Comment by lr4444lr
18 hours ago
IANAD, but
1) Isn't ApoB measurement pretty much in tandem with LDL, VLDL, and triglycerides? I realize it's being recognized now as the necessary factor for arterial dysfunction, but it seems like a lot of hoopla is being made as if it were some "silent" overlooked factor when for the vast, vast majority of people their ApoB levels are entirely explained by the other 3 lipid panel line items carrying it, and they have been in use for decades and are strongly targeted by the medical establishment
2) Isn't Lp(a) a separate lipoprotein altogether which is an independent risk factor for MACE? I've never heard of it "disguising" other cholesterol in testing.
1) ApoB itself is more accurate than LDL and triglycerides. The latest evidence is that ApoB and Lp(a) together are more accurate than even LDL, VLDL, non-HDL, triglerycerides, etc combined: https://academic.oup.com/eurheartj/article-abstract/46/27/27...
2) The terminology is confusing, but each Lp(a) particle is "just" a cholesterol particle wrapped with an extra protein, apoprotein (a). So each Lp(a) particle includes one ApoB molecule (the structural protein in atherogenic cholesterol particles) and many cholesterol and triglyceride molecules, but the extra protein makes each Lp(a) particle about 6x more atherogenic than a typical cholesterol particle.
you're correct
there's a small subset of people with more atherogenic triglycerides that ApoB picks up over and above just tracking with the LDL, but...you probably knew that just looking at them