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Establishing cut-off values for apolipoprotein B and non-HDL-C according to LDL-C values in a South European

S Martinez-Hervas1, J T Real, M A Priego

  • 1Service of Endocrinology and Nutrition, Hospital Clínico Universitario, Valencia, Spain CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Barcelona, Spain.sergio.martinez@uv.es

International Journal of Clinical Practice
|December 18, 2012
PubMed

Insights

New cut-off values for apolipoprotein B (apoB) and non-HDL-C are proposed to better assess cardiovascular risk in populations with dyslipidaemia. These lipid markers offer improved risk classification beyond LDL-C alone, especially in Mediterranean populations.

Area of Science:

  • Cardiovascular Disease Prevention
  • Lipid Metabolism
  • Clinical Biochemistry

Background:

  • Low-density lipoprotein cholesterol (LDL-C) is the primary therapeutic target for dyslipidaemia and cardiovascular disease prevention.
  • Current guidelines use specific LDL-C cut-off points for intervention.
  • Dyslipidaemia with elevated triglycerides is common, potentially leading to misclassification of risk based solely on LDL-C.

Purpose of the Study:

  • To establish cut-off point values for apolipoprotein B (apoB) and non-high-density lipoprotein cholesterol (non-HDL-C).
  • To correlate these values with established LDL-C cut-off points for cardiovascular risk assessment.
  • To evaluate their utility in a South European population.

Main Methods:

  • Cross-sectional study of 1501 subjects (18-80 years).
  • Fasting blood samples analyzed for cholesterol, HDL-C, triglycerides, and apoB.
  • LDL-C calculated using the Friedewald formula; non-HDL-C calculated as total cholesterol minus HDL-C.

Main Results:

  • Significant correlations found between apoB and LDL-C (r=0.86) and between apoB and non-HDL-C (r=0.91).
  • Proposed apoB cut-off points for LDL-C goals (70, 100, 130, 160 mg/dL) are 70, 80, 100, 115 mg/dL.
  • Proposed non-HDL-C cut-off values for LDL-C goals are 100, 120, 150, 190 mg/dL.

Conclusions:

  • LDL-C cut-off values may inaccurately estimate cardiovascular risk in individuals with mild hypertriglyceridaemia, common in Mediterranean populations.
  • Proposed apoB and non-HDL-C cut-off values can better account for atherogenic particles and patient risk classification.
  • Further prospective trials are needed to validate these findings with cardiovascular outcomes.
Abstract

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