ISF Logo   IS Forum
Forum Index Register Members List Events Mark Forums Read Help

Go Back   International Skeptics Forum » General Topics » Science, Mathematics, Medicine, and Technology
 


Welcome to the International Skeptics Forum, where we discuss skepticism, critical thinking, the paranormal and science in a friendly but lively way. You are currently viewing the forum as a guest, which means you are missing out on discussing matters that are of interest to you. Please consider registering so you can gain full use of the forum features and interact with other Members. Registration is simple, fast and free! Click here to register today.
Reply
Old 19th July 2018, 04:19 PM   #81
casebro
Penultimate Amazing
 
casebro's Avatar
 
Join Date: Jun 2005
Posts: 15,990
But the critical thing about Statins is that their advantage cones about via growth facotr, not LDL changes. As show by other drugs that lower LDL and do not benefit hearts.
__________________
Great minds discuss ideas.
Medium minds discuss events.
Small minds spend all their time on U-Tube and Facebook.
casebro is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 21st July 2018, 12:44 PM   #82
blutoski
Penultimate Amazing
 
blutoski's Avatar
 
Join Date: Jan 2006
Posts: 11,620
Originally Posted by Skeptical Greg View Post
98.1% Of subjects taking the statin did not have a CV event, but neither did 97% of the subjects taking the placebo.

How much of such a small number might be accounted for by other co-founders.
Maybe the placebo group ate more fried chicken, or maybe they smoked more.

Ideally, such factors would have been filtered out.

I will see if I can find the details on the actual study.


Probably the ASCOT study. Pubmed: [ASCOT-LLA]

There was a follow up, [The Anglo-Scandinavian Cardiac Outcomes Trial: 11-year mortality follow-up of the lipid-lowering arm in the U.K.]
__________________
"Sometimes it's better to light a flamethrower than curse the darkness." - Terry Pratchett
blutoski is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 21st July 2018, 12:46 PM   #83
blutoski
Penultimate Amazing
 
blutoski's Avatar
 
Join Date: Jan 2006
Posts: 11,620
Originally Posted by blutoski View Post
casebro's point is valid: we are at a stage for atorvastatin similar to where Jenner was when he confirmed vacaccination provided protection from smallpox. He didn't know exactly how it worked, but the studies show it did.

What Diamond's doing is what I call the French Philosopher's Disease: "Sure it works in the real world, but I don't understand how it works on paper, so I'm going to make a youtube video saying it doesn't actually work in the real world."
__________________
"Sometimes it's better to light a flamethrower than curse the darkness." - Terry Pratchett
blutoski is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 21st July 2018, 12:57 PM   #84
blutoski
Penultimate Amazing
 
blutoski's Avatar
 
Join Date: Jan 2006
Posts: 11,620
Originally Posted by Skeptical Greg View Post
98.1% Of subjects taking the statin did not have a CV event, but neither did 97% of the subjects taking the placebo.

How much of such a small number might be accounted for by other co-founders.
Maybe the placebo group ate more fried chicken, or maybe they smoked more.

Ideally, such factors would have been filtered out.

I will see if I can find the details on the actual study.
To put the numbers in context, if this was the ASCOT study, the timeframe was two years. If we extrapolate to lifetime benefits, let's say 30 years, the number of incidents would multiply by roughly 15, so instead of 3% placebo arm deaths we'd have 45%, the atorvastatin arm would be a third less at 30%. These numbers compare to the protection the population gets from not smoking vs smoking. It's potentially a big deal, but we don't have any studies performed this long to verify, my numbers are just back-of-the-envelope for illustrative purposes.

As mentioned in an above post, we're not sure how atorvastatin is protective. Diamond's hyperfocused on the lipid hypothesis (his rants seem to have originated from an outrage over health insurance pricing related to his cholesterol level, so he's on a mission to prove the lipid hypothesis wrong), and missing the other probable mechanisms, specifically there's a good case that the primary mechanism of protection is antiinflammatory.
__________________
"Sometimes it's better to light a flamethrower than curse the darkness." - Terry Pratchett
blutoski is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 21st July 2018, 02:01 PM   #85
Skeptical Greg
Agave Wine Connoisseur
 
Skeptical Greg's Avatar
 
Join Date: Jul 2002
Location: Just past ' Resume Speed ' .
Posts: 15,279
In which case, it would make more sense to address the cause of the inflammation..

