3 doctors weighed in:
What are the doctor recommended values for blood lipoproteins?
3 doctors weighed in

Dr. Andrew Chung
Internal Medicine - Cardiology
1 doctor agrees
In brief: LDL<100&HDL>50
Ldl < 100 mg/dl hdl > 50 mg/dl triglycerides < 150 mg/dl.

In brief: LDL<100&HDL>50
Ldl < 100 mg/dl hdl > 50 mg/dl triglycerides < 150 mg/dl.
Dr. Andrew Chung
Dr. Andrew Chung
Thank
1 comment
Dr. Milton Alvis Jr
The values mentioned above (& commonly promoted) are for cholesterol, not lipoproteins. Lipoproteins are NOT cholesterol, they are complex protein particles which transport all fat molecules (including cholesterol) around the body in the water outside cells. Our body is majority water. If we are slender, typically about 62% water; less than this if we have more body fat. Of all the body water, about ⅔ of the water is inside our cells, ⅓ outside. What creates the separation between inside and outside water? A membrane built from fat molecules with which water will not mix; thus serves to separate water from water. For plant cells the membrane fat molecules are mostly phospholipids (look up using Google images). For animal cells the membranes are built mostly from a combination of phospholipids and cholesterol (also look up using Google images). Cholesterol, a sterol fat molecule, is fundamental to the flexibility/fluidly of all animal cell membranes, the ability for animal cells to change shape = thus for animals to be able to move. Cholesterol stabilizes animal cell membrane structure & eliminates the need for a thick cell wall to protect the otherwise fragile membrane. Thus cholesterol, because it is part of animal cell structure, is a fat molecule manufactured by every animal cell, every cell in our body. (Cholesterol is also the starting molecule for all steroid hormones.) Like all fat molecules, in the water outside cells, cholesterol is transported within lipoprotein particles, along with all other fat molecules. Lipid (medical jargon) means fat, AKA oil, AKA hydrocarbon. These molecules are NOT soluble in water. Why? Because water molecules are charged, stick to one another and act as if they were a very large molecule, thus the high boiling point compared to seemingly similar sized molecules such as CO2. Because water molecules are charged and stick to other charged molecules (e.g. one another), they reject fat molecules which lack much charge differential; i.e. fats will not dissolve in water, will not go into solution so as to be able to travel around in the water outside cells. Solution: Our liver and intestinal cells manufacture and excrete a complex set of proteins which are soluble in water and self-assemble as surfactant particles which encapsulate ALL fat molecules (a process called emulsification). These protein particles which carry all fat molecules are called Lipoproteins. They are complex structures built of many interacting proteins which self-organize into particles which are soluble in water and carry all fat molecules (hidden inside) in water, i.e. fat-carrying-proteins. But do people like long names? No, people hate long names and prefer abbreviations. So, many decades ago, researchers shorted the longer descriptive phrase to the term “lipoproteins”. In the 1970s, people at the NIH, recognizing >3 decades of research that lipoproteins, especially Low Density Lipoprotein concentrations, were the primary driver of atherosclerosis, started promoting that physicians start doing something about those very unhealthy LDL levels. However, the cost of the research methods for measuring lipoproteins, at the time, was over $5,000 US per blood sample. So, given the high cost, what was done instead? They promoted guessing at Low Density Lipoprotein concentrations by measuring just one of the fat molecules which the lipoproteins carry. Why? Because this was less expensive. What fat did they pick? You guessed it: Cholesterol; a fat reliably known to be present because it is primarily made within the body. Does this work? Somewhat. However, LDL particles do not always carry the same mix of fat molecules; the mix of fat molecules is documented to vary over a 6:1 range, rarely an even wide range. However, if the total cholesterol is >250 mg/dL, especially >300 mg/dL, LDL particle concentrations are essentially always also high. But what if total cholesterol is not so high? Answer: The correlation starts falling apart. Indeed at low (often healthy) levels it is commonly reversed. This is why further, still inadequate, approximations have been added since 1980; e.g. HDL-Cholesterol, triglycerides, etc. On the commonly performed lipid profile, a total cholesterol of <200 mg/dL is listed as desirable. Why, because at concentrations below 200 mg/dL, total cholesterol is not a very reliable indicator of LDL particle number, i.e. the correlation becomes increasingly unreliable, individual by individual. However, does <200 mg/dL correlate with optimal health? No! Indeed, in the US, the typical total cholesterol before someone has an obvious ST-elevation myocardial infarction (obvious heart attack), the total cholesterol is ~170 mg/dL. So what good is being in the “desirable” range? Well, better than higher, but still not great. What solutions are available for this conundrum? Since the later 1990s, direct high accuracy measures of actual LDL and HDL particle numbers and sizes have been available for <$100 using what is commonly called the “NMR particle test” from an academic spin-off company in Raleigh, NC. This different approach to protein particle measurement developed from extensive research combined with computer automation has brought the cost way down and accuracy way up.
Dr. Milton Alvis Jr
Preventive Medicine
In brief: Low Nl LDL&High HDL
Rec: ldl-p <700 nmol/l & large HDL >9 µmol/l.
Lipoproteins transport all fat molecules in the water outside cells. Cholesterol (a fat molecule comprising about 30% of all the membrane fat molecules & manufactured within every animal cell) has never been the correct issue. Cholesterol was promoted because less expensive to measure & correlates with outcomes only if very high but misleading when low.

In brief: Low Nl LDL&High HDL
Rec: ldl-p <700 nmol/l & large HDL >9 µmol/l.
Lipoproteins transport all fat molecules in the water outside cells. Cholesterol (a fat molecule comprising about 30% of all the membrane fat molecules & manufactured within every animal cell) has never been the correct issue. Cholesterol was promoted because less expensive to measure & correlates with outcomes only if very high but misleading when low.
Dr. Milton Alvis Jr
Dr. Milton Alvis Jr
Thank
1 comment
Dr. Milton Alvis Jr
The values usually promoted are for cholesterol, not lipoproteins. Lipoproteins are NOT cholesterol, though they do transport cholesterol, and all other fat molecules, in the water outside cells. Cholesterol is a fat molecule manufactured by every cell in the body and transported by the lipoproteins, along with all other fat molecules within the water outside cells. Lipid means fat, AKA oil, AKA hydrocarbon. These molecules are NOT soluble in water. Water molecules are charged and stick to one another, thus the high boiling point. Water molecules reject fat molecules, thus fats will not dissolve and travel through the water outside cells. Solution: Our liver and intestinal cells manufacture and excrete a complex set of proteins which are soluble in water and encapsulate ALL fat molecules (a process called emulsification). These complex proteins are called Lipoproteins, meaning fat-carrying-proteins. But people hate long names; they prefer abbreviations. So, many decades ago, researchers shorted the long descriptive phrase to lipoproteins. In the late 1970s, the cost of measuring lipoproteins was over $5,000 US per blood sample. So people at the NIH promoted guessing at lipoproteins by measuring one of the fat molecules they carry. Why? Because this was less expensive. What fat did they pick? You guessed it: Cholesterol.
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