The Drive with Peter Attia — Tom Dayspring (5)

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

Leave a Reply