*Geek Box: ApoB
Known as ‘ApoB’, this marker has emerged as a refined measure of all atherogenic lipoproteins in circulation. Historically, LDL-cholesterol has been the focus of assessing cardiovascular risk, given this atherogenic lipoprotein has been established as causal in the process of atherosclerosis. However, there are other lipoproteins with atherogenic potential; very-low density lipoprotein [VLDL]., intermediate density lipoprotein [IDL]., and lipoprotein(a) [Lp(a)], all of which have the potential to penetrate the arteries, become trapped, and generate the processes of atherosclerosis. This pool of atherogenic lipoproteins has not historically been measured with any accuracy; ’non-HDL cholesterol’ was a crude measure, taken by subtracting HDL out of the measure of total cholesterol. However, each atherogenic lipoprotein particle contains one molecule of ApoB; consequently, measuring ApoB provides a direct measure of the exact number of atherogenic lipoproteins in circulation. From 2019, the European Atherosclerosis Society have recommended a direct measure of ApoB to assess cardiovascular risk, where circumstances allow for it.