Interpreting VAP test results

[probiotic]

Forgive me for jumping in with such a long-winded technical question while still being a fresh newbie here, but after not getting a bottom line answer yet on other forums, I thought I'd pass it by some of you experts. For over 5 years I have been eating a very LC high fat diet including lots of sat fats, mainly for intestinal health issues but also because I believe in it.

My lipid profile has for years had pretty good "ratios" (Eades and others), with low (i.e. good) tri (49) and high (i.e. good) HDL (76) but also high total chol (265) and calculated LDL (172). In light of some familial history for heart disease, and my ongoing inflammatory condition, in my latest test I opted to get the more detailed VAP test. Some of the data still confuses me.

On the positive side, the LDL density pattern was listed as Type A which I understand means they are larger and less harmful in size. However, my
Lp(a) was flagged high (21) vs. the reference of <10, and the "most protective" HDL, HDL-2, were 21, much less than the "less protective" HDL-3 at 55 (though both values were well above the minimum of 10 desired reference). Total VLDL were 15.5 (reference <30), with VLDL1+2 large buoyant 7.5 (reference <20) and LVDL3 small remnant 8 (ref <10)and IDL 6 (ref <20) rounding out the data.

The bottom line question is, do I need to be concerned about the high LDL and high Lp(a) with this sort of data or does the density pattern A and good VLDL and IDL numbers "confirm" that things are fine after all, or should I pursue even more advanced tests.

Many thanks if you waded through this!

[Belfrybat]

I'm sure someone else will come along who can answer your questions. My take is not to be worried, but I'll leave a more detailed analysis up to the "experts". I just wanted to say welcome to the forum. Come and join us in the Challenge area as that is where we are more vocal.

[probiotic]

Thanks for the warm welcome... Yes I will go say hi in the busier "room" of what is clearly a great group. I notice my sort of question crops up time and again for LCers, since some of us do get high TC's and LDL's, and the "ratios" are not yet considered definitive in the mainstream, at least not to the extent that very high LDL's are discounted. So I look forward to the experts' comments. Cheers.

[Gaelen]

The bottom line question is, do I need to be concerned about the high LDL and high Lp(a) with this sort of data or does the density pattern A and good VLDL and IDL numbers "confirm" that things are fine after all, or should I pursue even more advanced tests.

First, probiotic, no 'forgiveness' necessary, and welcome in!

I think the most important thing we should all remember about blood reports are that they are only one aspect of the things happening in a total body system. I used to read hundreds of blood reports a day when I was in a different position in this company, and when you see that many, the asterisks for out-of-range data become a simple marker that makes you want to go and take a look at the other things--the animal's general body condition, clinical observations, ECG reports, food and water consumption data, blood pressure and pulse oximetry, etc.

People tend to get wrapped around the axle by those asterisks, even though they're just individual points on an entire report. My mom has high blood pressure for which she's always taken meds...but while her pressure is now within normal limits, her pulse pressure--the difference between the systolic and diastolic numbers--is too large. Her lipid profile looks okay, except that her trigylcerides are too high, which makes the ratios that involve triglycerides out of whack. High tri's aren't good, but in combination with the elevated pulse pressure, they tell me that her blood vessels' elasticity is not what it should be and that her risk for a cardiac event is worse than it would be if she could get either the high tri's or the pulse pressure or both under control. Alone, each is just a high marker. Together, they spell trouble because it shows me an overall body system weakness that's consistent between a couple of different types of measures.

Conversely, I don't think that individual 'good' datapoints confirm that things are okay all by themselves, or that you don't need to investigate further. If you've got a couple of significant high markers that point consistently to a certain type of problem, then you need to take steps to address them. I wouldn't rest easy that your good datapoints confirm anything, but would instead keep an eye on several other indicators of potential cardiac issues--blood pressure, fasting and non-fasting blood glucose, general body condition, stress test and ECG response. If none of those shows any findings that support concern about the high markers, then you could keep an eye on things--but if any of those findings support an increased cardiac risk consistent with your VAP high markers, then you need to work harder to address those high markers in the context of your whole body system.

I'm not a doc, I don't play one on TV...I just read a lot of results and I have to make assessments of the test subjects and analyze their responses to tests based on those results. Most times, I say "I want more data" when I see asterisks, but that data doesn't have to be expensive to get. Your body is a system, and you just have to consider the whole system. Seldom do things that are truly a problem go wrong in only one area--so if one area is giving me worrisome results, I start checking other things to try to find a pattern. That's what good diagnostics is all about.

Hope this helps. YMMV. ;)

[probiotic]

Gaelen,
Many thanks for your excellent points. As regards other indicators, weight is not an issue at all, I exercise 4-5 times a week 1-2 hours each time (strength and cardio), blood pressure is on the high side of normal sometimes but not always, FBG's are pretty average with A1C around 5.0%, but I do have a chronic inflammatory and arguably auto-immune (ulcerative colitis) condition which waxes and wanes.