Diet?
__________________
" The main problem I have with the idea of heaven, is the thought of
spending eternity with most of the people who claim to be going there. "
Skeptical Greg is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 21st July 2018, 06:41 PM   #86
blutoski
Penultimate Amazing
 
blutoski's Avatar
 
Join Date: Jan 2006
Posts: 11,620
Originally Posted by Skeptical Greg View Post
In which case, it would make more sense to address the cause of the inflammation..

Diet?
Age, for most of us. Genetics prevails. There are dietary suspects, but once the damage is done there's no known reversal.

(ref above, my undergrad is MBI, my primary focus was immune system, my masters was specifically research into how the immune system adapts/fails with exposure to HIV, but there is a lot of general knowledge; my second research project was lupus, which is an immune system glitch due to genetics)
__________________
"Sometimes it's better to light a flamethrower than curse the darkness." - Terry Pratchett
blutoski is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 21st July 2018, 06:43 PM   #87
blutoski
Penultimate Amazing
 
blutoski's Avatar
 
Join Date: Jan 2006
Posts: 11,620
Originally Posted by blutoski View Post
Age, for most of us. Genetics prevails. There are dietary suspects, but once the damage is done there's no known reversal.

(ref above, my undergrad is MBI, my primary focus was immune system, my masters was specifically research into how the immune system adapts/fails with exposure to HIV, but there is a lot of general knowledge; my second research project was lupus, which is an immune system glitch due to genetics)
ETA: also, the immune connection with statins' benefit is unproven at this time.
It would be too early to advocate a hypothetical treatment when statins are demonstrated to work.
__________________
"Sometimes it's better to light a flamethrower than curse the darkness." - Terry Pratchett
blutoski is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 22nd July 2018, 07:06 AM   #88
casebro
Penultimate Amazing
 
casebro's Avatar
 
Join Date: Jun 2005
Posts: 15,990
I suspect that the data exists to tell which DNA variant is helped by Statins. Which will explain how Statins actually work. But don't expect Big Pharma to tell us that 60% of us shouldn't by their chemical.

Inflammation is a good candidate, via IRS-1 or another hormone receptor gene. Seems a known fact that statins lower insulin resistance, also raise IGF-1 levels. That, wah-lah, might be the answer.
__________________
Great minds discuss ideas.
Medium minds discuss events.
Small minds spend all their time on U-Tube and Facebook.
casebro is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 22nd July 2018, 12:53 PM   #89
Skeptical Greg
Agave Wine Connoisseur
 
Skeptical Greg's Avatar
 
Join Date: Jul 2002
Location: Just past ' Resume Speed ' .
Posts: 15,279
Originally Posted by blutoski View Post
Age, for most of us. Genetics prevails. There are dietary suspects, but once the damage is done there's no known reversal.

(ref above, my undergrad is MBI, my primary focus was immune system, my masters was specifically research into how the immune system adapts/fails with exposure to HIV, but there is a lot of general knowledge; my second research project was lupus, which is an immune system glitch due to genetics)
Diet and othe4r lifestyle changes can definitely limit increases in risk factors and longevity..
__________________
" The main problem I have with the idea of heaven, is the thought of
spending eternity with most of the people who claim to be going there. "
Skeptical Greg is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 22nd July 2018, 12:58 PM   #90
Skeptical Greg
Agave Wine Connoisseur
 
Skeptical Greg's Avatar
 
Join Date: Jul 2002
Location: Just past ' Resume Speed ' .
Posts: 15,279
Blutoski:

I would seriously be interested in an educated opinion of my post above...

If you feel it would be inappropriate, I would be fine with that, also.
__________________
" The main problem I have with the idea of heaven, is the thought of
spending eternity with most of the people who claim to be going there. "
Skeptical Greg is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 22nd July 2018, 02:40 PM   #91
blutoski
Penultimate Amazing
 
blutoski's Avatar
 
Join Date: Jan 2006
Posts: 11,620
Originally Posted by Skeptical Greg View Post
Blutoski:

I would seriously be interested in an educated opinion of my post above...

