On: Part V of V: Lp(a), inflammation, oxLDL, remnants, and more.

Episode: 24

Date: October 2018

Key Subjects:

• Lp(a) is a particularly high risk lipoprotein.
  • Genetic.
  • Important to know your Lp(a) mass or particle count.
• Three factors contributing to increased risk of CVD.
  • Cholesterol, chronic inflammation, endothelial function.
• Chronic inflammation:
  • Important to measure your inflammation levels.
  • Measure levels of oxidative stress (oxLDL or F2-isoprostanes).
• Endothelial function:
  • Measure SDMA and ADMA as biomarkers for endothelial function.
  • Both inhibit production of nitric oxide, which regulates endothelial function.
  • High homocysteine as well as oxidative stress prevent the breakdown of SDMA/ADMA and thereby contribute to lower nitric oxide and decreased endothelial functioning.
  • So if homocysteine is high, need to lower it…
• Remnants:
  • Lipoproteins of any type that fail to get cleared.
  • Dangerous because they become more cholesterol rich the longer they circulate.
  • apoC-III plays an important role in retarding the clearance of lipoproteins.
  • Important to measure apoC-III biomarker.
  • Statins may not work well on LDL particles with apoC-III.
  • Drug being developed to stop apoC-III synthesis in the liver (antisense drugs).

Key Takeaways:

• Measure oxidative stress (preferred: F2-isoprostanes; if high Lp(a): Lp-PLA2).
• Measure endothelial function: ADMA and SDMA.
• Measure apoC-III (to understand importance of remnants, potential resistance to statins).

Worth Listening:

• 8/10