Does measurement of apolipoprotein B have a place in cholesterol management?

Vega, Gloria Lena; Grundy, Scott M.

doi:10.1161/01.atv.10.5.668

Cited by 61 publications

(21 citation statements)

References 24 publications

(6 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, our results suggest that non-HDL cholesterol may predict CHD risk only among women with elevated triglyceride levels. In most persons with triglyceride levels below 2.26 mmol/l, VLDL cholesterol is not substantially elevated [19] and non-HDL cholesterol correlates highly with LDL cholesterol [20,21]. Therefore, at lower triglyceride levels, non-HDL cholesterol would be expected to provide little additional power to predict CHD.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, at lower triglyceride levels, non-HDL cholesterol would be expected to provide little additional power to predict CHD. When triglyceride levels are 2.26 mmol/l or higher, VLDL cholesterol levels are distinctly raised [19] and LDL cholesterol concentrations are less well correlated with non-HDL cholesterol levels [20,21]. In the presence of high serum triglycerides, non-HDL cholesterol, therefore, will better represent the concentrations of all atherogenic lipoproteins than will LDL cholesterol alone [1].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Joint role of non-HDL cholesterol and glycated haemoglobin in predicting future coronary heart disease events among women with type 2 diabetes

et al. 2004

View full text Add to dashboard Cite

Aims/hypothesis. Non-HDL cholesterol (the sum of LDL, VLDL and IDL cholesterol) is considered to be particularly valuable in the management of dyslipidaemia in type 2 diabetes. However, it remains uncertain whether the association between non-HDL cholesterol and cardiovascular risk in type 2 diabetes depends on the status of hyperglycaemia. We aimed to determine whether non-HDL cholesterol predicts CHD events among diabetic women independently of currently established risk factors and the status of glycaemic control. Methods. We prospectively followed 921 diabetic women in the Nurses' Health Study, who were free of cardiovascular disease at the time that blood was drawn in 1989/90. During 10 years of follow-up, we identified 122 incident CHD cases. Results. After adjustment for age, BMI, smoking, alcohol consumption, and other lifestyle risk factors, the multivariate relative risks (RRs) of CHD for extreme quartiles were 1.97 (95% CI: 1.14-3.43) for non-HDL cholesterol, 1.78 (1.02-3.11) for apolipoprotein B-100, and 1.93 (1.15-3.22) for LDL cholesterol. However, the association between non-HDL cholesterol and CHD risk was only apparent among women with elevated fasting triglycerides (RR for extreme quartiles: 3.80; p=0.045). HbA 1 c was strongly associated with increased CHD risk (RR for increase by 1 unit: 1.24; 95% CI: 1.13-1.35), and both non-HDL cholesterol and HbA 1 c additively predicted CHD risk (RR for the combination of high non-HDL cholesterol and high HbA 1 c [tertiles]: 4.59). Conclusions/interpretation. Our study suggests that non-HDL cholesterol and HbA 1 c are potent predictors of CHD risk in diabetic women. Therapies to lower CHD risk in diabetic patients should emphasise both glycaemic control and lipid lowering.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Joint role of non-HDL cholesterol and glycated haemoglobin in predicting future coronary heart disease events among women with type 2 diabetes

et al. 2004

View full text Add to dashboard Cite

show abstract

“…15 Total apo B levels correlate relatively strongly with non-HDL cholesterol levels. 16,17 The correlation is particularly strong in the absence of elevated serum triglycerides, but weakens somewhat as triglyceride levels rise. 16,17 Still, non-HDL cholesterol includes all of the cholesterol in apo B-containing lipoproteins.…”

Section: Atherogenicity Of Different Lipoprotein Speciesmentioning

confidence: 99%

“…16,17 The correlation is particularly strong in the absence of elevated serum triglycerides, but weakens somewhat as triglyceride levels rise. 16,17 Still, non-HDL cholesterol includes all of the cholesterol in apo B-containing lipoproteins. Because there is one apo B molecule per lipoprotein particle, total apo B concentrations are a measure of total particle number in LDLϩTGRLP, whereas non-HDL cholesterol provides the cholesterol content of these same lipoproteins.…”

Section: Atherogenicity Of Different Lipoprotein Speciesmentioning

confidence: 99%

Low-Density Lipoprotein, Non-High-Density Lipoprotein, and Apolipoprotein B as Targets of Lipid-Lowering Therapy

