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Apolipoprotein B - An ideal biomarker for atherosclerosis?
Kavita Singh1, Dorairaj Prabhakaran2
1Public Health Foundation of India, Gurugram, Haryana, India; Heidelberg Institute of Global Health, Heidelberg University, Germany.
Insights
Apolipoprotein B (Apo-B) is a key predictor of atherosclerotic cardiovascular disease. Measuring Apo-B offers a direct assessment of atherogenic lipoprotein particles, potentially simplifying dyslipidemia management.
Area of Science:
- Cardiovascular Medicine
- Lipid Metabolism
- Biomarker Discovery
Background:
- Atherosclerosis is a leading cause of cardiovascular disease.
- Dyslipidemia management often involves complex lipid profiles.
- Apolipoprotein B (Apo-B) is a component of atherogenic lipoproteins.
Purpose of the Study:
- To review the pathophysiological role of Apo-B in atherosclerosis.
- To summarize evidence supporting Apo-B as a cardiovascular risk predictor.
- To examine current guidelines on Apo-B in dyslipidemia management.
Main Methods:
- Literature review of pathophysiological mechanisms.
- Synthesis of evidence on Apo-B as a predictive biomarker.
- Analysis of international treatment guidelines for dyslipidemia.
Main Results:
- Apo-B is present in all atherogenic lipoprotein particles (VLDL, IDL, LDL, Lp(a)).
- Plasma Apo-B concentration directly reflects the number of atherogenic particles.
- Apo-B integrates information from triglycerides and cholesterol, serving as a singular atherogenic lipid marker.
Conclusions:
- Apo-B is a valuable biomarker for atherosclerosis.
- Measuring Apo-B can simplify and enhance atherosclerotic cardiovascular disease care.
- Further integration of Apo-B into clinical practice is recommended for dyslipidemia management.
Abstract:
This review article describes the pathophysiological mechanisms linking Apolipoprotein B (Apo-B) and atherosclerosis, summarizes the existing evidence on Apo B as a predictor of atherosclerotic cardiovascular disease and recommendations of (inter)national treatment guidelines regarding Apo B in dyslipidemia management. A single Apo B molecule is present in every particle of very low-density lipoprotein, intermediate density lipoprotein, low density lipoprotein, and lipoprotein(a). This unique single Apo B per particle ratio makes plasma Apo B concentration a direct measure of the number of circulating atherogenic lipoproteins. This review of global evidence on Apo B as a biomarker for atherosclerosis confirms that Apo B is a single atherogenic lipid marker present in all lipids sub-fractions except HDL-C, and thus, Apo B integrates and extends the information from triglycerides and cholesterol, which could simplify and improve care for atherosclerotic cardiovascular disease.
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