Paul Saladino· MD
There are cases of those with elevated LDL (while insulin sensitive) for all of these time periods with zero CACs.
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There are cases of those with elevated LDL (while insulin sensitive) for all of these time periods with zero CACs.
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we have to interpret LDL levels in the context of insulin sensitivity and I think the best way to measure insulin sensitivity across the board is fasting insulin or more specifically c-peptide
i've done multiple fasting insulins which remain very low less than three c-peptides less than 0.5 hscrp remains low and i had a coronary artery calcium scan about a year and a half ago which was a big fat zero so there was no calcium in my arteries on that scan which is not perfect but it was a pretty good indicator and at the time i had quote unquote elevated ldl but remained insulin sensitive with a low fasting insulin etcetera
and if you are insulin sensitive meaning in my opinion in a fasting insulin of less than five preferably less than three none of this really matters
And the reason that I think you should do those things is because when your lipids come back a little high, you can ask your physician, "Well, my fasting insulin is low. What do you think about that?" You can say, "My fasting glucose is low, my HS CRP is low, my hemoglobin A1C is low, and my fasting insulin is low."