2002

View full text Add to dashboard Cite

A lthough low-density lipoprotein (LDL) is widely recognized as the major atherogenic lipoprotein and the primary target of lipid-lowering therapy, 1 other lipoprotein species nonetheless appear to be involved in atherogenesis. These include very low-density lipoproteins (VLDL), intermediate-density lipoproteins (IDL), and highdensity lipoproteins (HDL). Both VLDL and IDL are triglyceride-rich lipoproteins (TGRLP). Thus, in the aftermath of unequivocal evidence that LDL lowering reduces risk for major coronary events and stroke, 2 the field of lipid study is turning more of its attention to the other lipoproteins that appear to be involved in atherosclerosis. The recent Adult Treatment Panel III (ATP III) report 1 of the National Cholesterol Education Program has summarized our current understanding of the relationship between other lipoprotein species and risk for coronary heart disease (CHD). See p 2537ATP III 1 placed more emphasis on TGRLP and HDL as secondary targets of lipid-modifying therapy than did previous ATP reports. 3 There is an emerging consensus that among TGRLP, cholesterol-rich remnant lipoproteins carry atherogenic potential. This view led ATP III to designate LDLϩIDLϩVLDL cholesterol (called non-HDL cholesterol) as "atherogenic cholesterol" and to identify it as a secondary target of therapy, after LDL cholesterol. In the ATP III report, however, non-HDL cholesterol as a secondary target is limited to persons who have elevated serum triglyceride levels (Ն200 mg/dL). In the majority of people who have lower triglyceride levels, LDL cholesterol contains the bulk of "atherogenic cholesterol" and thus is a sufficient target alone.The designation of elevated non-HDL cholesterol as a treatment target depended strongly on increasing data showing that high levels of cholesterol-rich TGRLP raise risk for CHD. Several reviews summarize the evidence for atherogenicity of triglyceride-rich remnants. 4 -6 On the other hand, only a limited number of studies 7,8 have examined the strength of association between non-HDL cholesterol and risk for CHD. The current report of Bittner et al 9 contributes to a growing body of information on the predictive power for major coronary events of non-HDL cholesterol. In the discussion to follow, the current status of non-HDL cholesterol as predictor of major coronary events and as a target of lipid-lowering therapy will be examined. Predictive Power of LipoproteinsEpidemiological studies reveal a strong independent relation between serum cholesterol levels and risk for CHD. 10 Since LDL is the major cholesterol-carrying lipoprotein of serum, it too is widely accepted as an independent risk factor. 1 Prospective surveys 11 further document that reduced serum levels of HDL cholesterol independently predict CHD incidence. The case for high serum triglycerides as a marker for TGRLP has been less robust. 11 Since HDL cholesterol and triglycerides are inversely correlated, when HDL is entered into multivariate predictive models, triglycerides are generally found to be weak pr...

show abstract

“…The usefulness of non-HDL cholesterol rather than low-density lipoprotein cholesterol as a tool for lipoprotein cholesterol screening and assessment of risk and therapy has been already recognized in the USA 17,18) . Another candidate marker for both remnant and LDL cholesterol is plasma apoB level 19) . ApoB is a direct marker for the particle number of apoB-containing lipoproteins and reflects risks of both remnants and LDL.…”

Section: Predictive Power Of Non-hdl Cholesterolmentioning

confidence: 99%

Proposed Guidelines for Hypertriglyceridemia in Japan with Non-HDL Cholesterol as the Second Target

Shimano

Arai

Harada‐Shiba

et al. 2008

JAT

View full text Add to dashboard Cite

The Japan Atherosclerosis Society (JAS) guidelines for the prevention of atherosclerotic diseases, proposing management for LDL cholesterol as the primary target, have successfully contributed to the prevention of cardiovascular events; however, recently, the impact of hypertriglyceridemia as an additional cardiovascular risk has become understood, especially in light of the rise in obesity, metabolic syndrome, and diabetes in the Japanese population. Rather than waiting to obtain conclusive domestic data confirming that hypertriglyceridemia is a cardiovascular risk factor and that its management is efficacious, we propose guidelines for hypertriglyceridemia using non-HDL cholesterol as a second target.

show abstract

Does measurement of apolipoprotein B have a place in cholesterol management?

Cited by 61 publications

References 24 publications

Joint role of non-HDL cholesterol and glycated haemoglobin in predicting future coronary heart disease events among women with type 2 diabetes

Joint role of non-HDL cholesterol and glycated haemoglobin in predicting future coronary heart disease events among women with type 2 diabetes

Low-Density Lipoprotein, Non-High-Density Lipoprotein, and Apolipoprotein B as Targets of Lipid-Lowering Therapy

Proposed Guidelines for Hypertriglyceridemia in Japan with Non-HDL Cholesterol as the Second Target

Contact Info

Product

Resources

About