High total cholesterol and/or elevated low-density lipoprotein (LDL) cholesterol do not
cause atherosclerosis
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Low levels of high-density lipoprotein (HDL) cholesterol are associated with both
atherosclerosis and insulin resistance, and insulin resistance appears to be the
foundational cause of heart disease. As such, the fasting insulin test is one of the best
predictors of atherosclerosis
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Insulin resistance is primarily driven by excessive consumption of the omega-6 fat
linoleic acid (LA). High LA intake is also associated with elevated levels of oxidized LDL
— found in atherosclerosis plaque — further confirming this link
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One theory is that oxidized LDL protects your body from oxidative damage by sacrificing
itself. If true, it may be beneficial to have higher, rather than lower, LDL levels
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The apoB test can also be helpful in assessing your atherosclerosis risk. As mentioned
above, apoB is the primary carrier for LDL, and research over the past decade shows it’s
an accurate predictor of cardiovascular risk when apoB is high and LDL is normal