Help with VAP interpretation, please

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Help with VAP interpretation, please


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Old 06-27-2014, 07:05   #1
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Default Help with VAP interpretation, please

Would someone help me with these? Salim? My life has been a mess lately - my husband died in April, and was very ill for a long time before that. Naturally I was under a ton of stress, my body flooded with cortisol night and day. These results are the worst I've ever had, and of course it makes my Dr. raise the statin flag again. I told her that I think that getting de-stressed, starting the fish oil that I always used to take but dropped 6 months ago or so, and maybe taking some niacin, plus more exercise, would be the solution. Through it all my diet never changed a bit, straight LC/fairly HF, except for a lot more wine during the months that my husband was dying. Does anyone see anything that I'm missing here?


Total LDL-Cholesterol Dir (H)181 mg/dL (<130 - )
Total HDL-Cholesterol Dir 56 mg/dL (>=40 - )
Total VLDL-Cholesterol Dir (H) 31 mg/dL (<30 - )
Sum Total Cholesterol (H) 269 mg/dL (<200 - )
Triglycerides-Direct (H) 158 mg/dL (<150 - )
TTL Non-HDL Chol(LDL+VLDL) (H) 212 mg/dL (<160 - )
Total apoB100 - Calc (H) 134 mg/dL (<109 - )
Lp(a) Cholesterol 6.0 mg/dL (<10 - )
IDL Cholesterol (H) 24 mg/dL (<20 - )
LDL-R (Real)-C (H) 151 mg/dL (<100 - )
Sum Total LDL-C (H) 181 mg/dL (<130 - )
Real-LDL Size Pattern (A) A/B (A - )
Remnant Lipo (IDL+VLDL3) (H) 43 mg/dL (<30 - )
RISK No
HDL-2 (Large,Buoyant) (L) 10 mg/dL (>15 - )
HDL-3 (Small,Dense) 47 mg/dL (>25 - )
VLDL-3 (Small Remnant) (H) 19 mg/dL (<10 - )

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Old 06-27-2014, 07:26   #2
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Here is what I think. IMHO
1) Women should try and keep HDL > 50. Yours is 56.
2) Total & LDL shows high as per world standards, which you are aware, and therefore the push for the statin. You've done well to refuse as these numbers are meaningless & they do not say anything much.
3) My own goal for TGs is 2 digits always. Your lab says <150, so you are not so bad at 158, but definitely I'd recommend <100.
4) From the standard lipid panel the ratio that Drs don't look at but is most important is TG/HDL. Yours is 158/56 = 2.8 Try and keep this below 2.0 where you are very safe. Though, risk begins over 3.0, so not very scary, but get it down if possible. LC/HF will make it happen.
5) Your Lp(a) score is good. This is largely genetic, so you are not in the predisposed to CVD category. More reason to cheer up.
6) Since Total Cholesterol is high, it figures that non-HDL numbers are bound to be high. So IDLs & remnant scores are also high. Once your Cholesterol settles down, all of these will come down in range. Nothing is abnormally high, so no issues. Each of these non-HDL particles carry a surface apolipoprotein B (either 48/100) So this score is also slightly high. Some labs will put your number in the safe range
7) Most importantly Pattern A is large & fluffy, which is benign. Pattern B is the small dense one that causes all the damage. From your post I could not make out whether your pattern is A or (-A). I assume that Risk is shown as "No" because that is what I'd tend to say, looking at those numbers. Certainly a little high, but no issues.

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Old 06-27-2014, 08:10   #3
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I'm very glad to see your phosphors again, Abra ... and very sorry indeed about your loss.

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Old 06-27-2014, 17:34   #4
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Thanks, skb, for the detailed analysis. I neglected to mention that for this series of tests my A1c also crept up to 6.1, the first time in almost 5 years that it's been above my usual 5.8 or 5.9. To me the whole panel reflects the stress I've been under, and I'm basically thinking of it as situational, but the triglycerides do have me mystified. I'm normally always in the double digits, and I have no clue what knocked them up so high. And I agree that the way they reported the size pattern is funky - I'm usually A, and this looks like this time I was A/B, which seems consistent with the HDL-2 being low.

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Old 06-27-2014, 18:12   #5
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I can't offer any more analysis, but *hugs* for your loss.

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Old 06-27-2014, 22:20   #6
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Nice to "see" you again Abra, I can't offer any analysis either. I just want to say I am so sorry for your loss. And yes, these results all could be a result of the great amount of stress you have been under. I wasn't a diabetic when I lost my DH, but all my systems were a mess for a long time after. It was like being kicked in the gut, stabbed in the heart and hit over the head with a crow bar all at the same time. Paralyzing, but it did get better in time.

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Old 06-27-2014, 23:51   #7
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Very sorry for your loss Abra, sending positive thoughts/energy your way.

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Old 06-28-2014, 09:12   #8
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Quote:
Originally Posted by Abra View Post
but the triglycerides do have me mystified. I'm normally always in the double digits, and I have no clue what knocked them up so high.
You mentioned "a lot more wine" in your OP. That is one of the contributors, the other one is fast carbs.

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Old 06-29-2014, 18:44   #9
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Wine is just about the only carb in my diet, other than those from dairy and greens. But do you know what the time-frame is for the lipid panels? For example, the A1c is said to be a 90 day snapshot that's heavily weighted toward the 30 days prior to the blood draw. What's the analogue for lipids, especially the triglycerides?

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Old 06-29-2014, 20:19   #10
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In my one experience, triglycerides jumped 127 points within three days of a carb-loaded weekend. We had spent a weekend celebrating our 25th anniversary, I had the blood draw two days after we got back & boom! All the other markers were fine - total cholesterol dropped, LDL even dropped, but triglycerides exploded.




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