Lipoprotein Assessment in the twenty-first Century

Lucero, Diego; Wolska, Anna; Aligabi, Zahra; Turecamo, Sarah; Remaley, Alan T.

doi:10.1016/j.ecl.2022.02.009

Cited by 6 publications

(3 citation statements)

References 86 publications

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“…ApoB100 comprises 4563 amino acids and is synthesized in the liver [23]. After lipidation via the microsomal triglyceride transfer protein (MTP), apoB100 is secreted as the main structural protein on VLDL [20,24]. It also contains a positively charged ligand-binding domain for the uptake of LDL through the LDLR [23].…”

Section: Apob Biochemistry and Lipoprotein Metabolismmentioning

confidence: 99%

“…During VLDL metabolism, remnant particles become enriched in cholesteryl esters, which are transferred to them from HDL particles via CETP [20,24,31]. VLDL is converted to IDL and much of this is subsequently converted to LDL, which contains approximately six to seven times more cholesterol than TG [20,26].…”

Section: Apob Biochemistry and Lipoprotein Metabolismmentioning

confidence: 99%

“…Oxidized apoB increases the uptake of LDL by macrophages and other cells to induce foam cell formation [35], and some of the lipid modification products promote inflammation [33,34]. Together, these processes eventually lead to atherosclerosis [20,24,31]. Given that it roughly estimates the concentration of LDL particles in circulation, LDL-C is associated with ASCVD events [36].…”

Section: Apob Biochemistry and Lipoprotein Metabolismmentioning

confidence: 99%

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Use of Apolipoprotein B in the Era of Precision Medicine: Time for a Paradigm Change?

Cole,

Zubirán,

Wolska

et al. 2023

JCM

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Atherosclerotic cardiovascular disease (ASCVD) remains the leading cause of death worldwide and the risk of a major cardiovascular event is highest among those with established disease. Ongoing management of these patients relies on the accurate assessment of their response to any prescribed therapy, and their residual risk, in order to optimize treatment. Recent international guidelines and position statements concur that the plasma concentration of apolipoprotein B (apoB) is the most accurate measure of lipoprotein associated ASCVD risk. This is especially true for the growing number of individuals with diabetes, obesity, or the metabolic syndrome, and those on statin therapy. Most guidelines, however, continue to promote LDL-C as the primary risk marker due to uncertainty as to whether the greater accuracy of apoB is sufficient to warrant a paradigm shift. Recommendations regarding apoB measurement vary, and the information provided on how to interpret apoB results is sometimes insufficient, particularly for non-lipid specialists. Misinformation regarding the reliability of the assays is also frequently repeated despite its equivalent or better standardization than many other diagnostic assays. Thus, demand for apoB testing is relatively low, which means there is little incentive to increase its availability or reduce its cost. In this review, we examine the results of recent clinical outcomes studies and meta-analyses on the relative values of apoB, LDL-C, and non-HDL-C as markers of ASCVD risk. Although there is seemingly minimal difference among these markers when only population-based metrics are considered, it is evident from our analysis that, from a personalized or precision medicine standpoint, many individuals would benefit, at a negligible total cost, if apoB measurement were better integrated into the diagnosis and treatment of ASCVD.

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Section: Apob Biochemistry and Lipoprotein Metabolismmentioning

confidence: 99%