, 1:21*pm, Peabody <waybackNO746SPA...@yahoo.com> wrote:
    > These are the two tests available to me that might be useful in
    > measuring particle size. *Has anyone reviewed them and come to a
    > conclusion as to which offers more useful and/or valid information?
    >
    > And a more basic question. *My HDL is 72, and my triglycerides are
    > 44. *But on the other side, I have a terrible family cardiac
    > history, was a heavy smoker long ago, and am being treated for
    > hypertension. *So I was just trying to assess what my risk level
    > might be, and whether I should be taking any meds beyond aspirin. *
    > But with a TG/HDL ratio of 0.61, is there really any chance that
    > either test would show anything other than large/fluffy? *In other
    > words, would it be a waste of money to get either test?


    If you want to know the condition of your arteries, forget the
    surrogote indicators and look at the source.

    You can get an ultra sound of your carotid artery or a calcium scan
    ( with some radiation) or your coranary arteries.

    Regards
    Randy

  6. #6
    Kurt Guest

    Default Re: Particle size tests - VAP vs NMR LipoProfile

    On Apr 17, 8:17*pm, "ra...@val.com" <ra...@val.com> wrote:
    > This "large LDL is harmless" notion is carried on by a subset of low
    > carb folks that like to rationalize their high LDL levels (due to high
    > saturated fat intake), but its not supported by science.
    >
    > Regards
    > Randy


    Thanks Randy. This should be repeated often in here whenever the usual
    misinformation is presented as fact by the usual suspect.

    Kurt


  7. #7
    Peabody Guest

    Default Re: Particle size tests - VAP vs NMR LipoProfile

    Susan says...

    > If it were me, I'd be more concerned about the reason
    > for the ht, which is typically endocrine in origin... I
    > don't recall if you've had renin/ aldosterone testing.


    Yes, I had both tested, and they were either normal or low.
    I get essentially no BP lowering from ACE inhibitors, ARBs,
    or Tekturna. What works is calcium channel blockers - I'm
    now on two of them, and now routinely get readings in the
    120s. Well, HCTZ also works, but then nothing else does, if
    you know what I mean.

    I've asked the question of my doctors - what would be the
    likely cause of HTN that doesn't respond at all to any of
    the renin/angiotensin/aldosterone stuff, but responds well
    to CCBs? And all I get for an answer is shrugged shoulders.
    A few years ago I went through tests for essentially all of
    the secondary HTN causes, but nothing interesting came up.

    > Is that medicated lipids, btw, or diet induced?


    Not sure what you mean. I'm not on any meds for lipids. I
    go to the gym every day and do both cardio and weights, I'm
    not overweight, and don't eat useless carbs - not a "low
    carb" diet at all, more like 1/3 of calories. I eat a fair
    amount of nuts, berries, dark chocolate and olive oil. And
    a glass of wine with dinner. The only med I take that's a
    bit unusual is a vanishingly small, near-homeopathic dose of
    Arimidex, which is an aromatase inhibitor. I take that to
    offset the tendency of Diltiazem to cause increased estrogen
    levels in men - not a good thing.



  8. #8
    Peabody Guest

    Default Re: Particle size tests - VAP vs NMR LipoProfile

    [email protected] says...

    > Just for the record, LDL particle size has not shown to
    > be an indicator or correlated with CVD.


    I could have sworn I had seen such a correlation reported.

    > On the other hand LDL Particle Number has been shown to
    > be an indicator of issues.


    Well then that would argue for choosing the NMR LipoProfile
    test, which directly measures particle number. I think the
    VAP test is more of a finer breakdown of cholesterol
    fractions.

    > The issue was confused for quite a while because folks
    > with small ldl particle sizes have high of ldl particle
    > numbers. When you account for this association ldl
    > particle size is factored out as an indicator. I'll dig
    > up the references again if any wants to see it, but
    > thats the most recent view by real scientiests just
    > interested in science.


    Yes, that would be helpful.


  9. #9
    [email protected] Guest

    Default Re: Particle size tests - VAP vs NMR LipoProfile

    On Apr 18, 10:23*am, Peabody <waybackNO746SPA...@yahoo.com> wrote:
    > ra...@val.com says...
    >
    > *> Just for the record, LDL particle size has not shown to
    > *> be an indicator or correlated with CVD.
    >
    > I could have sworn I had seen such a correlation reported.
    >
    > *> On the other hand LDL Particle Number has been shown to
    > *> be an indicator of issues.
    >
    > Well then that would argue for choosing the NMR LipoProfile
    > test, which directly measures particle number. *I think the
    > VAP test is more of a finer breakdown of cholesterol
    > fractions.
    >
    > *> The issue was confused for quite a while because folks
    > *> with small ldl particle sizes have high of ldl particle
    > *> numbers. When you account for this association ldl
    > *> particle size is factored out as an indicator. I'll dig
    > *> up the references again if any wants to see it, but
    > *> thats the most recent view by real scientiests just
    > *> interested in science.
    >
    > Yes, that would be helpful.


