Trigs and VLDL
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Question:
Preston: One more article that just recently became available online in full. (I am finding that articles that were only available online a year or so ago as abstracts are now becoming available in full on some journals. Hence, I am reviewing some of my older printouts. Unfortunately, there are other journals that have become more restrictive even on older articles.) "Hepatic accumulation of lipid substrates perturbs apolipoproteinB-100 (apoB) metabolism in insulin-resistant, obese subjects and may account for increased risk of cardiovascular disease. … In conclusion, in visceral obesity, atorvastatin increased hepatic clearance of all apoB-containing lipoproteins, whereas fish oils decreased hepatic secretion of VLDL-apoB. The differential effects of atorvastatin and fish oils on apoB kinetics support their combined use in correcting defective apoB metabolism in obese, insulin-resistant subjects." Source: Regulatory Effects of HMG CoA Reductase Inhibitor and Fish Oils on Apolipoprotein B-100 Kinetics in Insulin-Resistant Obese Male Subjects With Dyslipidemia http://diabetes.diabetesjournals.org/cgi/content/full/51/8/2377 (Read the whole article and some of the articles citing this article.) Frank – Hide quoted text — Show quoted text -> As the original poster here, thanks for your many comments. No, I am not a doc. or scientist, just a science-interested layreader (especially about my own conditions 
. However, I think I’ve left my diab. specialist a little in the dust as he still believes that trigs are not an individual risk factor in CAD/CVD while all of the newer literature implicate trigs almost beyond question. (snipped)
Response:
Frank et al– Looks like I’m going to be burping up fish oil again since you apparently need 10g. or more daily to affect the profile (apparently the alpha-linolenic acid in flaxseed oil has no impact on hTG). I’m also wondering whether to go with fenofibrate of the older gemfibrozil for lowering my TG’s. While the newer fenofibrate seems somewhat more effective in that regard it also increases homocysteine by 40-50% in clinical trials! While there’s no solid, final evidence that homocysteine is an independent market for CAD/CVD I don’t think I want to take that chance. Comments? -Preston – Hide quoted text — Show quoted text – > Preston: > One more article that just recently became available online in full. (I > am finding that articles that were only available online a year or so > ago as abstracts are now becoming available in full on some journals. > Hence, I am reviewing some of my older printouts. Unfortunately, there > are other journals that have become more restrictive even on older > articles.) > "Hepatic accumulation of lipid substrates perturbs apolipoproteinB-100 > (apoB) metabolism in insulin-resistant, obese subjects and may account > for increased risk of cardiovascular disease. … In conclusion, in > visceral obesity, atorvastatin increased hepatic clearance of all > apoB-containing lipoproteins, whereas fish oils decreased hepatic > secretion of VLDL-apoB. The differential effects of atorvastatin and > fish oils on apoB kinetics support their combined use in correcting > defective apoB metabolism > in obese, insulin-resistant subjects." Source: Regulatory Effects of HMG > CoA Reductase Inhibitor and Fish Oils on Apolipoprotein B-100 Kinetics > in Insulin-Resistant Obese Male Subjects With Dyslipidemia > http://diabetes.diabetesjournals.org/cgi/content/full/51/8/2377 (Read > the whole article and some of the articles citing this article.) > Frank > As the original poster here, thanks for your many comments. No, I
am not a doc. or scientist, just a science-interested layreader (especially about my own conditions . However, I think I’ve left my diab. specialist a little in the dust as he still believes that trigs are not an individual risk factor in CAD/CVD while all of the newer literature implicate trigs almost beyond question. (snipped)
Response:
