JISCMail - ACB-CLIN-CHEM-GEN Archives

But also look at his recent presentation to the UK Parlement on low CHO diet and diabetes https://youtu.be/HvMFj6NxPGI before you start telling your patients to stop taking low CHO diets.

Elizabeth Mac Namara

On May 1, 2019, at 04:07, Sharpe, Peter <[log in to unmask]> wrote:

Is there evidence that these patients are at increased risk of CV disease? If so, should we be discouraging low CHO diets?

Kindest regards

Peter

Dr Peter Sharpe

Consultant Chemical Pathologist

Associate Medical Director, Research & Development

Southern Health & Social Care Trust

Ext: 60869

Tel: 028 38360696

Fax: 028 38334582

From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Ian Young
Sent: 01 May 2019 08:56
To: [log in to unmask]
Subject: Re: Puzzling patient

It sounds from the discussion as if there are a few of these cases. I assume that there is a genetic basis for hyper-responsiveness. It might be worth defining a phenotype and gathering them together with a view to some genetic studies if anyone has time to lead on it….

Best wishes

Ian

Ian S.Young

Professor of Medicine

Queen’s University Belfast

[log in to unmask]

Tel: 02890632743

From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Waise, Ahmed
Sent: 01 May 2019 08:52
To: [log in to unmask]
Subject: Re: Puzzling patient

Last year I had a 55 year patient, on statin for primary prevention, and who went on a ketogenic diet and lost three stones. LDL rose from 2.6 to 15.7 mmol/L with ApoB >3 gm/L. Sterols did not show significant abnormality. I think it presumed that AN patient can have high raised LDL due to a similar mechanism.

Ahmed Waise

From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Paul Collinson
Sent: 30 April 2019 12:44
To: [log in to unmask]
Subject: Puzzling patient

I would be interested in the collective wisdom of the mailbase users especially those with a particular interest in lipid disorders.

I have an 18-year-old girl with a cholesterol of 21.1 mol/L triglyceride 1.5 mmol. History is slightly complicated as she previously had anorexia nervosa diagnosed as due to an autonomic dysfunction which made her feel full easily. She remains underweight however. In addition, she does not tolerate carbohydrate very well and has a diet which is predominantly meat and dairy. Genetic testing excludes familial hypercholesterolaemia with a high likelihood of polygenic hypercholesterolaemia.

Carotid imaging shows no evidence of early atherosclerosis.

Any suggestions would be most gratefully received as I am very puzzled as to what is going on. My current working hypothesis is a combination of diet plus the underlying polygenic hypercholesterolaemia.

Professor Paul Collinson	T: +44 (0)208 725 5934 sec (0)208 725 5923
Consultant Chemical Pathologist and Professor of Cardiovascular Biomarkers	F: +44 (0)208 725 5868
Clinical Blood Sciences	E: [log in to unmask]
*St. George's Healthcare NHS* Trust**	W: www.stgeorges.nhs.uk

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