There’s a backstory to that. One of the authors (Nicholas G Norwitz) IS the patient being described.
I think only Dave Feldman’s LMHR (lean mass hyper-responder) study will answer or help answer these questions: people with super high LDL but very high HDL (>80) and very low trigs (below 80?), and who are lean and athletic and on low carb.
Or maybe as simple as “lipids are a misleading metric for everyone”?