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Cholestrol ratio query...

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Sharron1

Well-Known Member
Relationship to Diabetes
Type 2
My GP contacted me today to ask if i had any further thoughts about Statins. I thought we had previously agreed to wait until my next Hba1c in September. I just want to ask about the actual numbers. My ratio of total cholesterol and HDL at my last test in Feb was 2.37. I have looked on various websites for diabetics (not a great idea, but my GP isn't too keen to explain stuff) and it said that this ratio was in a green, healthy zone. Does anyone know if this is correct? I just wonder if it different for diabetics and she is focussing on something else?
 
I had to smile last week actually - my chol hasn't been brill for years and absolutely not for a diabetic, bearing in mind the level for us is lower than for anyone without diabetes cos you know, to quote a certain dour Scottish undertaker in the Warmington on Sea Home Guard, We're doomed, Captain, all doomed! and about to drop dead from diagnosis onwards. Anyway, so it was 4.5 which is about the lowest it's been in living memory! - to which she commented that she wasn't worried about it being 'a bit high' as the ratio was fine - to which I thought that's good, saves me educating yet another diabetes consultant about exactly why I'm so violently opposed to ever taking another statin tablet as long as I have the capacity to refuse them.

Hence, I reckon they would like it to be under 4.
 
trophywench said:
I had to smile last week actually - my chol hasn't been brill for years and absolutely not for a diabetic, bearing in mind the level for us is lower than for anyone without diabetes cos you know, to quote a certain dour Scottish undertaker in the Warmington on Sea Home Guard, We're doomed, Captain, all doomed! and about to drop dead from diagnosis onwards. Anyway, so it was 4.5 which is about the lowest it's been in living memory! - to which she commented that she wasn't worried about it being 'a bit high' as the ratio was fine - to which I thought that's good, saves me educating yet another diabetes consultant about exactly why I'm so violently opposed to ever taking another statin tablet as long as I have the capacity to refuse them.

Hence, I reckon they would like it to be under 4.
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Thank you TW, I hust get so confuses abouth the lack of conversation, i thought 4 was the 'magic' number but I also remember another GP telling me the ratio is the important detail to look out for.
 
Sharron1 said:
Thank you TW, I hust get so confuses abouth the lack of conversation, i thought 4 was the 'magic' number but I also remember another GP telling me the ratio is the important detail to look out for.
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Unfortunately some GP's don't do conversation.
 
Can't help with the ratio as I can't access the hospital test results to see them but I can tell you the total Chol was 4.8 and the HDL 1.7 in my case. I'm 70 though so what's said to be OK for me may very well not be for someone else.
 
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Someone on another thread suggested I read The Cholesterol Myth. It is a revelation. I would recommend it in turn.
 
everydayupsanddowns said:
For TC:HDL ratio the Mayo clinic suggests below 3.37 as ideal (though this is probably for a non-D person).
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That's a non-HDL cholesterol target (3.37 mmol/L = 130 mg/dL), not a ratio target.

FWIW, the AHA and ACC don't give guidance on cholesterol ratios or non-HDL cholesterol in their most recent updates - focus is mainly just on LDL.
 
Well they can't measure LDL Eddy, only calculate it once they've actually tested HDL Trigs and total chol.
 
trophywench said:
Well they can't measure LDL Eddy, only calculate it once they've actually tested HDL Trigs and total chol.
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LDL can be measured but as I understand it, the gold-standard ultracentrifugation method is expensive and time consuming, and alternative commercial chemical methods aren't very well validated.

FWIW, there's also a more sophisticated estimation method - the Martins/Hopkins Equation - updating the old Friedewald thing.

The latest 2018 AHA/ACA cholesterol guidelines go into this.
 
Or the ‘Iranian formula’, which is slightly different in ways that I can no longer remember. Hadn’t heard of Martins/Hopkins before - thanks for that 🙂

It has tickled me in the past that so much effort goes into hitting precise target values for something which isn’t actually being measured, but only ‘best guessed’ at from a variety of other factors.
 
everydayupsanddowns said:
Or the ‘Iranian formula’, which is slightly different in ways that I can no longer remember. Hadn’t heard of Martins/Hopkins before - thanks for that 🙂

It has tickled me in the past that so much effort goes into hitting precise target values for something which isn’t actually being measured, but only ‘best guessed’ at from a variety of other factors.
Click to expand...

I know, right? "3.37 mmol/L"....
 
Eddy Edson said:
That's a non-HDL cholesterol target (3.37 mmol/L = 130 mg/dL), not a ratio target.
Click to expand...

Oops! You are of course quite right...

Heart UK reinforce the message that ‘the lower the better’ for TC:HDL, but at least give a hint

This should be as low as possible. Above 6 is considered high.​
​

Taking a Cholesterol test & what the results mean

Your cholesterol levels depend on your genes as well as your lifestyle, so the only way to know whether your cholesterol level is healthy is to get a blood test
www.heartuk.org.uk www.heartuk.org.uk
​

So @Sharron1’s ratio of 2.37 looks pretty decent to my unexpert eye.

Am I right in thinking a ratio of 1 would mean all HDL and nothing else? And a ratio of 2 would be ‘half and half’?
 
everydayupsanddowns said:
Oops! You are of course quite right...

Heart UK reinforce the message that ‘the lower the better’ for TC:HDL, but at least give a hint

This should be as low as possible. Above 6 is considered high.​
​

Taking a Cholesterol test & what the results mean

Your cholesterol levels depend on your genes as well as your lifestyle, so the only way to know whether your cholesterol level is healthy is to get a blood test
www.heartuk.org.uk www.heartuk.org.uk
​

So @Sharron1’s ratio of 2.37 looks pretty decent to my unexpert eye.

Am I right in thinking a ratio of 1 would mean all HDL and nothing else? And a ratio of 2 would be ‘half and half’?
Click to expand...
Thanks to everyone. I didn't appreciate that this cholestrol info is so complicated Well it certainly is for me.
 
Me too, I’m now sitting looking blankly at my results, I thought they were good because individually they’re 1.something, but now I don’t know.
 
Madeline said:
Me too, I’m now sitting looking blankly at my results, I thought they were good because individually they’re 1.something, but now I don’t know.
Click to expand...
Have a good weekend!!
 
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