Low-density lipoprotein cholesterol/apolipoprotein B ratio is superior to apolipoprotein B alone in the diagnosis of coronary artery calcification

Chang, Tsui-Yen; Chen, Jong-Dar

doi:10.1097/mca.0000000000001004

Cited by 7 publications

(4 citation statements)

References 22 publications

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“…The wide acceptance of LDL-C coupled with the added expense and complication of measuring apoB has thus far prevented a major shift toward clinical application of plasma apoB at the point-of-care [ 275 , 276 ]. This may change as standardization of apoB measurement improves and as data supporting the benefits of apoB in cardiovascular health assessment accumulate [ 277 , 278 ].…”

Section: Discussionmentioning

confidence: 99%

Apolipoprotein B and Cardiovascular Disease: Biomarker and Potential Therapeutic Target

et al. 2021

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Apolipoprotein (apo) B, the critical structural protein of the atherogenic lipoproteins, has two major isoforms: apoB48 and apoB100. ApoB48 is found in chylomicrons and chylomicron remnants with one apoB48 molecule per chylomicron particle. Similarly, a single apoB100 molecule is contained per particle of very-low-density lipoprotein (VLDL), intermediate density lipoprotein, LDL and lipoprotein(a). This unique one apoB per particle ratio makes plasma apoB concentration a direct measure of the number of circulating atherogenic lipoproteins. ApoB levels indicate the atherogenic particle concentration independent of the particle cholesterol content, which is variable. While LDL, the major cholesterol-carrying serum lipoprotein, is the primary therapeutic target for management and prevention of atherosclerotic cardiovascular disease, there is strong evidence that apoB is a more accurate indicator of cardiovascular risk than either total cholesterol or LDL cholesterol. This review examines multiple aspects of apoB structure and function, with a focus on the controversy over use of apoB as a therapeutic target in clinical practice. Ongoing coronary artery disease residual risk, despite lipid-lowering treatment, has left patients and clinicians with unsatisfactory options for monitoring cardiovascular health. At the present time, the substitution of apoB for LDL-C in cardiovascular disease prevention guidelines has been deemed unjustified, but discussions continue.

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Section: Discussionmentioning

confidence: 99%

Apolipoprotein B and Cardiovascular Disease: Biomarker and Potential Therapeutic Target

et al. 2021

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“…The measurement of LAR has gained increased attention in recent years. Multiple studies [ 49 – 52 ] have indicated that LAR is associated with cardiovascular diseases and the development of cardiovascular diseases later in life. Drexel et al [ 22 ] recently reported that LAR can predict major adverse cardiovascular events in patients with preexisting atherosclerotic cardiovascular diseases.…”

Section: Discussionmentioning

confidence: 99%

The LDL-C/ApoB ratio predicts cardiovascular and all-cause mortality in the general population

Zhang

Wang

et al. 2023

Lipids Health Dis

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Background Generally, low-density lipoprotein (LDL) particle size can be inferred from the LDL cholesterol concentration to total apolipoprotein B concentration ratio (LDL-C/ApoB ratio, hereinafter called LAR), which is a good predictor of cardiovascular disease. However, the predictive ability of LAR for mortality risk in the general population is still unclear. This study aimed to explore the association between LAR and cardiovascular as well as all-cause mortality among American adults. Methods The present study was a secondary analysis of existing data from the National Health and Nutrition Examination Survey (NHANES). The final analysis included 12,440 participants from 2005 to 2014. Survival differences between groups were visualized using Kaplan‒Meier curves and the log-rank test. The association of LAR with cardiovascular and all-cause mortality was evaluated using multivariate Cox regression and restricted cubic spline analysis. Age, sex, coronary artery disease, diabetes, lipid-lowering medication use and hypertriglyceridemia were analyzed in subgroup analyses. Results The median age in the study cohort was 46.0 years [interquartile range (IQR): 31.0–62.0], and 6,034 (48.5%) participants were male. During the follow-up period, there were 872 (7.0%) all-cause deaths and 150 (1.2%) cardiovascular deaths. Compared with individuals without cardiovascular events, those who experienced cardiovascular deaths had a lower LAR (1.13 vs. 1.25) (P < 0.001). The adjusted Cox regression model indicated that lower LAR was an independent risk factor for both cardiovascular [hazard ratio (HR) = 0.304, 95% confidence interval (CI): 0.114–0.812] and all-cause mortality (HR = 0.408, 95% CI: 0.270–0.617). Moreover, a significant age interaction was observed (P for interaction < 0.05), and there was a strong association between LAR and mortality among participants over 65 years of age. Further analysis showed an inverse association between LAR and both cardiovascular and all-cause mortality. Conclusions LAR can independently predict cardiovascular and all-cause mortality in the general population.