    Hi,

    I provided some references on the status small Ldl and coranary
    disease.

    It seems there were some very good reasons for holding small Ldl
    suspect, but the latest research and analsys shows the sm Ldl is
    guilty by association only. The confusion stemed from some tricky
    confounders, that once accounted for, removed small ldl from being the
    bad guy of the ldl family.

    Reference 1 is a very good primer on Ldl and reveiws all the major
    research. It shows how confounders, revealed by multi-variate
    analysis, cast a differnt light on the matter.

    Reference 2 is from the lead author of a study looking and ldl size
    clogging up arteries. She discusses how small Ldl can seem to be worse
    until proper counfounders are considered.

    Reference 3 is the latest review of the best studies looking at Ldl
    size and coranary disease.

    All the reference find Ldl particle number to be strongly causitive,
    but Ldl particle size disappears in the full picture. Links to the
    full papers of [1] and [2] are provided and are recommended if you
    like to dig into issues in depth.

    Regards
    Randy

    Ref:
    1. Full paper available
    Low-Density Lipoprotein Size and Cardiovascular
    Disease: A Reappraisal
    FRANK M. SACKS AND HANNIA CAMPOS
    Conclusions
    The burden of proof for any newly proposed risk factor is
    that it must add significantly to risk assessment by existing
    measurements, or that it is equivalent but more economical.
    LDL subtyping does not meet either of these expectations.
    Metabolic studies demonstrate that large and small LDL
    subtypes are atherogenic. In as much as any type of LDL is
    contained in the plasma total LDL concentration, the standard
    clinical measurement of risk, all LDL types should be
    viewed as harmful. The best indicator of response to lipid
    therapy is a reduction in the plasma concentration of atherogenic
    lipoproteins, as conventionally measured by LDL and
    triglycerides, but alternatively by non-HDL cholesterol or
    apo B (91).
    Acknowledgments

    http://jcem.endojournals.org/cgi/reprint/88/10/4525.pdf

    2.
    LDL PARTICLE SIZE: DOES IT MATTER?
    www.athero.org/commentaries/comm564.pdf - Similar
    Summary
    Small LDL confounded the association of large LDL with IMT because of
    its strong inverse
    correlation with large LDL, which may underlie the widespread belief
    that large LDL confers
    less cardiovascular risk than small LDL. Contrary to current opinion,
    both small and large LDL
    were significantly associated with subclinical atherosclerosis
    independent of each other,
    traditional lipids, and established risk factors, with no association
    between LDL size and
    atherosclerosis after accounting for the concentrations of the two
    subclasses. This knowledge
    may contribute to our understanding of atherogenesis, and future
    studies examining LDL size
    and atherosclerosis should account for the significant inverse
    correlation between small and large
    LDL.

    References
    1. Stampfer MJ, Krauss RM, Ma J, et al. A prospective study of
    triglyceride level, low-density
    lipoprotein particle diameter, and risk of myocardial infarction. JAMA
    1996;276:882-88.

    2. Gardner CD, Fortmann SP, Krauss RM. Association of small low-
    density lipoprotein particles
    with the incidence of coronary artery disease in men and women. JAMA
    1996;276:875-81.

    3. Lamarche B, Tchernof A, Moorjani S, et al. Small, dense low-density
    lipoprotein particles as a
    predictor of the risk of ischemic heart disease in men. Prospective
    results from the Quebec
    Cardiovascular Study. Circulation 1997;95:69-75.

    4. Hulthe J, Wiklund O, Bondjers G, Wikstrand J. LDL particle size in
    relation to intima-media
    thickness and plaque occurrence in the carotid and femoral arteries in
    patients with
    hypercholesterolaemia. J Intern Med 2000;248:42-52.

    5. Campos H, Moye LA, Glasser SP, Stampfer MJ, Sacks FM. Low-density
    lipoprotein size,
    pravastatin treatment, and coronary events. JAMA 2001;286:1468-74.

    6. Cromwell WC, Otvos JD. Low-density lipoprotein particle number and
    risk for cardiovascular
    disease. Curr Atheroscler Rep 2004;6:381-87.

