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Apolipoprotein-B (apo B) and Non-High Density Lipoprotein-cholesterol (non-HDL-C) are more strongly associated with cardiovascular (CV) risk than low-density lipoprotein cholesterol. Though apo B and non-HDL-C are correlated, significant discordances can exist among certain individuals. We evaluated the relationship between apo B and non-HDL-C, assessed apo B/non-HDL-C ratio as a method to understand their agreement/concordance in a clinically understandable fashion and to identify predictors of discordant values.
We performed a chart review of new patient visits to the University of Michigan Lipid Management Clinic from January 2004 to June 2010. Patient factors associated with the apo B/non-HDL-C ratio were assessed. Pearson's correlation coefficients and Bland-Altman plot were used to investigate the relationship between apo B and non-HDL-C. Logistic regression models were used to determine the effects of patient's demographic and clinical characteristics on apo B/non-HDL-C.
We identified a total of 672 patients (57% male; mean age: 52 ± 14 years). Mean apo B and non-HDL-C were 117.3 ± 36.6 and 198.6 ± 86.7 mg/dL, respectively and were moderately correlated (r=0.61, p<0.001). The mean apo B/non-HDL-C ratio was 0.62 ± 0.12. Ratios 0.1 different from the mean were pre-specified per standard deviation to be patients with discordant values. Ninety (13.4%) patients had values 0.72. Significant predictors of a high apo B/non-HDL-C ratio in multivariate analyses were systolic blood pressure and HDL-cholesterol, while triglycerides and total cholesterol were associated with low ratio.
Though apo B and non-HDL-C are moderately correlated, they can be highly discordant among some individuals. Several predictors can help identify patients with discordant values; however, the clinical meaning (i.e., CV risk) of a high apo B compared to non-HDL-C (or vise versa) remains to be established.
Poster Sessions, Expo North
Saturday, March 09, 2013, 3:45 p.m.-4:30 p.m.
Session Title: Prevention: Lipoproteins, Particles and Ratios
Abstract Category: 24. Prevention: Clinical
Presentation Number: 1145-3
- 2013 American College of Cardiology Foundation