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.
And the way-- I think about Apo B-- because there's really cool tests now. You can use mass spec to look at C-peptide and insulin to look at your insulin resistance, which is really cool. But if you can't get that, you can ask your doctor for an Apo B because it's sort of a surrogate marker for every non-good type of cholesterol particle, if that makes sense.
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non-HDL-C is better than LDL-C (it at least tries to capture VLDL-C and TG burden).
Non-HDL-C is better than LDL-C, but why not just have the gold standard for total atherogenic particle load?
there's very little difference to try to impute or infer something about remnant cholesterol from VLDL is as complicated as trying to assess LP little-a by looking at LDL cholesterol
again the data are probably more clear on non HDL cholesterol versus LDL cholesterol that's typically what the literature talks about but as you can tell that non HDL cholesterol and LDL cholesterol are two of the three variables you would need so there's a strong correlation between non HDL cholesterol and remnant cholesterol and yes I believe non HDL cholesterol is more predictive than LDL cholesterol
we get another calculation called non HDL cholesterol that even better correlates with april-b or LDL particle concentration than does LDL cholesterol
before you declare make any statements on based on an HDL metric please make sure you have an LDL particle april-b metric in front of you also and pretty much base what you're going to advise the patient on risk and assessment based on
and hey that's a free calculation too so they use non HDL cholesterol as a marker of remnants
and there is significant discordance howland Sneiderman has published it many times as good as non HDL cholesterol meaning better than LDL cholesterol as a metric of a Bobi
i find it all right it's probably gives you a little bit more information for the reasons you just described versus ldl cholesterol yeah beyond ldl cholesterol but as sniderman has clearly shown in several studies even though non-hdl cholesterol
Here's my little Pearl so there's another metric people should look at it's called U non HDL cholesterol think of what that means that's the cholesterol that's not in your HDL particles in essence it's your apal B cholesterol so how would I know if your apob cholesterol is up I can't look at apob B but if I did that calculation non-hdl cholesterol if your apob is looking good but non-hdl cholesterol is still a little high I'm suspecting you got some of them Remnant V the old particles floating around
the good news is though you don't have to concern yourselves with LDL cholesterol non-hdl cholesterol HDL cholesterol none of those things actually matter once you know the apob and the lp little a