    7. Kuller L, Arnold A, Tracy R, et al. Nuclear magnetic resonance
    spectroscopy of lipoproteins and
    risk of

    3.
    http://www.ncbi.nlm.nih.gov/pubmed/19349632
    Systematic review: association of low-density lipoprotein subfractions
    with cardiovascular outcomes.
    Ip S, Lichtenstein AH, Chung M, Lau J, Balk EM.
    Tufts Medical Center and Tufts University, Boston, Massachusetts
    02111, USA.
    <P>BACKGROUND: Measures of low-density lipoprotein (LDL) subfractions
    have been
    proposed as an independent risk factor for cardiovascular disease.
    PURPOSE: To
    review published studies that reported relationships between LDL
    subfractions
    and cardiovascular outcomes. DATA SOURCES: MEDLINE (1950 to 5 January
    2009), CAB
    Abstracts (1973 to 30 June 2008), and Cochrane Central Register of
    Controlled
    Trials (2nd quarter of 2008), limited to English-language studies.
    STUDY
    SELECTION: 3 reviewers selected longitudinal studies with 10 or more
    participants that reported an association between LDL subfractions and
    incidence
    or severity of cardiovascular disease and in which plasma samples were
    collected
    before outcome determination. DATA EXTRACTION: Data were extracted
    from 24
    studies. The 10 studies that used analytical methods available for
    clinical use
    (all of which used nuclear magnetic resonance) had full data
    extraction,
    including quality assessment (good, fair, or poor). All studies were
    extracted
    by 1 researcher and verified by another. DATA SYNTHESIS: All 24
    studies, and the
    subset of 10 nuclear magnetic resonance studies, were heterogeneous in
    terms of
    the specific tests analyzed, analytical methods used, participants
    investigated,
    and outcomes measured. Higher LDL particle number was consistently
    associated
    with increased risk for cardiovascular disease, independent of other
    lipid
    measurements. Other LDL subfractions were generally not associated
    with
    cardiovascular disease after adjustment for cholesterol
    concentrations. No study
    evaluated the incremental value of LDL subfractions beyond
    traditional
    cardiovascular risk factors or their test performance. Limitation:
    Publication
    bias was a possibility. CONCLUSION: Higher LDL particle number has
    been
    associated with cardiovascular disease incidence, but studies have
    not
    determined whether any measures of LDL subfractions add incremental
    benefit to
    traditional risk factor assessment. Routine use of clinically
    available LDL
    subfraction tests to estimate cardiovascular disease risk is
    premature
    PMID: 19349632 [PubMed - indexed for MEDLINE]</P>

  10. #10
    Peabody Guest

    Default Re: Particle size tests - VAP vs NMR LipoProfile

    [email protected] says...

    > It seems there were some very good reasons for holding
    > small Ldl suspect, but the latest research and analsys
    > shows the sm Ldl is guilty by association only. The
    > confusion stemed from some tricky confounders, that once
    > accounted for, removed small ldl from being the bad guy
    > of the ldl family.


    Thanks very much for providing those references. I do
    wonder, though, whether the logic isn't a bit circular, and
    whether it's a question of which measure is the "base" and
    which is the newcomer. And the first reference pretty much
    assumes going in what I'm wondering about - that all LDL
    cholesterol is equally atherogenic.

    But I need to read the full studies. In any case, I assume
    your advice would be to take the NMR LipoProfile test, which
    directly measures particle number.


  11. #11
    [email protected] Guest

    Default Re: Particle size tests - VAP vs NMR LipoProfile

    > But I need to read the full studies. *In any case, I assume
    > your advice would be to take the NMR LipoProfile test, which
    > directly measures particle number.


    Yes, particle number is the major indicator, particle size is iffy at
    best. That's what the data shows.

    Links to the full papers of the first 2 references are provided. I
    highly recommend them both.

    If you really want to know what shape your arteries are in, get an
    ultra sound of your carotid or a calcium scan.

    Regards
    Randy

  12. #12
    outsider Guest

    Default Re: Particle size tests - VAP vs NMR LipoProfile

    On 4/19/2011 11:55 AM, [email protected] wrote:
    >> But I need to read the full studies. In any case, I assume
    >> your advice would be to take the NMR LipoProfile test, which
    >> directly measures particle number.

    >
    > Yes, particle number is the major indicator, particle size is iffy at
    > best. That's what the data shows.
    >
    > Links to the full papers of the first 2 references are provided. I
    > highly recommend them both.
    >
    > If you really want to know what shape your arteries are in, get an
    > ultra sound of your carotid or a calcium scan.


