Plasma concentrations of cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, apolipoprotein (apo) B, and lipoprotein(a) (Lp[a]) in 46 persons heterozygous for the apo B-3500 mutation causing familial defective apo B-100 (FDB) were compared with those in 57 non-FDB relatives. FDB patients had 50% to 70% higher mean concentrations of cholesterol, LDL cholesterol, and apo B than non-FDB relatives (P50 years old had atherosclerotic disease. In contrast, all 18 non-FDB relatives >50 years old were apparently healthy. A total of 8 FDB patients with atherosclerotic disease had 36% higher cholesterol concentrations, 28% higher apo B concentrations, 50% higher triglyceride concentrations, and 120% higher Lp(a) concentrations than FDB patients without clinical atherosclerosis. The haplotype background for the apo B-3500 mutation in these Danish families, as defined with seven markers, was comparable to that found in kindreds from the United States, Canada, Austria, Italy, and Germany. A polipoprotein B-100 (apo B-100) is the major struc-/ \ tural protein of low-density lipoproteins (LDLs) A. A . and very-low-density lipoproteins (VLDLs). Binding of apo B-100 to the LDL receptor is essential for the normal removal of LDL from plasma.1 A single G-to-A substitution in the codon for amino acid 3500 in the apo B protein causes a substitution of glutamine for arginine that reduces the binding affinity of apo B-100 for the LDL receptor.2 The clinical entity caused by this mutation, familial defective apo B-100 (FDB), is inherited as an autosomal dominant trait. The mutation has been found in many European populations and in immigrant populations of European descent. 3 The biochemical and clinical phenotype of the mutation is at present not entirely clear. 26 A thorough review of published and unpublished data from 135 FDB subjects from 56 families fied on the basis of a certain lipoprotein profile (ie, familial hypercholesterolemia or type Ila hyperlipidemia) or manifest atherosclerotic disease. As discussed by the authors, 7 the results are therefore likely to be biased by the selection method.Comparison of biochemical and clinical phenotypes in FDB subjects and non-FDB subjects from the same families, in which environmental and other genetic factor...