If you feel it would be inappropriate, I would be fine with that, also.
Basically. It's one thing to discuss research, in this case the accuracy of how a company describes results from a specific study; it's another to give medical advice.
__________________
"Sometimes it's better to light a flamethrower than curse the darkness." - Terry Pratchett
blutoski is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 22nd July 2018, 04:42 PM   #92
casebro
Penultimate Amazing
 
casebro's Avatar
 
Join Date: Jun 2005
Posts: 15,990
Originally Posted by Skeptical Greg View Post
Blutoski:

I would seriously be interested in an educated opinion of my post above...

If you feel it would be inappropriate, I would be fine with that, also.
I'm only studying on the net to become an amateur Gynecologist, but I'll give an opinion. And I don't even need no history or tests.

Most people do not die of heart problems. It looks to me that you are one of those.
__________________
Great minds discuss ideas.
Medium minds discuss events.
Small minds spend all their time on U-Tube and Facebook.
casebro is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 23rd July 2018, 10:07 AM   #93
Skeptical Greg
Agave Wine Connoisseur
 
Skeptical Greg's Avatar
 
Join Date: Jul 2002
Location: Just past ' Resume Speed ' .
Posts: 15,279
Originally Posted by blutoski View Post
Basically. It's one thing to discuss research, in this case the accuracy of how a company describes results from a specific study; it's another to give medical advice.
Does an educated opinion necessarily have to be advice?

Don't take this as contentious, but my question came from what I feel was " an argument from authority " on your part..

Quote:
I get it, and I have my own opinions on the topic (My MSc is Research Medicine, my wife is an MD who does medical research - evaluating medical research is what passes as dinner conversation at our house).
How do medically trained people make the decision to prescribe cholesterol lowering drugs, other than some arbitrary and often misleading numbers. Calculated LDL ( LDL-c ) is very arbitrary, and the only possible criteria she may have had.

" Your LDLc is higher than guidelines. We need to lower it. "

MY PCP was oblivious to scientifically sound information that suggested I am not a good ( have nothing to gain, other than possible serious side effects ) candidate for statin therapy..
__________________
" The main problem I have with the idea of heaven, is the thought of
spending eternity with most of the people who claim to be going there. "
Skeptical Greg is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 30th July 2018, 09:18 AM   #94
casebro
Penultimate Amazing
 
casebro's Avatar
 
Join Date: Jun 2005
Posts: 15,990
Here's a bit of info re: the different functionality between Insulin, and Insulin like Growth Factor, IGF. Keep in mind that the IRS-1 ( Insulin Receptor Substrate) gene defect lowers the amount of IGF in your system- same substrate used for both the insulkin receptor and the growth hormone receptor, which kicks off the production of IGF.

Quote:
https://www.ncbi.nlm.nih.gov/pubmed/11606465:

Thirty genes, 27 of which were not previously known to be IGF-1 responsive, were up-regulated by IGF-1 but not by insulin. Nine genes, none of which was previously known to be insulin responsive, were up-regulated by insulin but not by IGF-1.
So the fact that you have Diabetes (and obesity) means LOTS of health problems are in common, but probably NOT caused by the high sugars.
__________________
Great minds discuss ideas.
Medium minds discuss events.
Small minds spend all their time on U-Tube and Facebook.

Last edited by casebro; 30th July 2018 at 09:19 AM.
casebro is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 30th July 2018, 12:47 PM   #95
Skeptical Greg
Agave Wine Connoisseur
 
Skeptical Greg's Avatar
 
Join Date: Jul 2002
Location: Just past ' Resume Speed ' .
Posts: 15,279
What do you mean by " high sugars "? High blood sugar?
A diet that is high in sugar will definitely drive all kinds of health issues.
__________________
" The main problem I have with the idea of heaven, is the thought of
spending eternity with most of the people who claim to be going there. "
Skeptical Greg is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 30th July 2018, 12:58 PM   #96
casebro
Penultimate Amazing
 
casebro's Avatar
 
Join Date: Jun 2005
Posts: 15,990
Originally Posted by Skeptical Greg View Post
What do you mean by " high sugars "? High blood sugar?
A diet that is high in sugar will definitely drive all kinds of health issues.
We are talking diabetes and insulin resistance, so yeah, blood sugar levels.

And what I am saying is that high BS may not be the driver of morbidity that we have been taught. Hyperinsilinemia and low IGF are the drivers of much of the Diabetic morbidity.

