What is the significance of Apolipoprotein B (ApoB) 135?

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Last updated: March 28, 2025 • View editorial policy

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From the Guidelines

Apolipoprotein B (ApoB) is a significant marker for cardiovascular risk assessment, and its measurement can provide a more accurate estimate of the number of atherogenic particles in the bloodstream than traditional LDL cholesterol measurements alone. The specific variant "ApoB 135" likely refers to a particular molecular weight or form of this protein. ApoB is the primary protein component of low-density lipoprotein (LDL) particles, often called "bad cholesterol." Elevated levels of ApoB are associated with an increased risk of cardiovascular diseases, including atherosclerosis, heart attacks, and strokes. According to the 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the management of blood cholesterol 1, ApoB measurement can be particularly useful in patients with hypertriglyceridemia.

Key Points

  • ApoB is a protein that plays a crucial role in the metabolism of lipids, particularly in the transport of cholesterol and triglycerides.
  • Elevated levels of ApoB are associated with an increased risk of cardiovascular diseases.
  • ApoB measurement provides a more accurate assessment of cardiovascular risk than traditional LDL cholesterol measurements alone.
  • The treatment targets for ApoB are <80 mg/dL and <100 mg/dL in those at very high and high total CV risk, respectively, as recommended by the ESC/EAS guidelines for the management of dyslipidaemias 1.
  • Management of high ApoB levels typically involves lifestyle modifications (diet low in saturated fats, regular exercise, weight management) and may require medications such as statins, PCSK9 inhibitors, or other lipid-lowering therapies depending on individual risk factors and overall health status.

Clinical Implications

  • Clinicians should consider measuring ApoB in patients with hypertriglyceridemia or those at high risk of cardiovascular disease.
  • ApoB measurement can help identify patients who may benefit from more aggressive lipid-lowering therapy.
  • The use of ApoB as a treatment target can help optimize lipid-lowering therapy and reduce the risk of cardiovascular events. As stated in the ESC/EAS guidelines 1, ApoB can be substituted for LDL-C as a treatment target, and its measurement can provide a more accurate estimate of the number of atherogenic particles in the bloodstream.

References

1
Guideline

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Dr.Oracle Medical Advisory Board & Editors, 2025

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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.

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