A reference post rather than a discussion. Corrections are the point; I would rather this be right than mine. It is about the lipid panel, and it is deliberately narrow — everything I am not confident about is marked as such.
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.
HsCRP is worth reading alongside them. The inflammatory-marker fall is often the most striking change on a panel and it is consistent with the cardiovascular outcome data.
The narrow version of the question 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. Tell me what I have not thought of.
lori_vegas said:ApoB is the more informative number and it is cheap.
Agreed, and reference ranges are laboratory-specific. Comparing your number to somebody else's range, or to a screenshot from another country, is how people convince themselves something is wrong.
lori_vegas 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.
That is the short version; the long version is somebody else's post.
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View ResultsAnswering the narrow version, because the broad one does not have a single answer. Quarterly for the first year is convention rather than evidence, and it is defensible for a simple reason: it is roughly the interval over which HbA1c becomes informative again, since it reflects about three months of glycaemia. After the first year, and once doses are stable, annual is reasonable unless something specific is being followed.
Dr.NateNeph said:Agreed, and reference ranges are laboratory-specific.
Same pattern here, and in the same order.