IGF injections have been used to treat the hyperinsulinemia. I may try some to treat my leg muscles that have been bad since childhood. (Insulin resistance is life long, the diabetes symptom starts later) My endogenous IGF level is only tenth percentile.

To get the IGF, I think I can go to the muscle man gym, and hang put in the locker room, wait for some one to ask if I want to speed up the body building process. The steroids they use are IGF. Try it a couple weeks, see if my legs are capable of tap dancing- and want to.
__________________
Great minds discuss ideas.
Medium minds discuss events.
Small minds spend all their time on U-Tube and Facebook.
casebro is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 30th July 2018, 03:26 PM   #97
Skeptical Greg
Agave Wine Connoisseur
 
Skeptical Greg's Avatar
 
Join Date: Jul 2002
Location: Just past ' Resume Speed ' .
Posts: 15,279
The fact remains, in most cases, a low carb diet will reverse type 2 diabetes..
__________________
" The main problem I have with the idea of heaven, is the thought of
spending eternity with most of the people who claim to be going there. "
Skeptical Greg is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 30th July 2018, 05:11 PM   #98
casebro
Penultimate Amazing
 
casebro's Avatar
 
Join Date: Jun 2005
Posts: 15,990
Originally Posted by Skeptical Greg View Post
The fact remains, in most cases, a low carb diet will reverse type 2 diabetes..
Let me say this slowly: DIABETES IS ONLY THE SUGARS.

The patient still has the insulin resistance, the cause of so many of the side effects that get blamed on the sugars.

You are not believing me, do your own search <pseudo acromegaly>

But here is a partial list of my symptoms, things I have heard the docs say "we see a lot of that among diabetics" :

Trigger finger
Carpal tunnel
tendonitis
ruptured discs
skin tags
colon polyps
clogged arteries
calcifications
lucent lesions (bones)
Mayalgia
Scalloped cervical bones
pseudo foramen (looks like I drilled a hole in my thumb bone)
Peripheral neuropathy.

ad on nearly infinitum, I had a list of 45. ALL are listed as possible symptoms of Acromegaly, in spite of patients having normal sugars. Acromegaly, a messed up hormone system- like hyper insulinism, is caused by too much IGF. Too much insulin acts like-.... too much IGF.

And some of my symptoms have been since childhood, I didn't turn obese and diabetic until my 20s. I know, diet and exercise will push diabetes into remission, but I still won't be able to snap my fingers or do the cub scout salute. Or feel my fingers and toes. (nerve sheath overgrowth, like artery lining overgrowth, cuts down circulation)

eta: In fact, being a diabetic, studies show that it's OK to allow sugars to run twice as high as normals. Because? trying for normal doesn't do much at all for preventing the side effects. Not even enough to pay for the extra drugs. Look up UKPDS, United Kingdom Prospective Diabetes Study.
__________________
Great minds discuss ideas.
Medium minds discuss events.
Small minds spend all their time on U-Tube and Facebook.

Last edited by casebro; 30th July 2018 at 05:15 PM.
casebro is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 30th July 2018, 05:39 PM   #99
Skeptical Greg
Agave Wine Connoisseur
 
Skeptical Greg's Avatar
 
Join Date: Jul 2002
Location: Just past ' Resume Speed ' .
Posts: 15,279
0h, I believe you.

I am talking mainly about type 2... lots of sugar creates the insulin resistance, and things like fatty liver disease.. Surprise! It's not dietary fat that does that.
Most of the items in your list can be attributed to nutritional deficiencies and/or excesses..
__________________
" The main problem I have with the idea of heaven, is the thought of
spending eternity with most of the people who claim to be going there. "
Skeptical Greg is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 30th July 2018, 08:16 PM   #100
casebro
Penultimate Amazing
 
casebro's Avatar
 
Join Date: Jun 2005
Posts: 15,990
Originally Posted by Skeptical Greg View Post
0h, I believe you.

I am talking mainly about type 2... lots of sugar creates the insulin resistance, and things like fatty liver disease.. Surprise! It's not dietary fat that does that.
Most of the items in your list can be attributed to nutritional deficiencies and/or excesses..
Are you assuming I am T1? Nope, it's my T2 that is tied inextricably to insulin resistance.