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“…Several other lipid-related parameters, including non-HDL-C ( 42 ), AC ( 12 ), LDL-C/HDL-C ( 43 ), LDL-C/ApoB ratio ( 44 , 45 ), and HDL-C/ApoA1 ratio ( 46 , 47 ), have also been reported to be associated with CVD risk. However, the results of the current study did not show an independent correlation between BMI and these indicators.…”

Section: Discussionmentioning

confidence: 99%

Correlation of cardiovascular risk predictors with overweight and obesity in patients with familial hypercholesterolemia

Wang

2022

Front. Cardiovasc. Med.

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PurposeWe aimed to analyze the correlation between overweight and obesity-related indicators and cardiovascular risk predictors in patients with familial hypercholesterolemia (FH) and to evaluate their mutual predictive properties.MethodsA total of 103 patients with FH included from 2004 to 2017 were retrospectively analyzed. Pearson correlation analysis and multiple linear regression analysis were used to assess the correlation between overweight and obesity-related indicators and cardiovascular risk predictors in FH patients. Subject operating characteristic (ROC) curve was used to analyze their reciprocal predictive performance.Results(1) Atherogenic index of plasma (AIP) (β = 0.020) and ApoB/ApoA1 Ratio (BAR) (β = 0.015) were independently correlated with body mass index (BMI) (P < 0.05); AIP (β = 1.176) was independently correlated with waist-to-hip ratio (WHR) (P < 0.01); AIP (β = 1.575), BAR (β = 0.661) and atherogenic coefficient (AC) (β = 0.427) were independently correlated with waist-to-height ratio (WHtR) (P < 0.05). (2) The area under the ROC (AUC) for overweight corresponding to AIP, BAR, and AC were 0.695 (95% CI = 0.593–0.797, P < 0.01), 0.660 (95% CI = 0.555–0.766, P < 0.01), and 0.632 (95% CI = 0.525–0.740, P < 0.05), respectively; and AUCs for central obesity corresponding to AIP, BAR and AC were 0.757 (95% CI = 0.656–0.857, P < 0.001), 0.654 (95% CI = 0.536–0.771, P < 0.05) and 0.651 (95% CI = 0.538–0.764, P < 0.05), respectively. The AUCs for moderate risk of AIP corresponding to BMI, WHR, and WHtR were 0.709 (95% CI = 0.608–0.811, P < 0.001), 0.773 (95% CI = 0.678–0.867, P < 0.001), 0.739 (95% CI = 0.641–0.836, P < 0.001), respectively, and BMI, WHR and WHtR corresponded to an AUC of 0.691 (95% CI = 0.585–0.797, P < 0.01), 0.734 (95% CI = 0.632–0.835, P < 0.001), and 0.706 (95% CI = 0.603–0.810, P < 0.01) for high risk of AIP, respectively.ConclusionAIP has independent positive linear correlation with indicators related to overweight and obesity in FH patients; AIP has good predictive performance for overweight and obesity in FH patients, and WHR has good performance for identifying moderate and high risk of AIP in FH patients.

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Low-density lipoprotein cholesterol/apolipoprotein B ratio is superior to apolipoprotein B alone in the diagnosis of coronary artery calcification

Cited by 7 publications

References 22 publications

Apolipoprotein B and Cardiovascular Disease: Biomarker and Potential Therapeutic Target

Apolipoprotein B and Cardiovascular Disease: Biomarker and Potential Therapeutic Target

The LDL-C/ApoB ratio predicts cardiovascular and all-cause mortality in the general population

Correlation of cardiovascular risk predictors with overweight and obesity in patients with familial hypercholesterolemia

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