    Mine carotids are partially blocked. But, I was told, there's
    concern till they're 90% or more blocked. I do realize that
    when I lie on my ear I can hear the squish squish of my
    heartbeat. I can remember it was a very clear sharp sound
    when I was young, like footsteps across a wood floor. I am
    not at all sure whether there's more at work in that sound.
    Perhaps my heart isn't working as well as it was in my youth.

  13. #13
    [email protected] Guest

    Default Re: Particle size tests - VAP vs NMR LipoProfile

    On Apr 19, 12:37*pm, outsider <outsi...@sometime.invalid.net> wrote:
    > On 4/19/2011 11:55 AM, ra...@val.com wrote:
    >
    > >> But I need to read the full studies. *In any case, I assume
    > >> your advice would be to take the NMR LipoProfile test, which
    > >> directly measures particle number.

    >
    > > Yes, particle number is the major indicator, particle size is iffy at
    > > best. That's what the data shows.

    >
    > > Links to the full papers of the first 2 references are provided. I
    > > highly recommend them both.

    >
    > > If you really want to know what shape your arteries are in, get an
    > > ultra sound of your carotid or a calcium scan.

    >
    > Mine carotids are partially blocked. But, I was told, there's
    > concern till they're 90% or more blocked. I do realize that
    > when I lie on my ear I can hear the squish squish of my
    > heartbeat. I can remember it was a very clear sharp sound
    > when I was young, like footsteps across a wood floor. I am
    > not at all sure whether there's more at work in that sound.
    > Perhaps my heart isn't working as well as it was in my youth.


    Well, these things can reverse and get better. There are lots of
    studies documenting this, but most used methods (drugs) you would find
    unacceptable. There is some data this stuff can improve with non-drug
    methods, but I believe it's pretty severe.

    In any case go luck.

    Regards
    Randy

  14. #14
    Chris Malcolm Guest

    Default Re: Particle size tests - VAP vs NMR LipoProfile

    outsider <[email protected]> wrote:
    > On 4/19/2011 11:55 AM, [email protected] wrote:
    >>> But I need to read the full studies. In any case, I assume
    >>> your advice would be to take the NMR LipoProfile test, which
    >>> directly measures particle number.

    >>
    >> Yes, particle number is the major indicator, particle size is iffy at
    >> best. That's what the data shows.
    >>
    >> Links to the full papers of the first 2 references are provided. I
    >> highly recommend them both.
    >>
    >> If you really want to know what shape your arteries are in, get an
    >> ultra sound of your carotid or a calcium scan.


    > Mine carotids are partially blocked. But, I was told, there's
    > concern till they're 90% or more blocked. I do realize that
    > when I lie on my ear I can hear the squish squish of my
    > heartbeat. I can remember it was a very clear sharp sound
    > when I was young, like footsteps across a wood floor. I am
    > not at all sure whether there's more at work in that sound.
    > Perhaps my heart isn't working as well as it was in my youth.


    Interesting observation. I wonder if listening to one's carotid
    labyrinth through a stethoscope under various heartbeat
    etc. conditions would provide any useful information? It would be
    possible to make recordings of the sound for retrospective comparisons
    over the years.

    --
    Chris Malcolm

  15. #15
    Ellen K. Guest

    Default Re: Particle size tests - VAP vs NMR LipoProfile


    "outsider" <[email protected]> wrote in message
    news:iokh8l$mv2$[email protected]..
    > On 4/19/2011 11:55 AM, [email protected] wrote:
    >>> But I need to read the full studies. In any case, I assume
    >>> your advice would be to take the NMR LipoProfile test, which
    >>> directly measures particle number.

    >>
    >> Yes, particle number is the major indicator, particle size is iffy at
    >> best. That's what the data shows.
    >>
    >> Links to the full papers of the first 2 references are provided. I
    >> highly recommend them both.
    >>
    >> If you really want to know what shape your arteries are in, get an
    >> ultra sound of your carotid or a calcium scan.

    >
    > Mine carotids are partially blocked. But, I was told, there's
    > concern till they're 90% or more blocked. I do realize that
    > when I lie on my ear I can hear the squish squish of my
    > heartbeat. I can remember it was a very clear sharp sound
    > when I was young, like footsteps across a wood floor. I am
    > not at all sure whether there's more at work in that sound.
    > Perhaps my heart isn't working as well as it was in my youth.
    >


    According to the informational materials I received from LifeLine Screening,
    the percentage of blockage is only one factor in determining stroke risk,
    the other being the velocity of the blood flow, i.e. a person with a slight
    amount of plaque but no reduction in the velocity of the blood flow is not
    at greater risk than if there were no plaque. Personally I still feel no
    plaque would be preferable.


Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28