T1 is an auto-immune problem- your immune system attacks the insulin making beta cells in the pancreas. So you don't make insulin. It's only about 5% of diabetics. But guess what- the IRS gene defects are so common, T1 folks get all them disease symptoms too. Which adds to the confugalty of whether it's the high sugars or the high insulin that causes all those symptoms.
__________________
Great minds discuss ideas.
Medium minds discuss events.
Small minds spend all their time on U-Tube and Facebook.
casebro is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 2nd August 2018, 11:51 AM   #101
blutoski
Penultimate Amazing
 
blutoski's Avatar
 
Join Date: Jan 2006
Posts: 11,620
Originally Posted by Skeptical Greg View Post
Does an educated opinion necessarily have to be advice?
No, but on this forum, there's been an informal practice to not give opinions about specific cases when it's about a real person's medical diagnosis or prescription. There's no rule, and many members are happy to dispense medical advice all day, for example, the members in MLMs selling dietary supplements, but I personally prefer to fall on the side of caution.



Originally Posted by Skeptical Greg View Post
Don't take this as contentious, but my question came from what I feel was " an argument from authority " on your part..
It was, and that's not necessarily a bad thing, despite what pseudoskeptics hide behind. The fallacy is 'argument from invalid authority' (eg: we should listen to her opinions on vaccines because she's a famous actress).

In contrast ("This is a heart disease topic, we should listen to the expert in heart disease") is not an example of argument from invalid authority fallacy, it is in fact a good argument.




Originally Posted by Skeptical Greg View Post
How do medically trained people make the decision to prescribe cholesterol lowering drugs, other than some arbitrary and often misleading numbers. Calculated LDL ( LDL-c ) is very arbitrary, and the only possible criteria she may have had.

" Your LDLc is higher than guidelines. We need to lower it. "

MY PCP was oblivious to scientifically sound information that suggested I am not a good ( have nothing to gain, other than possible serious side effects ) candidate for statin therapy..
The answer depends on the guidelines communicated to MDs by their respective College in their region. As mentioned above, the drugs have long been demonstrated to work independently of their cholesterol reducing capacity, so many regions want GPs to consider multiple risk factors such as family history, current BMI, age, &c.
__________________
"Sometimes it's better to light a flamethrower than curse the darkness." - Terry Pratchett

Last edited by blutoski; 2nd August 2018 at 11:52 AM.
blutoski is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 2nd August 2018, 12:44 PM   #102
casebro
Penultimate Amazing
 
casebro's Avatar
 
Join Date: Jun 2005
Posts: 15,990
Originally Posted by blutoski View Post
The answer depends on the guidelines communicated to MDs by their respective College in their region. As mentioned above, the drugs have long been demonstrated to work independently of their cholesterol reducing capacity, so many regions want GPs to consider multiple risk factors such as family history, current BMI, age, &c.
I just got back form my diabetes nurse/educator. She doen't even want to test some lipids nowadays. Though they are included in the risk calculations, along with age, sex,race, smoker, some more items. My risk score for a heart attack in the next ten years is 33%. I'm a 65yo diabetic, I didn't think 33% is half bad.

eta:, Hmmm, life expectancy of 75, ten years from now, 40% of us die of heart attacks, looks to me that I am beating the numbers. But that just means that I'll die of cancer, ;like all of my brothers (2).
__________________
Great minds discuss ideas.
Medium minds discuss events.
Small minds spend all their time on U-Tube and Facebook.

Last edited by casebro; 2nd August 2018 at 12:48 PM.
casebro is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 3rd August 2018, 08:36 AM   #103
casebro
Penultimate Amazing
 
casebro's Avatar
 
Join Date: Jun 2005
Posts: 15,990
It's not the glucose level (diabetes), nor the obesity, it's the insulin resistance

Quote:
https://academic.oup.com/jcem/article/83/8/2773/2660508

In conclusion, approximately one of every five healthy, nonobese subjects in the most insulin-resistant tertile, followed for approximately 5 yr, had a serious clinical event. These data highlight the importance of insulin resistance as a predictor of CVD.
__________________
Great minds discuss ideas.
Medium minds discuss events.
Small minds spend all their time on U-Tube and Facebook.
casebro is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 3rd August 2018, 11:55 AM   #104
blutoski
Penultimate Amazing
 
blutoski's Avatar
 
Join Date: Jan 2006
Posts: 11,620
Originally Posted by casebro View Post
I just got back form my diabetes nurse/educator. She doen't even want to test some lipids nowadays. Though they are included in the risk calculations, along with age, sex,race, smoker, some more items. My risk score for a heart attack in the next ten years is 33%. I'm a 65yo diabetic, I didn't think 33% is half bad.
SG's personal inventory included having had smoked in the past, which according to Health Canada's website is actually up there as a risk factor with high lipid scores, obesity, and sedentary lifestyle. Lower than current smoker, but the risk seems to stay pretty high even after quitting. However, that's Health Canada's calculator. US regions may estimate risk differently and ask their GPs to act accordingly.


