Summary
The Drive podcast episode hosted by Peter Attia features a discussion with molecular medicine professor Dan Rader on high density lipoproteins (HDLs), or "good cholesterol." The conversation covers the biology of HDLs, their genesis, metabolism, life cycle, and function. The episode provides a comprehensive understanding of HDLs and their importance in cardiovascular health.
The episode discusses the APOA1 system and its role in HDL formation and transport in the bloodstream, as well as the APO B system and its role in transporting triglycerides for energy purposes. The discussion also touches on the history of lipid-lowering drugs and the importance of measuring Desmoistural levels in patients.
The podcast emphasizes the importance of measuring the function of HDL cholesterol rather than just its levels, as the current measure of HDL cholesterol is not sufficient in predicting the risk of cardiovascular disease. The speakers suggest that measuring the efficiency of HDL in extracting cholesterol from cells is a better predictor of risk. They also discuss the development of clinical assays to measure HDL function and the potential for using AI to find composite markers that predict e-flux capacity.
The podcast also delves into the process of reverse cholesterol transport (RCT), which involves efflux of cholesterol from macrophages to HDL, and then returning it to the liver for excretion. The more effective the process of RCT, the more protection against atherosclerosis.
The episode concludes with a discussion about the correlation between apoe concentration and neurodegenerative disease and the potential use of an assay for apoe concentration in the CSF. Overall, the episode provides a thorough exploration of HDLs and their importance in cardiovascular health and potential role in protecting against neurodegenerative diseases.