All– As the original poster here, thanks for your many comments. No, I am not a doc. or scientist, just a science-interested layreader (especially about my own conditions . However, I think I’ve left my diab. specialist a little in the dust as he still believes that trigs are not an individual risk factor in CAD/CVD while all of the newer literature implicate trigs almost beyond question. He agrees to add a fibrate to my Lipitor "it I really want it" for my trigs. While he prefers fenofibrate (Tricor) I’ve read lately (Medline abstracts) that fenofibrate tends to elevate serum homocysteine more than does fenfibozil–while further depressing LDL. I think my beta-blocker and thiazide diuretic also amplify my trigs a bit too. My LDL is already very low at 40. My concerns relate more directly to my elevated trigs and their corresponding increased VLDL and Chylomicron remnants which are generally small, dense and athergenic. Gemfibrozil seems to better impact the LpL lipace catabolism of those smaller ch. esthers than does fenofibrate. However, there remain those nasty earlier discussions about gemfibrozil’s relationship to the ill-fated Baycor. I started taking flaxseed oil but stopped when I read the abstracts that concluded that flaxseed’s alpha-linolenic acid parent of the fish oils was not effective in lowering TG’s. Looks like you just have to take all those fish oils caps directly up to 10 g./day. Even at 2g’s I burp up that crap all day. Oh, well. I’m no also a little concerned about possibly having nephrotic syndrome (NS). However while my uric acid levels are borderline high I don’t seem to be showing large amounts of proetin in my usine but have had some chronic hemostasis. Bilateral retrogrades and cystos, however, have turned up no source for the blood–determined as a "chronic undetermined condition". NS could explain the elevated trig levels as well, but I’m more inclined to lay the blame on metabolic syndrome rather than NS which is rather rare by comparrison. So what is the verdict here–fenofibrate/Lipitor or gemfibrozil/Lipitor? As a side discussion, my homocysteine level runs around 7.5–not high but not low either. I’m taking CoQ10, curcumin w/biperine and trimethylglycine (TMG) to lower it further but haven’t been re-tested yet. Any other ideas on lowering homocysteine? Thanks. Thanks, -Preston – Hide quoted text — Show quoted text – > I expect that finally explains my 4.6 A1c a month after intestinal > surgery. I always thought it was a couple of weeks on IV, and insulin > shots,(but only if Bg was 200 or over!) as opposed to my oral meds. > Sleepy >Preston: >(snipped) my entire lipid profile improved for the year that I paid >regular visits to my local Red Cross to donate blood. They really loved >me since I was CMV negative as well, … (snipped) >I am also CMV negative. They have a special donation day for the CMV >negatives here locally. >In a MHD post Dr. Biggs impact of giving blood donations on the HbA1c >levels >in response to the following: >> I’ve had Type II for about 9 years, and seem to have finally gotten it >> under control. Recently I also started donating blood. My question is this. >> If I donate blood within a month or so before getting an HbA1c test, am I >> going to produce erroroneus results? >"Absolutely yes. >The HBA1c goes down after new blood production is increased, either in >response to blood loss or due to the increased blood volume requirement >of >pregnancy. >The best example of this is in a May 1983 Diabetes Care article. The >450cc >volume is typical of a blood donation. >Here is the abstract: >’Nondiabetic adult subjects (N = 12) were studied to determine the >effect of >an approximately 450-ml acute blood loss upon glycosylated hemoglobin >measurements. After blood loss, the hematocrit significantly decreased >by >week 1 (P less than 0.001) and the reticulocyte count peaked by week 2. >All >glycosylated hemoglobins measured showed significant decreases post >blood >loss. The nadir was at week 4 for total A1, A1c, and irreversible A1c by >high-pressure liquid chromatography (HPLC), and at week 6 for >irreversible >A1 by HPLC and A1 by electrophoresis. The mean percent decrease in >glycosylated hemoglobins ranged from 4.6% (irreversible A1 by HPLC) to >8.6% >(total A1c by HPLC).’ >I would still encourage you to donate blood. Let your doctor know what >you >are doing so he can factor in the expected drop in your HbA1c. >William C Biggs MD" >http://groups.google.com/groups?hl=en&lr=&ie=UTF-8&threadm=tbst0fe84a… >Frank > OK, so what’s the speed of dark?
