Paul Saladino· MD
Stratifying the connection between "high cholesterol" and heart disease risk by insulin sensitivity clearly shows that metabolic health means everything here.
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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.
Stratifying the connection between "high cholesterol" and heart disease risk by insulin sensitivity clearly shows that metabolic health means everything here.
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hdl is a proxy for metabolic health or dysfunction with the lowest levels of hdl being associated with insulin resistance and the highest levels being associated with insulin sensitivity or metabolic health
then say well I'm metabolically healthy does it matter if my LDL cholesterol is 160 milligrams per deciliter I would say probably not if you're fasting insulin which is perhaps the easiest best metric of your metabolic health is good which in my opinion would be less than five micro IU per ml
Important to point out as well when we're talking about LDL we're not saying everything else doesn't matter. We are just saying that this is an independent risk factors is what I'm saying. Insulin sensitivity, metabolic health, all those things still matter. These are not mutually exclusive.