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[Michael Lustgarten]

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[Michael Lustgarten]

 

Cardiovascular Disease Biomarker Deep Dive (Test #7 In 2025)

 

 

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[Michael Lustgarten]

Part III: S-adenosyl-methionine: A Key Player For Lowering Homocysteine?

 

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[albedo]

As usual Michael, great video.

 

Give the variability of LP(a) (do you quantify that too?) how you can disentangle what is statistics from possible effects *caused* by external factors you act upon (diet, exercise, etc ...). I know LP(a) is largely genetics though but you also made a point in trying to get to low ASCVD % risk (great chart, btw). Very good you recommend to track data and not limit to one point.

 

BTW I decided (sorry ;-)) to go on low dose statins. 5-10 mg rosuvastatin dramatically improved all lipids biomarkers (unless LP(a) as i expected though). Still checking as I started recently about 70 yo. Very happy with numbers so far.

 

Also, as you are correlating to hsCRP I am running around 0.8 at 70 yo and also checking form time to time IL-6 and TNF-alpha.

 

Please keep up the good work!

[albedo]

sorry .. I forgot a piece of text: "....trying to get to low ASCVD % risk (great chart, btw) also by looking at hsCRP and lower inflammation". My apologizes.

[Michael Lustgarten]

Thanks albedo, will do, for as long as I live!

In terms of Lp(a) (or other biomarker variability), one way to account for it is by testing multiple times per year, and looking at year-to-year averages. Lp(a) is thought to be a relative constant, which has led many to say to only measure it once, but in my case, I've had values that have ranged from 70 to 145 nmol/L

Then, what's the recipe for keeping it low, not high? I've had some success with that, as the 10yr average is around 90 nmol/L (still too high, but not 145 nmol/L)

No worries on using a statin-note that statins don't generally reduce Lp(a), so I'd keep my eye on emerging meds that can lower it, especially when considering that Lp(a) is 6-7x more atherogenic than LDL...

[albedo]

Thank you for your reply Michael.

 

Yes, as I wrote, I did not expect statins to lower my LP(a). 

 

Over 20 years (now 70yo) my average LP(a) is 69 nmol/l (288 mg/l). As you also experienced, I also had great variability (max 126 nmol/l (525 mg/l) and min 35 nmol/l (147 mg/l). Of course one has to be cautious with methodologies and reference ranges when comparing labs in EU and US but there is standardization and I measured in both places.

 

After recently introducing a low dose 5-10mg rosuvastatin I can likes say:

• best ever LDL
• possibly better HDL 
• best ever ApoB/ApoA
• possibly better Apo A-I

 

[albedo]

Good point on TG (great your also pointed to VLDL ~ TG/5).

 

While my TG has going down since now 30+ years it’s not that great as you (at 71 mg/dl). But we differ in age of course.

 

I do also look at ratios: my TG/HDL looks pretty good I guess at 0.8. I understand as the TG/HDL ratio decreases, the LDL particles become larger and are vastly reduced in their atherosclerotic potential, see e.g. https://pmc.ncbi.nlm...les/PMC7691046/. Do you agree with that? Dr Sears also published on that if I recollect well.

 

While I see your deep dive into TG I do not see similar data for TG/HDL or similar ratios but maybe I am overlooking.

 

(again: incredible work you are doing! again: keep up the good work!)

 

[Michael Lustgarten]

Good point on TG (great your also pointed to VLDL ~ TG/5).

 

While my TG has going down since now 30+ years it’s not that great as you (at 71 mg/dl). But we differ in age of course.

 

I do also look at ratios: my TG/HDL looks pretty good I guess at 0.8. I understand as the TG/HDL ratio decreases, the LDL particles become larger and are vastly reduced in their atherosclerotic potential, see e.g. https://pmc.ncbi.nlm...les/PMC7691046/. Do you agree with that? Dr Sears also published on that if I recollect well.

 

While I see your deep dive into TG I do not see similar data for TG/HDL or similar ratios but maybe I am overlooking.

 

(again: incredible work you are doing! again: keep up the good work!)

I generally try to stay away from ratios, which can be misleading. For ex., an ApoB/ApoA1 ratio of 0.5 is within optimal, but if that's within the context of high ApoB and ApoA1 (110/220, for example), then it's misleading

Instead, I'm focused on optimizing the individual biomarkers, and by proxy, their ratio

Part IV of the Test #7 Analysis: Diet Composition

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Edited by Michael Lustgarten, Yesterday, 09:45 PM.

[albedo]

I generally try to stay away from ratios, which can be misleading. For ex., an ApoB/ApoA1 ratio of 0.5 is within optimal, but if that's within the context of high ApoB and ApoA1 (110/220, for example), then it's misleading

Instead, I'm focused on optimizing the individual biomarkers, and by proxy, their ratio

Part IV of the Test #7 Analysis: Diet Composition

 

Thank you. Yes, I agree: clearly ratios are only first approximation as by definition involve two variables and with individual biomarkers you are better off to catch causality and intervene as you are not confounding variables. I do because sometime literature is given in terms of ratios, e.g. for the ApoB/ApoA (I'm 0.5), see 

 

https://www.medscape...541799?form=fpf

 

and also

 

https://www.nsfa.ass...ou-hdl-enfin-de

 

https://academic.oup...edFrom=fulltext

 

(but of course my research must pale with respect to your ....    )

Edited by albedo, Yesterday, 10:07 PM.