What are ideal reference ranges and how is it managed?
Apolipoprotein B (Apo B) is considered atherogenic and should be incorporated into a comprehensive cardiometabolic assessment.
Apolipoproteins are the protein portions of lipoproteins. They participate in the transport of lipids in the blood and lymph systems, the transport of fats into the cell, and the synthesis of lipoproteins. Apo B, found in LDL, VLDL, and chylomicrons, makes cholesterol more soluble and more easily incorporated into the artery wall. Genetic mutations in the Apo B gene lead to hypercholesterolemia. Diets high in saturated fat and cholesterol can also increase Apo B and increase risk of atherosclerosis. Elevated levels are also seen with diabetes, hypothyroidism, and other chronic conditions (Pagana 2021).
Apo B appears to be a better marker of atherosclerosis risk than just measuring LDL-cholesterol or non-HDL cholesterol (Sniderman 2019). Apo B testing is currently incorporated into lipoprotein subfractionation testing which goes beyond just measuring cholesterol levels in the blood.
Ideally Apo B levels should be maintained below 90 mg/dL (0.9 g/L) though it would be prudent to investigate lifestyle and genetic factors further if levels increase above 80 mg/dL (0.8 g/L).
Keep an eye out for our upcoming blog for more on Apo B.
References
Pagana, Kathleen Deska, et al. Mosby's Diagnostic and Laboratory Test Reference. 15th ed., Mosby, 2021.
Sniderman, Allan D et al. “Apolipoprotein B Particles and Cardiovascular Disease: A Narrative Review.” JAMA cardiology vol. 4,12 (2019): 1287-1295. doi:10.1001/jamacardio.2019.3780