Non HDL cholesterol and apolipoprotein B – emerging risk factors

Non HDL cholesterol and apolipoprotein B – emerging risk factors

Non HDL cholesterol and apolipoprotein B – emerging risk factors: Standard cardiovascular risk predictor is the level of low density lipoprotein cholesterol (LDL-C). Two of the foremost emerging lipid risk markers are apolipoprotein B (apoB) and non–high-density lipoprotein cholesterol (non–HDL-C). Studies have shown that they perform better than LDL cholesterol in cardiovascular risk prediction both on and off treatment as well in the prediction of risk of sub clinical cardiovascular disease. The advantages cited include accuracy independent of triglyceride levels and prandial state of the person when the estimation is done.

Vimal Ramjee, Laurence S Sperling and Terry A Jacobson in their state of the art paper published in the Journal of American College of Cardiology [1] has finally concluded that non HDL cholesterol is the marker of better choice at present as it has established cut off points with safe and achievable goals. Specifically no additional cost is involved in estimation, only a quick mathematical calculation after a standard lipid profile estimation.

Christopher S Boot, Elizabeth Middling, Joy Allen and Robert D G Neely evaluated non-HDL cholesterol (NHDLC) to apolipoprotein B (apoB) ratio as a screening test for dysbetalipoproteinemia [2]. They concluded that NHDLC/apoB ratio can be used as a screening test for dysbetalipoproteinemia.

References

1. Vimal Ramjee, Laurence S Sperling, Terry A Jacobson. Non-high-density lipoprotein cholesterol versus apolipoprotein B in cardiovascular risk stratification: do the math. J Am Coll Cardiol. 2011 Jul 26;58(5):457-63.
2. Christopher S Boot, Elizabeth Middling, Joy Allen, Robert D G Neely. Evaluation of the Non-HDL Cholesterol to Apolipoprotein B Ratio as a Screening Test for Dysbetalipoproteinemia. Clin Chem. 2019 Feb;65(2):313-320.