Response:
As far as I know we have ONE doctor who posts here that you can count on helping and that is Dr William Biggs. We also have a nurse who posts here and that is RuthieGal from Michigan. May be others but I myself am not aware. As for the three you mention I don’t know them but almost all of us are diabetics with experience some more than others. As for the Lipitor I don’t remember my dose but I had to go off it as it did muscle damage to me and I can barely walk now. My sister takes it and has for years and it doesn’t do her that same way so this is where we get the term YMMV (your mileage may vary) Di
>Frank Roy >Preston: > Are y’all doctors? I surely am lost by the post…..I am taking Lipitor > also,… 40 mgs which seems a lot to me….they keep doubling it every few > months……Jerri
http://www.fringeweb.com/Ponds/JerrisPond
Response:
When I worked at the hospital CMV meant this Cytomegalovirus. Di
>y local Red Cross to donate blood. They really loved>me since I was CMV > negative > What is CMV negative? Is that like me…I am A negative with a D antibody? > Jerri
http://www.fringeweb.com/Ponds/JerrisPond
Response:
>> >Frank Roy >Preston: > Are y’all doctors? I surely am lost by the post…..I am taking >Lipitor > also,… 40 mgs which seems a lot to me….they keep doubling it >every few > months……Jerri >http://www.fringeweb.com/Ponds/JerrisPond
We have all types of diabetics here. A few of them are engineers, or were physics majors, or are in other highly technical fields. They post a lot of info that baffles the hell outta me. I try to read it though. The more I read it, the more I can understand it. I have gone from 0% understood to maybe 5% understood…..on a good day that is. That is what makes this group so interesting is the makeup of it’s members. Just goes to show that this disease does’nt dicriminate. You have your techies, your support people, your humorists, and a few a holes. Most people who respond are sincere in their beliefs. The good thing is that everything is open to honest debate, and that is how we arrive at a concensus..of sorts. The only Dr. that posts is Dr. Biggs. Chung is a crackpot troll, that if he hasn’t lost his license to practice, should, and soon, and Jai is a crackpot troll that isn’t even an MD. Sleepy OK, so what’s the speed of dark?
Response:
>y local Red Cross to donate blood. They really loved>me since I was CMV
negative What is CMV negative? Is that like me…I am A negative with a D antibody? Jerri http://www.fringeweb.com/Ponds/JerrisPond
Response:
I expect that finally explains my 4.6 A1c a month after intestinal surgery. I always thought it was a couple of weeks on IV, and insulin shots,(but only if Bg was 200 or over!) as opposed to my oral meds. Sleepy – Hide quoted text — Show quoted text – >Preston: >(snipped) my entire lipid profile improved for the year that I paid >regular visits to my local Red Cross to donate blood. They really loved >me since I was CMV negative as well, … (snipped) >I am also CMV negative. They have a special donation day for the CMV >negatives here locally. >In a MHD post Dr. Biggs impact of giving blood donations on the HbA1c >levels >in response to the following: > I’ve had Type II for about 9 years, and seem to have finally gotten it > under control. Recently I also started donating blood. My question is this. > If I donate blood within a month or so before getting an HbA1c test, am I > going to produce erroroneus results? >"Absolutely yes. >The HBA1c goes down after new blood production is increased, either in >response to blood loss or due to the increased blood volume requirement >of >pregnancy. >The best example of this is in a May 1983 Diabetes Care article. The >450cc >volume is typical of a blood donation. >Here is the abstract: >’Nondiabetic adult subjects (N = 12) were studied to determine the >effect of >an approximately 450-ml acute blood loss upon glycosylated hemoglobin >measurements. After blood loss, the hematocrit significantly decreased >by >week 1 (P less than 0.001) and the reticulocyte count peaked by week 2. >All >glycosylated hemoglobins measured showed significant decreases post >blood >loss. The nadir was at week 4 for total A1, A1c, and irreversible A1c by >high-pressure liquid chromatography (HPLC), and at week 6 for >irreversible >A1 by HPLC and A1 by electrophoresis. The mean percent decrease in >glycosylated hemoglobins ranged from 4.6% (irreversible A1 by HPLC) to >8.6% >(total A1c by HPLC).’ >I would still encourage you to donate blood. Let your doctor know what >you >are doing so he can factor in the expected drop in your HbA1c. >William C Biggs MD" >http://groups.google.com/groups?hl=en&lr=&ie=UTF-8&threadm=tbst0fe84a… >Frank
OK, so what’s the speed of dark?
