The atherosclerotic culprit is LDL particle number, not LDL cholesterol! LDL cholesterol values can be misleading. Optimal levels of LDL cholesterol can mask increased LDL particle numbers. It is the number and type of particles present cause atherosclerosis, not the amount of cholesterol they carry. A given level of LDL cholesterol could be caused by a small number of large LDL particles or a large number of small LDL particles.’ L-P provides the total number of LDL particles in nanomoles of particles per liter.
Many clinicians use small LDL-P to guide therapy. Studies show that people with lower LDL particle numbers have fewer events than those with higher LDL particle numbers. Unlike traditional measurement methods which quantify the lipid constituents of lipoprotein particles (like cholesterol and triglycerides), our proprietary nuclear magnetic resonance (NMR) test quantifies lipoprotein subclass particle numbers. Thus, it is possible to differentiate interventions which affect the lipid composition of lipoprotein particles from those which affect the numbers of particles (which is more strongly linked to cardiovascular and metabolic disease risk).
Twenty-nine percent of all deaths in the United States are caused by heart disease, which is the leading cause of death for both women and men. In the United States, more than 160,000 people die each year from stroke – the third leading cause of death. The Framingham study, showed that 50% of the people who suffered a heart attack had normal cholesterol levels. Patients with the following may benefit from the NMR LipoProfile test: Diabetes, Cardiometabolic risk/metabolic syndrome, previous heart attack, Family history of heart attack, High blood pressure, Overweight/Obesity, Low HDL (dyslipidemia), or High triglycerides. The NMR LipoProfile report includes a standard lipid panel (total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides), and a Cholesterol Expanded Lipoprotein Analysis (LDL-P, HDL-P, VLDL-P, LDL Size). If triglyceride level is >400 mg/dL, LDL cholesterol will not be calculated.
We are proud to announce that we can run the NMR LipoProfile with our patients through Labcorp. I’ve talked numerous amount of times about particle size checking and how it’s more important to look at that rather than the total cholesterol or LDL number. Below is one of my previous blogs talking about cholesterol management.