Patterico's Pontifications

3/30/2008

More Medical News: LDL Cholesterol

Filed under: Miscellaneous — DRJ @ 5:10 pm



[Guest post by DRJ]

I’m in the medical mood tonight. Cardiologists have told us that it’s important to have low levels of LDL cholesterol, known as the “bad” cholesterol. However, a new report from Japan says that people with low levels of LDL have higher overall death rates than those with high levels:

“A health study by Japanese researchers has found that people with low levels of LDL cholesterol — often referred to as “bad cholesterol” — are more likely to die than those with higher levels.

The finding comes as Japan prepares to introduce special health checkups from April, which list high LDL cholesterol as a factor in deciding whether a person has metabolic syndrome. It is likely the results of the survey will stir debate over the designation of LDL cholesterol as “bad.”

Low LDL is still linked with decreased risk of stroke and heart attacks but it’s also linked with an increased risk cancer and respiratory ailments – hence the higher overall death rates. The study’s author suggests:

“… the appropriate LDL cholesterol level for men is between 100 and 180 milligrams per deciliter of blood. He suggests women should have a level of at least 120 milligrams.
***
“Excessively lowering an LDL level that is within an appropriate range is dangerous,” he said. “Cholesterol is needed in the body and immune function drops when it is low, and it is possible that the death rate rises as a result.”

Interesting. In politics and medicine, moderation is often the winner.

— DRJ

17 Responses to “More Medical News: LDL Cholesterol”

  1. Great! What’s next?

    Cheddar cheese fries with ranch dressing is a health food?

    Oh, I know. Grumble, grumble.

    Eric Blair (2708f4)

  2. A health study by Japanese researchers has found that people with low levels of LDL cholesterol — often referred to as “bad cholesterol” — are more likely to die than those with higher levels.

    And here I thought the probability of death was 1. Can’t anyone in the media write anymore. It is the probability of premature death..

    Not a Yank (fe7b46)

  3. A lot of people consider the probability of premature death to be 1.0.

    I know I do!

    Daryl Herbert (4ecd4c)

  4. Cholesterol is a crucial intermediary in the synthesis of a number of hormones, including stress hormones. I always wondered when the cardiologists would hit the point of diminishing returns. This appears to be it.

    Mike K (86bddb)

  5. Don’t forget this good news as well:

    Via CnnCholesterol and Vytorin

    DrT (340565)

  6. That’s it — no more salads with my burgers. From now on only fries.

    JVW (0b3fa7)

  7. I wrote about this subject earlier this year. LDL cholesterol comes in different varieties. The “oxidized” LDL is especially bad, the other types not so bad.

    Dr. Eric Topol, a noted cardiovascular researcher at Scripps Health, says the cholesterol theory is incomplete. The “bad” LDL cholesterol isn’t all bad. Just a small part is associated with higher risks of cardiovascular disease. And cholesterol-lowering drugs also have other effects that contribute to reducing heart disease.

    “Not many years ago, we used to measure total cholesterol. We didn’t have the fractions, HDL and LDL,” Topol said. “Unfortunately, here in 2008 we’re in the same way as far as LDL. As it turns out, LDL is not just one bad cholesterol. There’s some fraction of it that is ultra-bad. That’s the ‘oxidized LDL’ —- the small dense particles.”

    While the Enhance trial was a failure from the commercial point of view, it still produced valuable scientific information, said Topol, a doctor/researcher who is Scripps’ chief academic officer

    “You can lower the LDL cholesterol, but you didn’t help the arteries in any way. That helps to support the tenet that just looking at LDL cholesterol (alone) is just too simplistic,” Topol said. “You’ve got to drill down to the type of LDL.”

    Researchers have also figured out what the “oxidized LDL” is doing that’s so bad, Topol said —- it inflames artery walls, which then are more likely to pick up plaque. The rest of the LDL particles are not especially bad, he said. “Not that you’d want to have them around in your bloodstream, but they’re nothing like the other fraction.”

    Medical studies going back more than a decade have repeatedly linked inflammation and heart disease. Infection appears to be a major cause, as infections often cause inflammation. Periodontal (gum) disease, which leaks infectious bacteria into the blood, has been linked with heart attacks.

    Bradley J. Fikes (1c6fc4)

  8. People with low LDL die at the same rate as people with high LDL: 1 per capita.

    Steverino (6772c8)

  9. Excellent article, Bradley. Thanks for the link.

    DRJ (a431ca)

  10. You’re welcome, DRJ. If you or anyone else wants to take a crack at some medical geekery on the trial, try this New England Journal of Medicine editorial.

    Bradley J. Fikes (1c6fc4)

  11. Plus, people who are breathing have more medical complications than those who aren’t.

    Another Drew (8018ee)

  12. Not a big surprise if you think about it huh? My brother has polythysemia – too many red blood cells, not good. But the opposite, Anemia, too few red blood cells is also not good. This study merely demonstrates that too little LDL is a bad thing too- in other words LDL is useful to ones body in some way.

    Is there some push to eliminate all LDL from the human body?
    The jist of Mr Fikes’ article is also not surprising. As medical researchers explore how compounds in the human body function (via clinical trials here) they are going to find more and more complex interactions and distinctions.

    EdWood (5f1d4c)

  13. Interesting that this is a Japanese study. The Japanese have historically had very low cholesterol levels which have been implicated in the high rate of cerebral hemorrhage in that population. I remember when this

    http://findarticles.com/p/articles/mi_m1200/is_n16_v135/ai_7551979

    was published.

    Perhaps one can have too little of a bad thing?

    Teflon Dad (b9958c)

  14. Another excellent link, Teflon Dad. The Japanese research is quite interesting. I’m more familiar with research concerning the immune system, but it’s probably all related.

    DRJ (a431ca)

  15. I’m going to die. My total cholesterol is 103.

    PCD (5ebd0e)

  16. Cholesterol limits are set to sell drugs. My otherwise healthy father was prescribed Lipitor for his high cholesterol; a couple months later he had a stroke. It is my ‘opinion’ that he would not have had that stroke without the help of the drug. And absent other debilitating criteria would still be healthy today. It was years ago, but still pisses me off.

    Thomas (b7fe33)

  17. Interesting discussion. I know people, and doctors, who are almost obsessed with low cholesterol and I think, how can this be a good thing, to lower it to absurd levels?

    I take half the prescribed dose of a statin drug, and I’m within normal. I guess that makes me an uppity patient, but I think it works.

    Patricia (f56a97)


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