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The Peter Attia Drive

#238 – AMA #43: Understanding apoB, LDL-C, Lp(a), and insulin as risk factors for cardiovascular disease

Jan 16, 2023
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24:23

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Quick takeaways

  • Hyperinsulinemia is strongly associated with increased risk of cardiovascular disease and can be assessed through tests like OGTT.
  • APOB is a better predictor of cardiovascular risk compared to LDLC as it accounts for other atherogenic particles and may require pharmacotherapy to manage.

Deep dives

Relationship between Hyperinsulinemia and AS CBD

Hyperinsulinemia, particularly in cases of type 2 diabetes, is strongly associated with increased risk of atherosclerotic cardiovascular disease (AS CBD). Hyperinsulinemia influences AS CBD risk through various mechanisms, including the upregulation of APOC3 expression. This leads to increased triglyceride concentration and the production of triglyceride-rich LDL particles, both of which are atherogenic. Hyperinsulinemia also contributes to endothelial dysfunction, which further exacerbates AS CBD risk. Understanding insulin levels can be crucial in assessing AS CBD risk, and tests like OGTT can provide valuable insights.

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