Originally Posted by casebro View Post
eta:, Hmmm, life expectancy of 75, ten years from now, 40% of us die of heart attacks, looks to me that I am beating the numbers. But that just means that I'll die of cancer, ;like all of my brothers (2).
This is where I frustrate the risk analyzers: my parents both died in their 20s from situations that had nothing to do with chronic illness, so my risk level is unknown, and many calculators don't have the ability to incorporate that.
__________________
"Sometimes it's better to light a flamethrower than curse the darkness." - Terry Pratchett
blutoski is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 3rd August 2018, 01:11 PM   #105
Skeptical Greg
Agave Wine Connoisseur
 
Skeptical Greg's Avatar
 
Join Date: Jul 2002
Location: Just past ' Resume Speed ' .
Posts: 15,279
If my lungs and arteries are all clear, what is the likelihood that my having last smoked over thirty years ago, actually a risk factor for me now?

Also as I mentioned above, my Cardiac CT calcium score is zero.. This indicates a risk of CVD at less than 5%..

My PCP is apparently using a risk calculator that does not include either of these factors..

The best calculator would include her own judgement which she seems to be reluctant to use..
__________________
" The main problem I have with the idea of heaven, is the thought of
spending eternity with most of the people who claim to be going there. "

Last edited by Skeptical Greg; 3rd August 2018 at 01:12 PM.
Skeptical Greg is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 3rd August 2018, 01:18 PM   #106
casebro
Penultimate Amazing
 
casebro's Avatar
 
Join Date: Jun 2005
Posts: 15,990
Originally Posted by Skeptical Greg View Post

The best calculator would include her own judgement which she seems to be reluctant to use..
And you wonder why I champion Genetics. It'll be the only consideration towards individualized medicine. Or I guess the "new speak" name is "Precision Medicine".
__________________
Great minds discuss ideas.
Medium minds discuss events.
Small minds spend all their time on U-Tube and Facebook.
casebro is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 16th September 2018, 06:51 AM   #107
casebro
Penultimate Amazing
 
casebro's Avatar
 
Join Date: Jun 2005
Posts: 15,990
Quote:
http://citeseerx.ist.psu.edu/viewdoc...=rep1&type=pdf

RESEARCH DESIGN AND METHODS
— A total of 4,483 subjects aged 35–70 years
participating in a large family study of type 2 diabetes in Finland and Sweden (the Botnia study)
were included in the analysis of cardiovascular risk associated with the metabolic syndrome.
In subjects who had type 2 diabetes (n
1,697), impaired fasting glucose (IFG)/impaired
glucose
tolerance (IGT) (n 798), or insulin-resistance with normal glucose tolerance (NGT)
(n 1,988),
Looks like 'Insulin Resistance without Diabetes' is more common than T2D. And has a Relative risk of heart troubles of 1.7 the "normals", or 80% as bad as diabetes. (table 4)

It's the IR that kills us.
__________________
Great minds discuss ideas.
Medium minds discuss events.
Small minds spend all their time on U-Tube and Facebook.

