You are probably familiar with getting routine cholesterol checks as part of your annual checkup, but you may not be familiar with the protein apolipoprotein B (ApoB). While not routinely tested, ApoB levels provide insight into your risk for cardiovascular disease beyond a standard cholesterol and lipid panel. A recent meta-analysis of 12 studies found that that ApoB was the most potent marker of cardiovascular disease risk.
"Understanding ApoB levels is a powerful tool for assessing heart disease risk," said Dr. Margery Connelly, strategic director of diagnostics research and development at Labcorp and Fellow of the American Heart Association. “By measuring ApoB levels, we can identify patients who may have normal levels of low-density lipoprotein (LDL) cholesterol (i.e., the “bad” type of cholesterol that can cause plaque buildup in the arteries) and yet are at risk for cardiovascular events. This allows us to better personalize care and empower patients to improve their heart health."
In this guide, we’ll look at what ApoB is, who should be tested, and how you can take charge of your heart health.
What is ApoB?
ApoB is the major structural protein on LDL, very low-density lipoprotein (VLDL), and Lp(a) particles which are responsible for transporting cholesterol and fatty molecules through your blood to cells and tissues. Because the cholesterol in LDL and VLDL contributes to the buildup of plaque, a waxy fat that can block your arteries and cause a heart attack, they have been referred to as “bad cholesterol. Conversely, high-density lipoprotein (HDL) cholesterol is considered “good cholesterol.”
Usually, your healthcare provider will assess your risk of developing cardiovascular disease by looking directly at your LDL levels or by calculating your non-HDL cholesterol, which is your HDL cholesterol subtracted from your total cholesterol.
However, these metrics may not always the most accurate method of assessing risk, especially for those with:
- Diabetes
- High triglycerides
- Metabolic syndrome (a group of interrelated conditions that include high blood pressure and abnormal triglyceride or cholesterol levels)
Since there is one ApoB molecule for each of the “bad” lipoprotein molecules, measuring your ApoB levels through a blood test like the one offered by Labcorp can give you and your provider a more accurate representation of your risk for developing cardiovascular disease.
Who should consider ApoB testing?
ApoB testing may be right for you if:
- You have an existing cardiometabolic condition such as diabetes, prediabetes or elevated lipid levels
- You have an existing inflammatory condition such as rheumatoid arthritis or inflammatory bowel disease
- You have a family history of high cholesterol, heart disease or high triglycerides
“Tracking ApoB levels over time empowers patients to make informed lifestyle and dietary changes to improve their heart health," said Dr. Connelly.
For example, ApoB testing done along with a lipid panel before and after implementing dietary changes like reducing saturated fats and eating more fiber, or lifestyle changes like increasing exercise, can show if ApoB levels respond positively.
Normal ApoB levels are 66 to 133 mg/dL for an adult man and 60 to 117 mg/dL for an adult woman, but can vary depending on the individual and their preexisting conditions. The best way to determine your normal ApoB range is through repeated testing and talking with your healthcare provider.
Knowing your ApoB levels and how they may respond to lifestyle changes can empower you to make informed health decisions.
Take charge of your heart health with Labcorp OnDemand
Testing and monitoring key heart health markers such as ApoB can help you and your healthcare provider evaluate your heart health goals and milestones so you can tailor your dietary and lifestyle changes to decrease your risk of heart disease.
If you are interested in understanding your heart health, Labcorp OnDemand’s Complete Heart Health Test is an expanded panel that includes ApoB and other key indicators of cardiovascular risk like cholesterol, triglycerides and GlycA.
