Peter Attia· MD
I think that HDL function say cholesterol reflux has the ability to allow us to more specifically assign risk better than just measuring HDL cholesterol
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The evidence is convergent. Multiple independent sources reach the same conclusion, the underlying mechanism is well-characterized, and even the field's most cautious voices treat it as worth doing.
I think that HDL function say cholesterol reflux has the ability to allow us to more specifically assign risk better than just measuring HDL cholesterol
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I think realistically we need a good reproducible easy to run automatable assay that then is tested in large numbers of people and shown to predict risk better than HCL cholesterol itself
I think there's a chance we could have a more widely available clinical assay to us for this purpose within the next say two to three years right now it's still under development
we do get into HDL and we do comment on the fact that HDL functionality is not captured by HDL cholesterol an HDL particle number an apoa concentration and all of those things
now of course we can't measure HDL phospholipid content there are hundreds of phospholipids you would you would get a lipidome coming back that you you couldn't even pronounce half of the phospholipids or at least the fatty acids that are in those phospholipids and same with the protein if there's 150 of them I guarantee the average doctor might be familiar with about 10 of those proteins and not with the rest of them so I don't know how to determine a patient's HDL functionality