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Biomarkers

ApoB

Apolipoprotein B (ApoB) is the structural protein of atherogenic lipoproteins, including LDL, VLDL, IDL, and Lp(a). Because ApoB-100 is typically present as approximately one molecule per atherogenic particle, plasma ApoB serves as a clinical proxy for atherogenic particle number. Multivariable Mendelian randomization (e.g., Richardson et al.) prioritizes ApoB and particle burden as the causal lipid driver of coronary artery disease, making ApoB a more accurate predictor of cardiovascular events and mortality than LDL cholesterol alone. Lower ApoB is associated with reduced atherosclerotic disease. Per the NLA Expert Clinical Consensus on apoB, typical targets are <90 mg/dL for borderline-to-intermediate risk, <80 mg/dL for high risk, and <60 mg/dL for very high risk.

Sources

  1. Sniderman AD, Thanassoulis G, Glavinovic T, Navar AM, Pencina M, Catapano A, Ference BA. (2019). Apolipoprotein B particles and cardiovascular disease: a narrative review. *JAMA Cardiology*doi:10.1001/jamacardio.2019.3780
  2. Richardson TG, Sanderson E, Palmer TM, Ala-Korpela M, Ference BA, Davey Smith G, Holmes MV. (2020). Evaluating the relationship between circulating lipoprotein lipids and apolipoproteins with risk of coronary heart disease: A multivariable Mendelian randomisation analysis. *PLOS Medicine*doi:10.1371/journal.pmed.1003062