Apolipoprotein B test may be more accurate measure of heart disease risk

The traditional lipid panel may not give the full picture of cholesterol-related heart disease risk for many Americans, according to a study led by UT Southwestern Medical Center researchers and published in . There are different types of cholesterol particles that can cause heart disease, including low-density lipoproteins (LDL), very low-density lipoproteins (VLDL), and intermediate-density lipoproteins (IDL). LDL-C is a measure of the weight of cholesterol in LDL particles and is one of the most common tests people use to measure cholesterol risk.

Every LDL, VLDL, and IDL particle has a single protein on its surface called apolipoprotein B (apoB). Prior research has shown that the number of "bad" cholesterol particles, measured by a for apoB, is the most accurate marker for cholesterol risk. However, current guidelines do not recommend testing for apoB in all people.

Instead, most only have their LDL-C measured, but that does not test for the total number of LDL particles. Measuring LDL-C alone may not be adequate to find people with high apoB levels, UTSW researchers and colleagues said. "For most patients, the LDL-C measurement is usually 'good enough' because people with high LDL-C also usually have high apoB and vice versa, but that's not true for everyone," said senior author Ann Marie Navar, M.

D., Ph.D.

, Associate Professor of Internal Medicine in the Division of Cardiology and in the Peter O'Donnell Jr. School of Public Health at UT Southwestern. "Some people have h.