Is hypertriglyceridemia a reliable indicator of cholesterol-depleted apoB particles?
Because cholesterol-depleted apoB particles are thought to be a hallmark of hypertriglyceridemia, American, Canadian and European Lipid Guidelines suggest screening for apoB only in patients with hypertriglyceridemia. Accordingly, this study examines the relationship of triglycerides to the LDL-C/ap...
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Published in | Journal of clinical lipidology |
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Main Authors | , , , , , |
Format | Journal Article |
Language | English |
Published |
United States
12.05.2023
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Subjects | |
Online Access | Get full text |
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Summary: | Because cholesterol-depleted apoB particles are thought to be a hallmark of hypertriglyceridemia, American, Canadian and European Lipid Guidelines suggest screening for apoB only in patients with hypertriglyceridemia. Accordingly, this study examines the relationship of triglycerides to the LDL-C/apoB and non-HDL-C/apoB ratios. METHODS: The study cohort consisted of 6272 NHANES subjects adjusted for a weighted sample size of 150 million subjects without previously diagnosed cardiac disease. Data was reported by LDL-C/apoB tertiles as weighted frequencies and percent. Sensitivity, specificity, negative predictive and positive predictive values were calculated for triglycerides thresholds of >150 mg/dL and >200 mg/dL. The range of values of apoB for decisional levels of LDL-C and non-HDL-C were also determined RESULTS: Among patients with triglycerides >200 mg/dL, 75.9% were amongst the lowest LDL-C/apoB tertile. However, this represents only 7.5% of the total population. Of patients with the lowest LDL-C/apoB ratio, 59.8% had triglycerides <150mg/dL. Moreover, there was an inverse relationship between non-HDL-C/apoB such that elevated triglycerides were associated with the highest tertile of non-HDL-C/apoB. Finally, the range of values of apoB for decisional levels of LDL-C and non-HDL-C was determined and is so broad- 30.3-40.6 mg/dl apoB for different levels of LDL-C and 19.5 to 27.6 mg/dl apoB for different levels of non-HDL-C- that neither is an adequate clinical surrogate for apoB. CONCLUSION: Plasma triglycerides should not be used to restrict the measurement of apoB since cholesterol-depleted apoB particles may be present at any level of triglyceride. |
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ISSN: | 1933-2874 1876-4789 |