Last edited by casebro; 16th September 2018 at 07:02 AM.
casebro is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 16th September 2018, 07:08 AM   #108
casebro
Penultimate Amazing
 
casebro's Avatar
 
Join Date: Jun 2005
Posts: 15,990
Nuther one:

Quote:
http://care.diabetesjournals.org/content/33/6/1179

CONCLUSIONS HOMA-IR is associated with all-cause mortality in the nondiabetic U.S. population but only among persons with normal BMI.
IR is genetic, NOT caused by obesity. Quite the reverse.
__________________
Great minds discuss ideas.
Medium minds discuss events.
Small minds spend all their time on U-Tube and Facebook.
casebro is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 23rd September 2018, 02:07 PM   #109
casebro
Penultimate Amazing
 
casebro's Avatar
 
Join Date: Jun 2005
Posts: 15,990
Originally Posted by casebro View Post
Nuther one:

IR is genetic, NOT caused by obesity. Quite the reverse.
From that paper " Using a mathematical simulation model, Eddy et al. (9) recently estimated that insulin resistance was responsible for 42% of myocardial infarctions in the U.S. and was the most important single cause of coronary artery disease."
__________________
Great minds discuss ideas.
Medium minds discuss events.
Small minds spend all their time on U-Tube and Facebook.
casebro is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 28th November 2018, 05:55 PM   #110
casebro
Penultimate Amazing
 
casebro's Avatar
 
Join Date: Jun 2005
Posts: 15,990
Originally Posted by casebro View Post
I suspect that the data exists to tell which DNA variant is helped by Statins. Which will explain how Statins actually work. But don't expect Big Pharma to tell us that 60% of us shouldn't by their chemical.

Inflammation is a good candidate, via IRS-1 or another hormone receptor gene. Seems a known fact that statins lower insulin resistance, also raise IGF-1 levels. That, wah-lah, might be the answer.
Originally Posted by casebro View Post
But the critical thing about Statins is that their advantage cones about via growth facotr, not LDL changes. As shown by other drugs that lower LDL and do not benefit hearts.
Originally Posted by casebro View Post
From that paper " Using a mathematical simulation model, Eddy et al. (9) recently estimated that insulin resistance was responsible for 42% of myocardial infarctions in the U.S. and was the most important single cause of coronary artery disease."
Building on my previous reading, I see that the IRS-1 gene (insulin resistance gene) also directly causes hypertension by interfering with a PPAR enzyme in the PI3 system. And guess what- Statins are PPAR ummm ligands or substrates or inhibitors, whatever... So it looks like the actual benefits of Statins are probably NOT from lowering cholesterol, but from boosting endogenous output of NOx in the endothelial cell lining the arteires, which relaxes arteries and lowers blood pressure.

Google points to papers looking into it circa 2004-2013, and a Cochrane review, but I couldn't find the Cochrane report.

eta: here's one https://www.ncbi.nlm.nih.gov/pubmed/20129921 " Does peroxisome proliferator-activated receptor-gamma (PPAR gamma) protect from hypertension directly through effects in the vasculature? "
__________________
Great minds discuss ideas.
Medium minds discuss events.
Small minds spend all their time on U-Tube and Facebook.

Last edited by casebro; 28th November 2018 at 06:38 PM.
casebro is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 28th November 2018, 06:50 PM   #111
casebro
Penultimate Amazing
 
casebro's Avatar
 
Join Date: Jun 2005
Posts: 15,990
A little closer to the OP subject:

And another data-bit today, sorry no link, was a Cochrane review looking at the efficacy of Statins: For every 1,000 people treated for 5 years, 18 heart attacks are postponed. They used the word "prevented" but I think it really means 'postponed beyond the five year mark'.

Ok. done with my flurry for today.
__________________
Great minds discuss ideas.
Medium minds discuss events.
Small minds spend all their time on U-Tube and Facebook.
casebro is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 29th November 2018, 04:58 PM   #112
Skeptical Greg
Agave Wine Connoisseur
 
Skeptical Greg's Avatar
 
Join Date: Jul 2002
Location: Just past ' Resume Speed ' .
Posts: 15,279
WTF? That could mean 982 people out of a thousand had heart attacks!

Do you have a link to the study?
__________________
" The main problem I have with the idea of heaven, is the thought of
spending eternity with most of the people who claim to be going there. "
Skeptical Greg is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Reply

International Skeptics Forum » General Topics » Science, Mathematics, Medicine, and Technology

Bookmarks

Thread Tools

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Forum Jump


All times are GMT -7. The time now is 10:36 PM.
Powered by vBulletin. Copyright ©2000 - 2018, Jelsoft Enterprises Ltd.

This forum began as part of the James Randi Education Foundation (JREF). However, the forum now exists as
an independent entity with no affiliation with or endorsement by the JREF, including the section in reference to "JREF" topics.

Disclaimer: Messages posted in the Forum are solely the opinion of their authors.