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61 lines
3 KiB
Markdown
61 lines
3 KiB
Markdown
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# Lipid Triad
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https://pubmed.ncbi.nlm.nih.gov/29241485/
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"Many CVRF-free middle-aged individuals have atherosclerosis. LDL-C, even at levels currently considered normal, is independently associated with the presence and extent of early systemic atherosclerosis in the absence of major CVRFs. These findings support more effective LDL-C lowering for primordial prevention, even in individuals conventionally considered at optimal risk."
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Lipid combos:
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https://pubmed.ncbi.nlm.nih.gov/25458651/
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"Aside from isolated hypertriglyceridemia, low levels of HDL-C, high levels of LDL-C, and high levels of TG in any combination were associated with increased risk of CVD."
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LMHR paper:
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https://pubmed.ncbi.nlm.nih.gov/35106434/
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"These data suggest that, in contrast to the typical pattern of dyslipidemia, greater LDL cholesterol elevation on a CRD tends to occur in the context of otherwise low cardiometabolic risk."
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---
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# LDL Bounty
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## Criteria
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1. **HDL Cholesterol of 50 mg/dL or above (≥ 1.29 mmol/L)**
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2. **Triglycerides of 100 mg/dL or below (≤ 1.13 mmol/L)**
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3. **LDL Cholesterol of 130 mg/dL or above (≥ 3.36 mmol/L)**
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4. **Either high Coronary Heart Disease (CHD) or high Cardiovascular Disease (CVD) (see the section below)**
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5. By “**normal**” and “**non-treated**“, I mean:
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- No stratifying by specific genetics
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- No stratifying by drugs (no drug studies)
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- No stratifying by a particular illness in advance of the study. (duh!)
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- _In other words, just a generally broad group of people like [Framingham Offspring](https://www.ncbi.nlm.nih.gov/pubmed/27166203) or the [Jeppesen study](https://www.ncbi.nlm.nih.gov/pubmed/11176761)_
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6. And here’s some fine print that should be obvious, but just in case…
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- The study needs to be published in a reputable journal
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- It has to be dated before this article was posted, of course
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- The study needs to have at least 400 participants that are stratified by this criteria. (The two studies above have over 500)
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- I’d prefer no unusual “modeling” or “adjustments” to alter the data too far from it’s original set. This one goes by the honor system — if you have such a study and it is clearly warranted, I can give it a pass.
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"High" defined as greater than the average rates of CVD per age group in the American population.
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### Criticisms
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1. Vanishingly small population subset. Unreasonable to expect it to have been studied.
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2. If studied in the general population, they won't be keto, so translation to keto subjects may be dubious.
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3. The sheer weight of the evidence in favour of LDL's causal role in ASCVD cuts deeply against the notion that this population subset would be protected to begin with.
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4. Comparing this isolated cohort to the American general population is methodology that is beyond fringe, bordering on insane.
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5. Ultimately if this is taken to be an indication that LDL is fine in this particular context, it would qualify as an appeal to ignorance.
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---
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# Hashtags
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#lipidology
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#lipid_triad
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#LMHR
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#LDL
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#triglycerides
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#HDL
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#clowns
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#clownery
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#debate
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#debate_opponents
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