Putting this up for argument rather than for agreement. I have read it twice and I am still not certain what it supports.
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.
Where I think it is weakest: the comparator does most of the work in how this gets reported, and it is not the comparator most people think they are citing.
What would genuinely help is knowing 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. Numbers rather than impressions, if you have them.
Figures above are from the primary publication rather than the press summary. If a number here disagrees with one you have, post yours and we will work out which of us is reading a secondary source.
nancy_portland said:ApoB is the more informative number and it is cheap.
Omega-3 index improvement on the lipid panel: often overlooked but my omega-3 index went from 4.2% to 7.7% over 13 months. I supplemented with 2g EPA+DHA daily.
This matters because omega-3s are anti-inflammatory and cardioprotective, complementing the GLP-1 benefits. Target omega-3 index is >8%. Combined with the triglyceride reduction from the medication, my lipid profile is the best it's been in decades.
nancy_portland 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.
I would rather be corrected than agreed with, if it comes to it.
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View ResultsTirzTom said:Careful with treating an unchanged LDL-C as a failure.
Advanced lipoprotein testing on the lipid panel — going beyond standard lipid panel:
| Marker | Baseline | Month 8 | Clinical Meaning |
|---|---|---|---|
| LDL-P | 1665 | 965 | Particle count (more precise than LDL-C) |
| Small dense LDL | 60% | 29% | Atherogenic pattern |
| Remnant cholesterol | 37 | 14 | Triglyceride-rich lipoproteins |
| oxLDL | 70 | 43 | Oxidative stress marker |
The shift from small dense to large buoyant LDL is particularly important — it represents a fundamental change in the atherogenic profile.
Dr.GastroMayo said:Omega-3 index improvement on the lipid panel: often overlooked but my omega-3 index went from 4.2% to 7.7% over 13 months.
Same experience, arrived at from the opposite direction.