What is the apolipoprotein A to apolipoprotein B ratio for values of 114 mg/dL and 108 mg/dL?

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Last updated: October 12, 2026 • View editorial policy

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Apolipoprotein B/A1 Ratio Calculation

The ratio of Apolipoprotein B to Apolipoprotein A1 for these values is 0.95 (108 mg/dL ÷ 114 mg/dL = 0.95), which represents a favorable cardiovascular risk profile.

Understanding the Calculation

The apolipoprotein ratio is calculated as ApoB/ApoA1 (not ApoA1/ApoB). Based on the provided values:

  • Apolipoprotein A1 (ApoA1): 114 mg/dL
  • Apolipoprotein B (ApoB): 108 mg/dL
  • Ratio = 108 ÷ 114 = 0.95

Clinical Interpretation

This ratio of 0.95 indicates relatively low cardiovascular risk. The ApoB/ApoA1 ratio combines atherogenic (harmful) and protective lipoprotein markers into a single metric, where higher ratios indicate higher cardiovascular risk 1.

Why This Ratio Matters

  • ApoB represents the total number of atherogenic particles (LDL and small VLDL) in circulation - each atherogenic particle contains exactly one ApoB molecule 1
  • ApoA1 is the major protein component of HDL (protective lipoproteins), with low concentrations associated with increased disease risk 1
  • The ratio intuitively combines harmful and protective elements into a single cardiovascular risk marker 1

Risk Context

A ratio below 1.0 generally suggests:

  • The protective lipoprotein burden (ApoA1) exceeds the atherogenic burden (ApoB)
  • Lower cardiovascular risk compared to ratios >1.0
  • Favorable lipoprotein particle distribution

Important Clinical Caveats

The ApoB/ApoA1 ratio serves primarily as a risk marker, not necessarily a treatment target. While the ratio effectively identifies increased cardiovascular risk, evidence for using it to guide therapy intensity remains limited 1.

Key Considerations:

  • Lowering the numerator (ApoB) has strong evidence through statin therapy, which reduces atherogenic particles 1
  • Raising the denominator (ApoA1/HDL) lacks robust clinical trial support for cardiovascular benefit, despite biological plausibility 1
  • Recent evidence shows ApoB provides incremental discrimination beyond conventional lipid markers for atherosclerosis severity 2
  • Individual variation exists: Even at similar LDL-C levels, ApoB can vary significantly, meaning discordance between traditional lipid markers and apolipoprotein measurements is common 3

When to Measure Apolipoproteins

The National Lipid Association recommends apolipoprotein testing to:

  • Augment standard lipid panels for improved risk assessment 4
  • Identify discordance between LDL-C and actual atherogenic particle burden 3
  • Diagnose distinct lipoprotein phenotypes 4
  • Guide lipid-lowering therapy decisions, particularly in metabolic syndrome or hypertriglyceridemia 5

In this specific case with ApoB 108 mg/dL and ApoA1 114 mg/dL, the ratio of 0.95 suggests favorable cardiovascular risk from a lipoprotein particle perspective, though this should be interpreted alongside other cardiovascular risk factors and clinical context.

References

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.