What are the arguments in favour of measuring apolipoprotein B (apoB) in clinical practise?
• ApoB measures the total number of atherogenic particles in plasma. It is, therefore, inherently the most coherent pathophysiologic parameter. • Small, dense low-density lipoprotein (LDL) contains less cholesterol than normal LDL particles but is more atherogenic than normal LDL. Increased numbers of small, dense LDL is one of the most common of the metabolic abnormalities that are associated with premature coronary artery disease. LDL cholesterol does not equate to measuring LDL particles whereas the number of LDL particles is the major determinant of apoB. • Normolipidemic patients may nevertheless have an elevated apoB concentration. Their increased risk cannot be recognized without measuring apoB. • Hypertriglyceridemic patients may have an elevated apoB concentration, in which case a statin should be the drug of first choice. If their apoB is not elevated, they require no treatment because they are not at increased risk for atherosclerosis. • The assay for apoB is today available
