Apolipoprotein B, non‐HDL cholesterol and LDL cholesterol for identifying individuals at increased cardiovascular risk
Year: 2010
Type: article
Study design: Observational Study
Abstract: . Holewijn S, den Heijer M, Swinkels DW, Stalenhoef AFH, de Graaf J. (Address: Division of Vascular Medicine, Department of General Internal Medicine; Department of Epidemiology and Biostatistics; Department of Endocrinology; and Department of Laboratory Medicine; Laboratory of Clinical Chemistry, all at the Radboud University, Nijmegen Medical Centre, Nijmegen, The Netherlands) Apolipoprotein B, non‐HDL cholesterol and LDL cholesterol for identifying individuals at increased cardiovascular risk. J Intern Med 2010; 268: 567–577. Background. To compare apolipoprotein B (apoB), nonhigh‐density lipoprotein‐cholesterol (non‐HDL‐c) and low‐density lipoprotein‐cholesterol (LDL‐c) for identifying individuals with a deteriorated cardiovascular (CV) risk profile, including a panel of subclinical atherosclerosis measurements and prevalent cardiovascular disease (CVD) in a Dutch population‐based cohort. Methods. Clinical and biochemical measurements and a panel of noninvasive parameters of subclinical atherosclerosis were determined in 1517 individuals, aged 50–70 years. Results. Both men and women with increasing levels of apoB and non‐HDL‐c were more obese, had higher blood pressure and fasting glucose levels, and a more atherogenic lipid profile. Furthermore, compared to the reference group (composed of those with apoB, non‐HDL‐c and LDL‐c levels in the bottom quartiles), participants with high apoB and high non‐HDL‐c levels had a lower ankle–brachial index at rest (−3.5% and −3.1%, respectively) and after exercise (−6.3% and −4.7%, respectively), a thicker near wall (+4.8% and +4.2%, respectively), far wall (both +6.2%), and mean intima–media thickness (+5.7% and +5.3%, respectively) and more plaques (+54.2% and +54.3%, respectively). In addition, they also showed increased stiffness parameters (e.g. pulse wave velocity both +3.6%). Less clear differences in CV risk profile and subclinical atherosclerosis parameters were observed when participants were stratified by LDL‐c level. Furthermore, apoB but not LDL‐c detected prevalent CVD, and non‐HDL‐c only detected prevalent CVD in men. The discriminatory power for prevalent CVD expressed as area under the receiver operating characteristic curve was 0.60 (P < 0.001) for apoB, 0.57 (P = 0.001) for non‐HDL‐c and 0.54 (P = 0.108) for LDL‐c. Conclusion. Our data support the use of first apoB and secondly non‐HDL‐c above LDL‐c for identifying individuals from the general population with a compromised CV phenotype.
Source: Journal of Internal Medicine
Institution: Radboud University Medical Center
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W1920570639