Bear in mind I'm not a doctor, I more have something of a Hermione complex. I've read a lot about this stuff and I pass on what seems interesting to me.
Your numbers are confusing. Would I be accurate in guessing you are not American? I don't usually see lab numbers for cholesterol presented as nmol/L. I'm seeing three different numbers there for your HDL. Here in the States, we don't even look at large HDL, ha ha, at least not on the lab results that the typical patient sees. That's not mentioned in the media, etc.
Here in the States we measure by mg/dl. I see you do have mg/dl numbers for both HDL and LDL. Your mg/dl HDL number is excellent by American standards. Current wisdom says that risk of heart disease is reduced if HDL is over 60 mg/dl. Low HDL at that measurement is 40 mg/dl for men and 50 mg/dl for women.
Looking at Wikipedia, which discusses the various measurement parameters, large HDL needs to be over 7.3 μmol/L and total HDL needs to be over 34.9 μmol/L for greatest heart disease protection. I am not well-versed enough in those teeny metric units of measure to say whether that's equivalent to the units you present in your list above. You'll want to ask your doctor.
Your LDL is calculated. There is no way you have any idea what your LDL is doing unless you have them do a direct count. Your triglycerides are just low enough that they might skew the Friedenwald equation. (Google that, it's very interesting.) Your small LDL is well below the danger threshold according to your laboratory. I'm going to guess that even if a direct count matched Friedenwald, you've got big and fluffy going on there. If it were me I would not worry about it.
There is a lot of debate about who exactly benefits from statin therapy. The general gist seems to be that if you're a guy and have already had a heart attack, you would probably benefit--but the benefit arises from reducing systemic inflammation. And the benefit translates to about one subsequent heart attack prevented out of 50 men. So you put yourself at risk for the side-effects--muscle pain, reduction in mental function, increased risk of metabolic syndrome and diabetes, and so on--on a gamble that you might be that one guy out of 50 who never has another heart attack.
If the one benefit from statins is a reduction in inflammation, you can take care of that on your own. Stop eating glutens if you're still eating them in that 10 percent not-Paleo thing you do. Cut your sugar intake--if you're going to cheat anyway, cheat with sugar-free treats. (Ignore anybody here who says you're killing yourself. When they find a hard link between non-aspartame artificial sweeteners and chronic disease, and that risk is greater than from the consumption of sugar, then maybe they'll have a case.) And watch your fatty acid intake. I'm afraid Cordain missed the boat on this one: you want more saturated fat than nonsaturated in your diet. And of the nonsaturated fatty acids you eat, you want to aim for as close to a 1:1 omega-3 to omega-6 ratio as possible. As you don't have time to sit around measuring, try these tricks:
- Choose wild-caught fish over farmed when you eat fish.
- Cut down on chicken intake. It's massively high in PUFAs. On days you eat it, consider supplementing with fish oil high in omega-3s. Some people just take cod liver oil every day (Green Pasture fermented is best, I get it in capsules) because that's omega-3s and vitamin A and D supplementation all in one fell swoop. Krill oil is supposedly good too.
- Get grass-finished beef if you can. The PUFA ratios are much, much better.
Your triglyceride level is actually better than much of the population. It may not be what the typical 100 compliant Paleo person gets but it's better than 300 or more, which is what a lot of people out there have.
Your CRP's normal. Your A1C is almost there. If you cut your sugar intake and eat more veggies than fruits and up your sat-fat intake you might tackle that one without drug intervention. You might consider buying a glucose meter and testing yourself one hour after you finish a meal to see if any foods you eat get you up over 140 mg/dl (or the equivalent where you live). That's the danger zone. If any food puts you up over that upper limit, drop it.
I would say you are on the right track even if you're not all the way there yet. Way to go.