As far as I can tell (only from the abstract though) this study
is simply saying that the ratio of LDL/HDL didn't show much
difference than a simple TC/HDL measurement in terms of
predicting a coronary event. Keep in mind this is a cohort study
meaning that it is observational and not a randomized controlled
trial. This leaves it vulnerable to bias and uncontrolled
variables. You can only really detect correlation rather than
causation. For example, you find ice-cream sales are associated
with increases in outdoor temperature. During periods of
increased outdoor temperature there has also been found to be an
increase in drownings. From this observation, you could
hypothesize that increases in ice cream sales are associated
with increases in drownings. In this paper higher TC/HDL and
HDL/LDL ratios are both associated with increased risk of a
coronary event. It doesn't say that LDL particle does not. Check
these studies out and give them to your doc: This is a study out
of Berkeley talking about how pattern B