#21 - Tom Dayspring, M.D., FACP, FNLA – Part II of V: Lipid metrics, lipid measurements, and cholesterol regulation

The Peter Attia Drive

Peter Attia, MD

Health & Fitness, Medicine, Fitness

4.7 • 7.3K Ratings

🗓️ 16 October 2018

⏱️ 87 minutes

🔗️ Recording | iTunes | RSS

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Summary

In this five-part series, Thomas Dayspring, M.D., FACP, FNLA, a world-renowned expert in lipidology, and one of Peter's most important clinical mentors, shares his wealth of knowledge on the subject of lipids. In Part II, Tom provides a 101 on lipids and lipoproteins. Tom and Peter also discuss the history and techniques used to measure lipoproteins, and more.

We discuss:

Lipoprotein basics [1:30];
Gofman and the ultracentrifuge [5:15];
Lipoprotein structure, function, metabolism [6:45];
Lipoprotein and cholesterol measurement, and NMR technology [15:15];
LDL-C vs LDL-P and apoB [30:45];
Sterols and cholesterol synthesis [39:45]; and
More.

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Transcript

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0:00.0	Hey everyone, welcome to the Peter Atia Drive. I'm your host, Peter Atia.
0:10.0	The drive is a result of my hunger for optimizing performance, health, longevity, critical thinking,
0:15.7	along with a few other obsessions along the way. I've spent the last several years working
0:19.6	with some of the most successful top performing individuals in the world, and this podcast
0:23.8	is my attempt to synthesize what I've learned along the way to help you live a higher quality
0:28.3	and more fulfilling life. If you enjoy this podcast, you can find more information on today's
0:32.4	episode and other topics at peteratiamd.com.
0:36.1	Hi everybody, welcome to episode two of five in the week of day spring. This episode we
0:48.3	cover lipoprotein basics, what's lipoproteins in lipids 101. We talk about Goffman and the
0:54.0	ultra-centrifuge and how we came up with these whole ideas of densities of lipoproteins. We get
0:58.8	into very specifics around the lipoprotein structure, their function and their metabolism. We talk
1:04.3	about how to measure the lipoprotein and the cholesterol content and what NMR is and how it has changed
1:10.2	the game a little bit. We get into the distinctions between LDL cholesterol, LDL particle number and
1:15.2	APOB. There is some confusion here amongst physicians and presumably amongst patients. So hopefully
1:22.0	that will clear that up. We get into the biochemistry of lipids and then we talk about sterols specifically
1:28.2	as a more broad category.
1:29.4	Now before we could measure anything to do with lipoproteins, if my memory serves me correctly, it would
1:38.2	have been the late 40s, very early 50s when the first assays were developed, maybe it was 1951,
1:44.6	that could actually just measure total cholesterol. So you would take plasma from a patient, you would
1:51.4	presumably in an assay break down all of the lipoproteins and just aggregate the total amount of
1:56.4	cholesterol and you would yield that number which still amazingly shows up on a panel today. You
2:01.6	go and get a blood test and it might say your total cholesterol is 200 milligrams per desolate.
	...

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