Response:
Unless I have anything other than the transient side affects from the Zocor, I think my next checkup will be in 6 months. That is a long way off. I will try to report on the findings. My tour in Germany from 1985 to 1989 keeps me off of the eligible blood donor lists. I wonder if George would approve of the blood letting that goes on at my work place? Bob
– Hide quoted text — Show quoted text -> Interesting, Bob, keep me posted on the Zocor. One thing I noticed > was that not just my serum ferrite but my entire lipid profile > improved for the year that I paid regular visits to my local Red Cross > to donate blood. They really loved me since I was CMV negative as > well, but for some reason I couldn’t keep up my hemo to continue > qualifying. There’s something to be said for a little > blood-letting…just ask George Washington > -Preston
Response:
>Frank Roy >Preston:
Are y’all doctors? I surely am lost by the post…..I am taking Lipitor also,… 40 mgs which seems a lot to me….they keep doubling it every few months……Jerri http://www.fringeweb.com/Ponds/JerrisPond
Response:
Preston: (snipped) my entire lipid profile improved for the year that I paid regular visits to my local Red Cross to donate blood. They really loved me since I was CMV negative as well, … (snipped) I am also CMV negative. They have a special donation day for the CMV negatives here locally. In a MHD post Dr. Biggs impact of giving blood donations on the HbA1c levels in response to the following: > I’ve had Type II for about 9 years, and seem to have finally gotten it > under control. Recently I also started donating blood. My question is this. > If I donate blood within a month or so before getting an HbA1c test, am I > going to produce erroroneus results?
"Absolutely yes. The HBA1c goes down after new blood production is increased, either in response to blood loss or due to the increased blood volume requirement of pregnancy. The best example of this is in a May 1983 Diabetes Care article. The 450cc volume is typical of a blood donation. Here is the abstract: ‘Nondiabetic adult subjects (N = 12) were studied to determine the effect of an approximately 450-ml acute blood loss upon glycosylated hemoglobin measurements. After blood loss, the hematocrit significantly decreased by week 1 (P less than 0.001) and the reticulocyte count peaked by week 2. All glycosylated hemoglobins measured showed significant decreases post blood loss. The nadir was at week 4 for total A1, A1c, and irreversible A1c by high-pressure liquid chromatography (HPLC), and at week 6 for irreversible A1 by HPLC and A1 by electrophoresis. The mean percent decrease in glycosylated hemoglobins ranged from 4.6% (irreversible A1 by HPLC) to 8.6% (total A1c by HPLC).’ I would still encourage you to donate blood. Let your doctor know what you are doing so he can factor in the expected drop in your HbA1c. William C Biggs MD" http://groups.google.com/groups?hl=en&lr=&ie=UTF-8&threadm=tbst0fe84a… Frank
Response:
Preston: > Instead of expensively and directly measuring the Apolipids, IDL, chylomicrons, etc., etc. (the "bad" goo) the new yardstick for metabolic syndrome patients w/elevated TG 300 is to simply compute the non-HDL in mg/dl. Mine comes in at 152-42=110 which is under the <130 treatment threshold. I look just fine there. However, on another level the treatment standard is if non-HDL is >30mg/dl over LDL. In that case I fall miserably short (40+30=70). Which should be MY standard non-HDL benchmark? At any rate, it looks more and more like I’ll be adding fenofibrate to my atorvastatin regimen. Remember, I’m already on Metformin 2g/day and the Lipitor (also lisenopril w/HCT).
I’ll refer you to a 1997 Circulation journal article and some of the references used for the article as well as articles that subsequently referred to this article. I will not attempt to post many exerpts. Often the articles that cite an article lead to later research findings. Some exerpts: from the Results section: "Based on prior reports that the interrelationship of triglyceride-rich apoprotein C-III
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