Putting this up for argument rather than for agreement. I have read it twice and I am still not certain what it supports.
ApoB is the more informative number and it is cheap. LDL-C estimates cholesterol mass in atherogenic particles; ApoB counts the particles, and it is particle count that tracks risk — which is why the two can disagree and why the disagreement is the clinically interesting case. Triglycerides fall substantially with weight loss and improved insulin sensitivity, HDL moves modestly, and LDL-C often barely moves at all, which surprises people who expected everything to improve together.
Where I think it is weakest: the population was selected and supported in ways a real cohort is not, so I would read the effect size as a ceiling rather than an expectation.
The question I want answered is whether an unchanged LDL-C alongside a large triglyceride fall is a good result or a bad one, because ApoB and LDL-C seem to be telling different stories. I have searched first, so if this is covered somewhere point me at it and I will read it.
Figures above are from the primary publication rather than the press summary. If a number here disagrees with one you have, post yours and we will work out which of us is reading a secondary source.
Dr.MetabolicMD said:ApoB is the more informative number and it is cheap.
Tracking labs for the lipid panel — here's the panel I get every 3 months and why:
- CMP: glucose, electrolytes, kidney function, liver enzymes
- Lipid panel: total cholesterol, LDL, HDL, triglycerides
- A1C: 3-month glucose average
- hsCRP: inflammatory marker
- CBC: blood counts, anemia screening
- B12, folate, iron: nutritional deficiency screening
- TSH, free T4: thyroid monitoring
- Lipase: pancreatic safety check
Total cost with insurance: about $26 copay. Without insurance, request cash-pay pricing from Quest/Labcorp — usually $161.
Dr.MetabolicMD said:ApoB is the more informative number and it is cheap.
Careful with treating an unchanged LDL-C as a failure. If ApoB and triglycerides both fell, the particle picture improved regardless of what the calculated LDL says.
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View ResultsPharmD_Rodriguez said:Careful with treating an unchanged LDL-C as a failure.
Advanced lipoprotein testing on the lipid panel — going beyond standard lipid panel:
| Marker | Baseline | Month 8 | Clinical Meaning |
|---|---|---|---|
| LDL-P | 1674 | 974 | Particle count (more precise than LDL-C) |
| Small dense LDL | 64% | 30% | Atherogenic pattern |
| Remnant cholesterol | 38 | 18 | Triglyceride-rich lipoproteins |
| oxLDL | 79 | 42 | Oxidative stress marker |
The shift from small dense to large buoyant LDL is particularly important — it represents a fundamental change in the atherogenic profile.
TrialNerd_Beth said:Tracking labs for the lipid panel — here's the panel I get every 3 months and why: CMP: glucose, electrolytes, kidney function, liver enzymes Lipid…
Adding a me-too, because a thread of one person's experience is not much use. The detail I would add is minor and it is already implied above.