This gets cited here weekly, usually second-hand, so it is worth setting out what it does and does not establish.
ApoB is the more informative number and it is cheap. LDL-C estimates cholesterol mass in atherogenic particles; ApoB counts the particles, and it is particle count that tracks risk — which is why the two can disagree and why the disagreement is the clinically interesting case. Triglycerides fall substantially with weight loss and improved insulin sensitivity, HDL moves modestly, and LDL-C often barely moves at all, which surprises people who expected everything to improve together.
Where I think it is weakest: the completion rate deserves as much attention as the headline, because a large effect among those who finished is a different claim from a large effect among those enrolled.
So the question, as narrowly as I can put it: whether an unchanged LDL-C alongside a large triglyceride fall is a good result or a bad one, because ApoB and LDL-C seem to be telling different stories. If the honest answer is that nobody knows, that is a useful answer and I would rather have it.
Figures above are from the primary publication rather than the press summary. If a number here disagrees with one you have, post yours and we will work out which of us is reading a secondary source.
carl_compliance said:ApoB is the more informative number and it is cheap.
Omega-3 index improvement on the lipid panel: often overlooked but my omega-3 index went from 3.6% to 8.6% over 13 months. I supplemented with 2g EPA+DHA daily.
This matters because omega-3s are anti-inflammatory and cardioprotective, complementing the GLP-1 benefits. Target omega-3 index is >8%. Combined with the triglyceride reduction from the medication, my lipid profile is the best it's been in decades.
carl_compliance said:ApoB is the more informative number and it is cheap.
Careful with treating an unchanged LDL-C as a failure. If ApoB and triglycerides both fell, the particle picture improved regardless of what the calculated LDL says.
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Shop Reference StandardsDr.SleepRoch said:Careful with treating an unchanged LDL-C as a failure.
Before/after bloodwork compilation for the lipid panel — everything in one place for those who want comprehensive data:
| Category | Marker | Before | After 8mo | Change |
|---|---|---|---|---|
| Metabolic | A1C | 8.2% | 5.4% | ⬇️ 1.4% |
| Metabolic | Fasting Glucose | 131 | 85 | ⬇️ 31 |
| Lipids | LDL | 154 | 98 | ⬇️ 56 |
| Lipids | Triglycerides | 256 | 121 | ⬇️ 106 |
| Inflammation | hsCRP | 5.5 | 0.9 | ⬇️ 4.0 |
Every single metabolic marker improved. This is why I'm a believer in this therapy.
Dr.RenalNash said:Omega-3 index improvement on the lipid panel: often overlooked but my omega-3 index went from 3.6% to 8.6% over 13 months.
Same pattern here, and in the same order.