The contribution of ApoB and ApoA1 measurements to cardiovascular risk assessment

Abstract

LDL has been widely recognized as the major atherogenic lipoprotein and designated as the primary target for prevention of coronary heart disease (CHD); however, there is growing evidence that other triglyceride-rich lipoproteins, such as very low-density lipoprotein (VLDL) and intermediate density lipoprotein (IDL) carry atherogenic potential as well. This led to the designation of non-HDL cholesterol (HDL-C) (LDL + IDL + VLDL) as a secondary target of treatment for hyperlipidaemia. As each one of LDL, IDL and VLDL particles carries only one apolipoprotein B-100 (ApoB-100) molecule, the total ApoB value represents the total number of potentially atherogenic lipoproteins, whereas non-HDL-C provides the cholesterol content of these same lipoproteins. Recent data from epidemiological, observational and interventional studies suggest that non-HDL-C, apolipoproteins ApoA1 and ApoB may improve CHD risk assessment by identifying more high-risk individuals than the usual lipid profile alone. However, the targets for the optimal treatment of dyslipidaemia remain a subject of considerable debate. Further studies are needed to determine whether ApoB and ApoA1 are superior to conventional lipid parameters as predictors of cardiovascular disease or therapeutic targets of hyperlipidaemias. In this review, we summarize the current opinions on the use of ApoA1 and ApoB values as estimates of cardiovascular risk or as treatment goals in patients undergoing treatment for hyperlipidaemia.

The effects of atorvastatin on antioxidant/antiinflammatory propertiesof HDLs in hypercholesterolemics

“…In our study, LDL-C and Apo B levels were significantly decreased, as indicated in the Atorvastatin Comparative Cholesterol Efficacy and Safety Study after 3 months of statin therapy (20). HDL-C and Apo A1 levels did not change because statins have fewer effects on Apo A1 in patients with hypercholesterolemia (20). In some studies it was shown that statin treatment increased Lp(a) levels (21,22), but in some studies controversial effects were reported, as in ours (23,24).…”

“…In our study, LDL-C and Apo B levels were significantly decreased, as indicated in the Atorvastatin Comparative Cholesterol Efficacy and Safety Study after 3 months of statin therapy (20). HDL-C and Apo A1 levels did not change because statins have fewer effects on Apo A1 in patients with hypercholesterolemia (20).…”

Genetic Dominance Influences Blood Biomarker Levels in a Sample of 12,000 Swedish Elderly Twins

“…ApoB-containing particles in excess can lead to atherogenecity since apoB is the molecule mainly responsible for the oxidization of LDL, a key step in the atherogenic process. ApoA-I is crucial for the reverse cholesterol transport, since it enables esterification of cholesterol and promotes the externalization of excess cholesterol in peripheral cells to HDL (Andrikoula & McDowell, 2008;Walldius & Jungner, 2004).…”

Evaluation of the Apo Lipoprot E in - A1 Levels in Type Ii Diabetes Mellitus, With and Without Cad

“…Increased triglyceride concentration was associated with a reduced HDL/apo A-1 ratio suggesting that a relatively modest increase in triglycerides may rapidly alter the relative cholesterol content of HDL and thereby apo A-. 22,23 Mutation in apolipoprotein A-1 with a single amino acid replacement may form dimeric complexes and this may restrict HDL size and cause HDL deficiency. 24 In the present study, higher values for HbA1c are obtained in case of poor metabolic control and persistent hypoglycemia and this might have contributed to complications such as CAD in diabetic cases.…”