Understanding LDL-C

LDL-C stands for Low-Density Lipoprotein Cholesterol. It is often referred to as "bad" cholesterol because high levels of LDL-C can lead to the accumulation of cholesterol in the arteries, contributing to atherosclerosis (the buildup of plaque in the arteries) and increasing the risk of heart disease and stroke. LDL-C carries cholesterol from the liver to the cells of the body, but when there is an excess, it can deposit cholesterol in the artery walls, leading to the formation of plaque. Lowering LDL-C levels through lifestyle changes or medication is a key part of managing and reducing the risk of cardiovascular disease.

Note: While VLDL, IDL, LDL, or Lp(a) particles in themselves are not "bad", high levels of these lipoproteins can build up and block arteries (pro-atherogenic). These lipoproteins, however, are healthy in moderation, and very low levels can have negative implications, too.

Why does SiPhox measure LDL-C if ApoB is better at identifying risk of atherosclerosis?

Despite advancements in understanding atherosclerosis risks, LDL-C continues to hold value in cardiovascular risk assessment and is included as a biomarker in SiPhox Health panels. This persistence is due in part to the extensive body of guidelines and recommendations that still prioritize LDL-C levels. Measuring LDL-P poses its own challenges due to difficulties in achieving precise measurements. To bridge this gap, SiPhox also includes ApoB in its assessments, offering a broader view of atherogenic particles, encompassing LDL-P. This dual measurement strategy ensures that both healthcare providers and patients have a comprehensive understanding of atherosclerotic cardiovascular disease risk, facilitating more informed health decisions (Cole, 2023).

How can I better understand my results?

To better interpret your results, Johns Hopkins Medicine has released ranges for LDL-C:

  • Optimal: < 100 mg/dL
  • Elevated: 100-130 mg/dL
  • Borderline High: 130-160 mg/dL
  • High: 160-190 mg/dL
  • Very High: > 190 mg/dL

If your LDL-C is elevated, here are some lifestyle changes you can try:

Where can I learn more?

CDC - LDL and HDL Cholesterol and Triglycerides

Peter Attia, M.D. - Intro to lipids & lipoproteins: why there is no ‘bad’ or ‘good’ cholesterol (video)

Scientific literature:

Cole J, Zubirán R, Wolska A, Jialal I, Remaley AT. Use of Apolipoprotein B in the Era of Precision Medicine: Time for a Paradigm Change? J Clin Med. 2023 Sep 3;12(17):5737. doi: 10.3390/jcm12175737. PMID: 37685804; PMCID: PMC10488498.

Duncan MS, Vasan RS, Xanthakis V. Trajectories of Blood Lipid Concentrations Over the Adult Life Course and Risk of Cardiovascular Disease and All-Cause Mortality: Observations From the Framingham Study Over 35 Years. J Am Heart Assoc. 2019 Jun 4;8(11):e011433. doi: 10.1161/JAHA.118.011433. Epub 2019 May 29. PMID: 31137992; PMCID: PMC6585376.

Otvos JD, Mora S, Shalaurova I, Greenland P, Mackey RH, Goff DC Jr. Clinical implications of discordance between low-density lipoprotein cholesterol and particle number. J Clin Lipidol. 2011 Mar-Apr;5(2):105-13. doi: 10.1016/j.jacl.2011.02.001. PMID: 21392724; PMCID: PMC3070150.