Statements from the American College of Cardiology and the American Diabetes Association indicate that in addition to LDL cholesterol ["bad" cholesterol], ApoB levels should be measured to assess cardiovascular risk in some patients. ApoB is a protein associated with LDL particles that helps to more accurately describe disease risk, especially in patients with similar or slightly elevated blood lipid levels.

People have long known that there is a population, although their LDL cholesterol is normal or slightly elevated, but the risk of heart disease, stroke and so on. Elevated cholesterol is sure to increase the risk of cardiovascular disease, but about marginal or moderate elevations in heart and vascular disease?

Generally, LDL cholesterol is not actually measured when a standard lipid plate is administered. It is calculated by using the formula for the measurement of total cholesterol, HDL cholesterol ["good" cholesterol] and triglycerides. Therefore, the calculation only estimates the cholesterol content in the LDL score.

Cholesterol is not free in the blood; it is contained in the granules. The LDL particles in the blood are not exactly the same size or density. They have a range of sizes, the smallest being the most dense and the largest being the least dense. An analogy is the comparison of lead pellets with styrofoam-packed peanuts. The shot is smaller but heavier; the polystyrene foam is larger and has a lower density.

The standard calculation of LDL cholesterol levels does not give an indication of the amount of LDL particles. If there are many small, dense particles, LDL cholesterol measurements may not be very high, even with many particles.

The densest smallest particles are considered to be the most atherogenic [mostly causing atherosclerosis] and are most likely to cause cardiovascular disease, while the largest and "softest" particles are the least atherogenic. .

Therefore, consider lipid measurements. If there are a large number of mainly small, dense particles in the blood, the calculated LDL cholesterol may not be very high because the small particles do not have a very large amount of cholesterol. However, the risk of cardiovascular disease can be significant because there are actually a large number of small dense LDL particles.

Since each LDL particle has an ApoB [apolipoprotein B100] on its surface, the amount of ApoB can be used to estimate the amount of LDL particles. Thus, especially if the LDL cholesterol is critical or slightly elevated, the amount of ApoB can give an estimate of the number of particles, and thus the percentage of small dense particles that cause atherosclerosis can be calculated.

Therefore, ApoB measurements are particularly valuable for predicting which patients do not have very high LDL cholesterol and are at risk for cardiovascular disease. These patients can then be treated to further lower their cholesterol, change the particles to larger, denser LDL particles, and routinely monitor and early detection of the development of heart and vascular disease.

ApoB, cholesterol testing and predicting cardiovascular disease was originally published on Spring