Ok, we've been talking lately about Hyperinsulinemia / Insulin Resistance being one of the primary driver of the dysfunction that underpins Coronary Heart Disease and Atherosclerosis, and surmising that even the hallowed ApoB is just an interacting variable in the milieu - in other words: very low IR, then ApoB loses relevance...
Anyway, these guys amused me no end this evening with this paper: http://www.hindawi.com/journals/ije/2014/925650/ . Putting together the pieces, they are suggesting that ApoB should be used as a predictor of Insulin Resistance status(!). Oh dearie me - ApoB relegated to the status of 'surrogate variable to signify presence of a really important factor'? Some people will be rather put out by this suggestion....! The team have a point mind - ApoB/Apo-A1 ratio is the ultimate associative measure for CHD - so it makes sense that it predicts the IR that is a main cause, not so? In short, having a high ApoB blew away the other indicators of Insulin Resistance, including fasting glucose and trigs! From the paper: "ApoB/ApoA1 ratio in regression model had an OR of 17.95 for Insulin Resistance - while even Fasting Glucose and Triglycerides were only 3.75 and 2.29 respectively". (note: ApoA1 did not figure much in this study, so it's really ApoB they're seeing predictive effect from...). Now what if they had been measuring IR properly in a study like this, using the Kraft test (http://www.thefatemperor.com/blog/2015/9/5/fat-emperor-productions-present-the-kraft-interview-decoding-diabetes) ? What if they had been using this test for decades to decipher the heart disease drivers, like Reaven and Kraft were doing? Well, the world would be a rather different place - and the food pyramid would have been trashed before it really took hold.
Anyway, let's take a peak at the variable table for women:
..and the table for men:
And what about people who have LCHF and yet high ApoB? Well, the preponderance of the data would suggest no biggie there - but by all means swap yer Sat for Mono & W3 to get more comfortable ApoB levels and hedge against all bets - but just make sure that you stay LCHF, or you'll be set on fire inside ;-)