The problems with self diagnosis and belonging to forums

Let's say you belong to a forum that discusses cholesterol and triglycerides.

You have your blood tests and ask for advice.

You post your figures for triglycerides and also cholesterol.

Then some people say you should go and read more and send you off to sites

Here is an example

Look at the figures posted:

• Total cholesterol: 251 mg/dl (6.5 mmol/L)
• Calculated LDL-cholesterol (LDL-C): 169 mg/dl (4.4 mmol/L)
• HDL cholesterol (HDL-C): 31 mg/dl (0.8 mmol/L)
• Triglycerides (TG): 257 mg/dl ( 2.9 mmol/L)
• Glycated hemoglobin (HgbA1C): 7.1 %

The uncritical person will just accept the above....

From the site:

"Peter’s main problems were obesity, metabolic syndrome and type-2 diabetes. Glycated hemoglobin is a measure of long term blood sugar. A value higher than 6.5% indicates diabetes. His TG/HDL ratio was 8.3. A ratio higher than 3.5 is associated with insulin resistance. His LDL-C was certainly not ideal, but possibly not the biggest of his worries."

Now look at the figures above.

In USA units the ratio is indeed 8.3 but NOT using the UK units!!!!!

There it is about 3.6 and the article says 3.5 is just about OK

So, looking only at UK figures you think all is fine and go gaily on your way...to a stroke or heart attack!

Look at it logically

How can the ratio be bad in USA but OK in UK ??? Answer: it cannot

The site writer should have included a note for non-USA readers

If you live outside the US or are using mmol/L, you have to multiply this ratio by 0.4366 to attain the correct reference values.

If lipid values are expressed as mmol/L (like in Canada and Europe):

TG/HDL-C ratio less than 0.87 is ideal

TG/HDL-C ratio above 1.74 is too high

TG/HDL-C ratio above 2.62 is much too high

The USA advise total cholesterol below 200 mg/dl and LDL below 100 mg/dl. To convert mmol/l (UK) to mg/dl (USA) we multiply by 38.66. To convert mg/dl (USA) to mmol/l (UK) we divide by 38.66. Hence 200 mg/dl equates to 5.17 mmol/l and 100 mg/dl equates to 2.58 mmol/l.

BUT THAT IS CHOLESTEROL NOT NOT NOT TRIGLYCERIDES!!!!

For triglyceride, the conversion is: To convert mmol/l to mg/dl for triglyceride you multiply by 88.6.

This is because of molar mass. The chemical formula for cholesterol is C27H460 with a molar mass of 386 g/mol. The chemical formula for triglyceride is C55H98O6 with a molar weight of 856 g/mol.

When they measure cholesterol levels they are presumably measuring the total molar mass of all of the lipoproteins in the blood. Who’s to say what proportion of that is actually cholesterol and what proportion is other lipids and proteins?”

The blood cholesterol level

We need to start by saying that the blood cholesterol level is unreliable. The time of day, the time of year, whether or not you fasted beforehand, how much sun you’ve had recently, current stress levels, even running late for the blood test appointment – all can impact blood cholesterol levels. When people talk about their test results as if they are accurate they should be made aware of all of this.

The formula for blood cholesterol levels is: Total cholesterol = LDL + HDL + triglycerides/5

Few people know that we can only measure total cholesterol and HDL with the standard blood test. Yes – 1 equation, 4 unknowns, 2 measurable = not very scientific.

Total cholesterol = LDL (all approximate – 8% triglyceride, 45% cholesterol, 22% phospholipids and 25% protein) + HDL (all approximate – 4% triglyceride, 30% cholesterol, 29% phospholipids and 33% protein) + VLDL/5? (all approximate – 50% triglyceride, 22% cholesterol, 18% phospholipids and 10% protein) or just the triglyceride part of VLDL/5?

WHAT IS THE SIGNIFICANCE OF THIS?

If you are in the UK and you skim read the article and your trig/HDL is 3.0 you may think all is fine...when it is not