Need help understanding Lp(a) numbers

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johnyascorbate
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Need help understanding Lp(a) numbers

Post Number:#1  Post by johnyascorbate » Wed Sep 23, 2015 12:16 pm

My aunt recently had her lipoprotein(a) levels checked along with some other tests as well. Her blood work was done through Quest about 16 days ago. Her lipoprotein(a) clocked in at 158 mol/l, way outside of the normal range. I urged her to get a VAP test 6 days ago to get a more accurate picture.. To my amazement, her lipoprotein(a) level on the VAP test was only 13 mg/dl, which is not bad at all. I know the VAP test is measured differently and it's the only one that matters, but how could her numbers be so far off? Even my own Lp(a) tests done through Quest, and again through the VAP were obviously different, but not astonishingly far off compared to one another, as was the case with my aunt. Any ideas? Thank you!

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Re: Need help understanding Lp(a) numbers

Post Number:#2  Post by ofonorow » Fri Sep 25, 2015 5:58 am

First there needs to be a unit conversion, and unfortunately, experts once told me there is no good conversion between these units for Lp(a).

What was the normal (or range) on the Quest test? From memory, 70 nmol/l Lp(a) is roughly equivalent to 20 mg/dl? If this is true (and i'm sure johnwen will help here) then 158 was about double 70, or close to 40 mg/dl.

Confusion number 2. VAP recognizes that it is not merely the mass of Lp(a) -- because bigger particles are actually better (less "atherogenic") -- so they convert the mass to the same number of ordinary LDL particles. The "normal" on the VAP test is 10 mg/dl.

For example, in the VAP test they find 10 Lp(a) particles. They might actually be large and togetherweigh 100 mg/dl The VAP reports Lp(a) as what 10 particles of ordinary LDL cholesterol would weigh.

Supposedly the nmol/l is already a count of "moles" or particles, but the reason you cannot convert is because the mass of Lp(a) varies by a range of 1000 times (according to the Pauling/Rath patent).

Back to this person - in either case, her Lp(a) is elevated meaning a) she isn't taking enough vitamin C, b) she should be augmenting the vitamin C with the rest of the "Lp(a) binding inhibitors" - e.g. lysine and proline.
Owen R. Fonorow
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Re: Need help understanding Lp(a) numbers

Post Number:#3  Post by johnyascorbate » Fri Sep 25, 2015 8:09 am

ofonorow wrote: What was the normal (or range) on the Quest test? From memory, 70 nmol/l Lp(a) is roughly equivalent to 20 mg/dl?


Quest's range is <75 mol/l

ofonorow wrote: Back to this person - in either case, her Lp(a) is elevated meaning a) she isn't taking enough vitamin C, b) she should be augmenting the vitamin C with the rest of the "Lp(a) binding inhibitors" - e.g. lysine and proline.


I'm still a little confused about the numbers, Owen. The VAP test says normal is <10 mg/dl and my aunt is at 13 mg/dl. She is out of range in the VAP test, but any another Lp(a) test that reports the numbers in mg/dl says less than 30 mg/dl is best. I know ZERO Lp(a) is the goal, but should we look at it as her being below 30 mg/dl, which is what Pauling said is optimal? For instance Dr. Stephen Sinatra says, "LDL cholesterol subtype Lp(a): less than 30 mg/dL for a standard blood test; less than 10 mg/dL for a VAP test." If they're both reported in mg/dl, why does the reference range change? That is all I'm wondering.

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Re: Need help understanding Lp(a) numbers

Post Number:#4  Post by ofonorow » Mon Sep 28, 2015 7:02 am

Again, the VAP report counts the number of Lp(a) particles - but reports the weight as if all the particles were LDL.

This is from the recognition that mass alone does not tell the Lp(a) story, because Lp(a) mass varies (1000 fold) and the larger the better.

It is an attempt, like nmol/l to count "particles" rather then simply report mass.

Now the VAP report used to contain a lot more information Lp(a)! (I think they took it away so as not to confuse or turn off regular cardiologists) but they still retain the other numbers, and your physician can ask and obtain all the Lp(a) numbers from Atherotech.
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Re: Need help understanding Lp(a) numbers

Post Number:#5  Post by Johnwen » Tue Sep 29, 2015 9:43 am

Johnyascorbate wrote:
Quest's range is <75 mol/l


Not really the range is <75 nmol/L per Quest web page!


http://www.questdiagnostics.com/testcen ... ein%28a%29


The reference range cutpoint (75 nmol/L) approximates the Lp(a) 75th percentile in the Framingham Heart Study.

Now let’s convert nmol/L to umol/L

So she had a 158 nmol/l reading from Quest!
So we go here and poke in 158 to convert it to standard umol/l for LP(a) and we get .158 umol/l.

http://www.endmemo.com/sconvert/umol_lnmol_l.php

Now we convert this to mg/dL - LP(a)
We do this here and we come up with!!!

http://www.endmemo.com/medical/unitconv ... rotein.php

4.4257 mg/dl

So in reality the Quest reading was actually about 1/3 of the VAP test reading!
However like Owen said One is weight of the product in serum and the Vap is the amount in a quantity of the serum! So that could account for the difference.
Me! I would go with the VAP test readings.
13mg/dl isn’t all that bad start some Niacin at bed time and cut the sugar down to nill and it should drop if not she may have some inflammation going on somewhere which could be allergies or a cold or such! But I wouldn’t panic with a 13 make sure she stays on her Pauling therapy and maybe up her V-C a little.
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research!

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Re: Need help understanding Lp(a) numbers

Post Number:#6  Post by johnyascorbate » Thu Oct 01, 2015 10:46 am

Johnwen wrote: Not really the range is <75 nmol/L per Quest web page!


I made a typo, i meant nmol. Thanks for the input Owen and Johnwen.


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