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High cholesterol levels, insulin resistance, obese. Trying to lose weight. Chances for cardiovascular diseases?

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Cardiologist, Interventional
Practicing since : 1998
Answered : 411 Questions
Hello. I am 55, looking to lose 70 pounds, and have my LIPScience cholesterol report (which has some numbers a bit different from the Bio-Science blood test report). My overall glucose is 117, with A1C of 6.1%. Overall cholesterol is 209 with HDL of 44 and triglyc. of 96. But these others, which I am not familiar with, are of concern, though I don't think I have to freak out, but wonder whether I have to bother worrying about it. Here are:
HDL-P 25th percentile at 27.1 (higher risk CVD)
LDL size at 20.9 (Large) at 26.6 percentile.
Large HDL-P at 1.3 (low insulin resistant).
HDL size 8.3 at small insulin resistant
LP-IR Score of 47 at 50th percentile.
LDL-P 1858 (borderline high).
Posted Sun, 22 Apr 2012 in Cholesterol
Answered by Dr. Prabhakar C Koregol 20 hours later

Thanks for posting your query.

I understand your concern that you want to loose your weight. I would like to know what is your weight, height and BMI (Body mass index).

Good balanced diet which is low in fat and high protein will be helpful for weight reduction. You can take help of Nutritionist for that.

Avoid smoking and alcohol if you have habit of any.

Your glucose and HbA1c are within normal range.

Your Total cholesterol and LDL cholesterol levels are in the higher range and needs treatment. You need to recieve treatment for this which includes drugs like Statins, life style modification like daily walk and dietary changes. HDL which is called a good cholesterol, is low which needs to be corrected but there are no effective and proven medicines for the same. Daily exercise and healthy diet will help you for increasing HDL levels. This will also help for you in weight reduction.

Hope, I have answered your query. I will be available for follow up queries if any.

Above answer was peer-reviewed by
Follow-up: High cholesterol levels, insulin resistance, obese. Trying to lose weight. Chances for cardiovascular diseases? 1 hour later
Thank you. I am 5'8" and weigh around 250 pounds. I don't know the BMI, but am sure it is "bad." Anyway, yes I do want to lose weight, ande haven't been successful in around 10 years to lose 70 pounds. I try appetite suppressant/metabolism enhancers and reducing carbs and red meat, sugar, etc.

Aside from that, what are the importance of the cholesterol sizes relating to "insulin resistant" and their numbers and percentiles.

Supposedly the number of glucose at 117 and A1C at 6.1% are sometimes also considered above normal. As an aside, I have intraocular pressure of 21-24 in both eyes, which may be somehow related.
Finally, why are some numbers different between the BioScience report and the LiPScience report? Thank you.
Answered by Dr. Prabhakar C Koregol 21 hours later

Thanks for posting your query.

I would suggest you should have professional help of Dietician and exercise therapist to reduce weight.

Obesity is generally the main cause for your insulin resistence and thats reflected in your measurements but once you loose few pounds it tends to become normal.

The normal reference range of mean glucose level is 70- 140 mg/dl. Your value of 117 falls within normal range. A fasting glucose of 110 and above is considered abnormal. So your HbA1C and Mean glucose are within normal range.

In case of the lipid subfraction analysis (for that matter any medical test) normal value depend upon the assay (type of test) used and population basis on which the test is standardised. So that could explain the normal value being different from one lab to an other. Occassional ranges are put differently by different labs.

Your intraocular Pressure is on high which needs evaluation by Ophthalmologist to confirm the exact cause for it.

Hope, this explains your query.

Wish you good health.

Above answer was peer-reviewed by
Follow-up: High cholesterol levels, insulin resistance, obese. Trying to lose weight. Chances for cardiovascular diseases? 1 hour later
Thank you. The glucose at 117 was fasting, as was the A1C at 6.1%
Does this make any difference really?
I am still not sure I understand the significance and implications of the sizes and numbers of th cholesterol particles, and what difference it makes for cholesterol and cardiovascular health at all.
Follow-up: High cholesterol levels, insulin resistance, obese. Trying to lose weight. Chances for cardiovascular diseases? 9 hours later
I forgot to mention that my blood pressure varies between 126/85 to 150/86. Whenever I am at the doctor's office it seems to be higher. When I do several readings at one sitting at home in the morning it can vary. I know society is generally obsessed with the issue of lowering blood pressure, even below 120/80, but is it possible that for some people a higher reading is "normal" for them? And if so, how is this judged to be the case as in the case of IOP?
Answered by Dr. Prabhakar C Koregol 16 hours later
Hello again,

Thank you for the follow up.

Normal range of Fasting glucose levels is from 60 mg/dl to 110 mg/dl. 117 mg/dl with an HbA1c of 6.1 indicates that you do have some insulin resistance. HbA1c normally should be less than 5%.

Your cholesterol levels are on the higher side and they need to be controlled.

Higher cholesterol levels over prolonged periods coupled with obesity and hypertension do have serious effects on the cardiovascular system.

High cholesterol levels, high blood pressure cause atherosclerosis (Thickening and stiffening of the blood vessels), which in turn increases the blood pressure. High blood pressure leads to a variety of problems like heart attacks, stroke, kidney failure and many others.

Almost every part of the body is affected by high blood pressure.

The best way to lose weight and decrease the cholesterol levels is to indulge in regular exercise for a minimum of 45 minutes to one hour daily along with a strict diet plan.

Your diet plan should give you adequate amounts of calories but not excess. An average adult male would require around 1800 Kcal of energy per day. If you eat in excess, the excess energy gets converted into fat.

Coming to your blood pressure issue. It looks like typical case of the White coat hypertension. Thats BP being higher only at physician office.

There hasnt been any significant benefit obtained by lowering BP below 120/80mmHg. Higher reading cannot be considered normal once they are above 140/90mmHg in anyone.

To conclusively have diagnosis you might need a 24hr ambulatory BP monitoring.

Hope I have cleared all your doubts.

Wishing you good health.

Above answer was peer-reviewed by
Follow-up: High cholesterol levels, insulin resistance, obese. Trying to lose weight. Chances for cardiovascular diseases? 3 hours later
Thank you very much. I have a stationary bicycle in my salon, but I don't always ride on it.
My dieting issues are always a struggle, for some 10 years., to get rid of 30 kilos. Unfortunately if dieting involves still feeling HUNGRY, it usually fails. I do not eat out of control. But you probably know the joke of how some youunger people can eat without limit and be at a normal weight, and an older person puts on weight just drinking water!
Answered by Dr. Prabhakar C Koregol 7 hours later
Thanks for the follow up.

That is the reason I had told you in my last answer itself that dieting is not something one can do on his/her own. Especially when it is therapeutic you need to take professional help and follow it.

It should just be consumed like one more tablet or potion without much of emotional component. Most of the medical diet plan do not include being hungry.

How much weight one gains to the amount of food consumed is very individualistic and I fully agree that obese people don't always feel that , but the truth is whatever they are eating is in excess of what is their requirement.

Wishing you good health.
Above answer was peer-reviewed by
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