Apolipoprotein B (ApoB)

Why is ApoB important for your Healthspan?

‍Metabolism — Cardiovascular Health

ApoB directly quantifies the particles that can contribute to plaque buildup in your arteries, a key factor in heart disease and stroke. Lower ApoB levels are consistently associated with less arterial plaque and a significantly reduced risk of cardiovascular events, thereby supporting a longer, healthier life free from chronic disease. While traditional LDL cholesterol measures the amount of cholesterol inside these particles, ApoB offers a more accurate count of the particles themselves, which is considered a more reliable indicator of cardiovascular risk.

‍What is ApoB?

ApoB, or Apolipoprotein B, is a structural protein found on the surface of nearly all "unfavorable" cholesterol particles, including Low-Density Lipoprotein (LDL), Very Low-Density Lipoprotein (VLDL), and Intermediate-Density Lipoprotein (IDL). Each of these potentially plaque-forming particles carries just one ApoB molecule, making ApoB a direct and precise marker for the total number of these particles circulating in your blood. These lipoproteins are essential for transporting fats and cholesterol throughout the body, but when present in high numbers, they can penetrate arterial walls and contribute to atherosclerosis, the hardening and narrowing of arteries. Measuring ApoB thus provides a comprehensive assessment of one's exposure to these potentially damaging particles.

‍How do we take action?

Diet Enhancement — Exercise Improvement — Alcohol Reduction

To optimize ApoB levels, one should focus on foundational lifestyle modifications and, when necessary, consider medical interventions. This commonly involves adopting a balanced dietary pattern, such as a Mediterranean-style diet, which emphasizes whole, unprocessed foods, healthy fats, and fiber. Regular physical activity and maintaining a healthy body weight are also crucial, as they can significantly improve insulin sensitivity and positively influence lipid metabolism. Additionally, it is important to discuss with a healthcare provider any medications or supplements that might be beneficial for managing ApoB. Consistent monitoring of ApoB levels, alongside other relevant markers, is advisable to track progress and adjust strategies to help maintain arterial health and support long-term cardiovascular well-being.

‍Additional resources

1.Sandhu, P. K., Musaad, S. M., Remaley, A. T., Buehler, S. S., Strider, S., Derzon, J. H., Vesper, H. W., Ranne, A., Shaw, C. S., & Christenson, R. H. (2016). Lipoprotein Biomarkers and Risk of Cardiovascular Disease: A Laboratory Medicine Best Practices (LMBP) Systematic Review. The journal of applied laboratory medicine, 1(2), 214–229. https://doi.org/10.1373/jalm.2016.021006

2.Shapiro, M. D., & Fazio, S. (2017). Apolipoprotein B-containing lipoproteins and atherosclerotic cardiovascular disease. F1000Research, 6, 134. https://doi.org/10.12688/f1000research.9845.1

3.Contois, J. H., McConnell, J. P., Sethi, A. A., Csako, G., Devaraj, S., Hoefner, D. M., Warnick, G. R., & AACC Lipoproteins and Vascular Diseases Division Working Group on Best Practices (2009). Apolipoprotein B and cardiovascular disease risk: position statement from the AACC Lipoproteins and Vascular Diseases Division Working Group on Best Practices. Clinical chemistry, 55(3), 407–419. https://doi.org/10.1373/clinchem.2008.118356

4.Emerging Risk Factors Collaboration, Di Angelantonio, E., Gao, P., Pennells, L., Kaptoge, S., Caslake, M., Thompson, A., Butterworth, A. S., Sarwar, N., Wormser, D., Saleheen, D., Ballantyne, C. M., Psaty, B. M., Sundström, J., Ridker, P. M., Nagel, D., Gillum, R. F., Ford, I., Ducimetiere, P., Kiechl, S., … Danesh, J. (2012). Lipid-related markers and cardiovascular disease prediction. JAMA, 307(23), 2499–2506. https://doi.org/10.1001/jama.2012.6571

5.Gigante, B., Leander, K., Vikstrom, M., Frumento, P., Carlsson, A. C., Bottai, M., & de Faire, U. (2012). Elevated ApoB serum levels strongly predict early cardiovascular events. Heart (British Cardiac Society), 98(16), 1242–1245. https://doi.org/10.1136/heartjnl-2012-301852

6.Holme, I., Aastveit, A. H., Jungner, I., & Walldius, G. (2008). Relationships between lipoprotein components and risk of myocardial infarction: age, gender and short versus longer follow-up periods in the Apolipoprotein MOrtality RISk study (AMORIS). Journal of internal medicine, 264(1), 30–38. https://doi.org/10.1111/j.1365-2796.2008.01925.x

7.Meisinger, C., Loewel, H., Mraz, W., & Koenig, W. (2005). Prognostic value of apolipoprotein B and A-I in the prediction of myocardial infarction in middle-aged men and women: results from the MONICA/KORA Augsburg cohort study. European heart journal, 26(3), 271–278. https://doi.org/10.1093/eurheartj/ehi003

8.Shai, I., Rimm, E. B., Hankinson, S. E., Curhan, G., Manson, J. E., Rifai, N., Stampfer, M. J., & Ma, J. (2004). Multivariate assessment of lipid parameters as predictors of coronary heart disease among postmenopausal women: potential implications for clinical guidelines. Circulation, 110(18), 2824–2830. https://doi.org/10.1161/01.CIR.0000146339.57154.9B

9.Sniderman, A. D., Williams, K., Contois, J. H., Monroe, H. M., McQueen, M. J., de Graaf, J., & Furberg, C. D. (2011). A meta-analysis of low-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol, and apolipoprotein B as markers of cardiovascular risk. Circulation. Cardiovascular quality and outcomes, 4(3), 337–345. https://doi.org/10.1161/CIRCOUTCOMES.110.959247

10.Pencina, M. J., D'Agostino, R. B., Zdrojewski, T., Williams, K., Thanassoulis, G., Furberg, C. D., Peterson, E. D., Vasan, R. S., & Sniderman, A. D. (2015). Apolipoprotein B improves risk assessment of future coronary heart disease in the Framingham Heart Study beyond LDL-C and non-HDL-C. European journal of preventive cardiology, 22(10), 1321–1327. https://doi.org/10.1177/2047487315569411

11.Pearson, G. J., Thanassoulis, G., Anderson, T. J., Barry, A. R., Couture, P., Dayan, N., Francis, G. A., Genest, J., Grégoire, J., Grover, S. A., Gupta, M., Hegele, R. A., Lau, D., Leiter, L. A., Leung, A. A., Lonn, E., Mancini, G. B. J., Manjoo, P., McPherson, R., … Wray, W. (2021). 2021 Canadian Cardiovascular Society Guidelines for the Management of Dyslipidemia for the Prevention of Cardiovascular Disease in Adults. Canadian Journal of Cardiology, 37(8), 1129–1150. https://doi.org/10.1016/j.cjca.2021.03.016

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