Is Apolipoprotein B and Small, Dense low density lipoprotein a better marker of cardiovascular risk?
DOI:
https://doi.org/10.7439/ijbr.v6i10.2638Keywords:
Ultrasound, High Frequency Transducer, Hyperechoic, HypoechoicAbstract
The association between low density lipoprotein cholesterol and cardiovascular risk is well established. However, the measurement of the cholesterol content of this lipoprotein incompletely accounts for the risk of cardiovascular disease. As part of its limitations, LDL cholesterol concentration does not precisely count the number of LDL particles, but Apo B does. The levels of Apolipoprotein B and small dense low density lipoprotein have been shown to be associated with risk of cardiovascular disease.. There is one Apo B per LDL particle, hence, LDL-Apo B accurately defines LDL particle number. Also, the ratio of cholesterol to Apo B differs from person to person, thereby explaining why LDL-cholesterol level does not necessarily indicate LDL particle number. Furthermore, Apo B reflects the concentration of potentially atherogenic particles i.e. the total Apo B level is a measure of the total number of lipoprotein particles in LDL, IDL and VLDL (non-HDL cholesterol). This implies that if most Apo B-containing lipoproteins in each fraction are atherogenic, the total concentration of Apo B will indicate cardiovascular risk better than LDL cholesterol level does. A predominance of small, dense, low-density lipoprotein cholesterol particles has been associated with a 3-fold or even greater risk of coronary heart disease in a collection of cross-sectional studies. Recent prospective evidence describes small, dense, low-density lipoprotein cholesterol as predictive of coronary heart disease as most of the traditional risk factors like smoking and elevated blood pressure. Cardiovascular risk is more directly related to the number and sizes of circulating atherogenic particles than to the concentration of cholesterol in these particles, therefore, adopting the traditional lipid profile (Triglyceride, HDL, LDL, total cholesterol etc.) will result in an underestimation of the true atherogenic burden as well as serve as a poor assessment of cardiovascular risk in individuals.
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