[The use of apolipoprotein B in clinical practice to determine the risk for atherosclerosis]

Atherosclerosis is a multifactorial disorder in which lipid profiles play an important role. In addition to the conventional lipid parameters such as total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides, there is an increasing interest in plasma apolipoprotein B (apoB) for risk stratification in daily practice. ApoB is the structural protein of all atherogenic lipoproteins. Each of these lipoproteins contains one apoB molecule and therefore the apoB concentration is a direct reflection of the number of atherogenic particles in the blood. Some patients have a reasonably normal lipid spectrum but an elevated concentration of apoB, which is associated with an increased risk for atherosclerotic complications. This is especially the case for patients with atherogenic forms of hypertriglyceridaemia and with insulin resistance syndrome. On the basis of epidemiological data, it appears that apoB not only has added value as a risk parameter but also as a treatment target. However the clinical use of apoB levels requires a standardised method with better-defined reference values, as is already the case for total-cholesterol and LDL-cholesterol levels.