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Is hypertriglyceridemia a reliable indicator of cholesterol-depleted apoB particles?

Publication ,  Journal Article
De Marco, D; Pencina, K; Pencina, M; Dufresne, L; Thanassoulis, G; Sniderman, AD
Published in: Journal of Clinical Lipidology
January 1, 2023

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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Published In

Journal of Clinical Lipidology

DOI

EISSN

1876-4789

ISSN

1933-2874

Publication Date

January 1, 2023

Related Subject Headings

  • Cardiovascular System & Hematology
  • 1102 Cardiorespiratory Medicine and Haematology
  • 1101 Medical Biochemistry and Metabolomics
 

Citation

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De Marco, D., Pencina, K., Pencina, M., Dufresne, L., Thanassoulis, G., & Sniderman, A. D. (2023). Is hypertriglyceridemia a reliable indicator of cholesterol-depleted apoB particles? Journal of Clinical Lipidology. https://doi.org/10.1016/j.jacl.2023.05.093
De Marco, D., K. Pencina, M. Pencina, L. Dufresne, G. Thanassoulis, and A. D. Sniderman. “Is hypertriglyceridemia a reliable indicator of cholesterol-depleted apoB particles?Journal of Clinical Lipidology, January 1, 2023. https://doi.org/10.1016/j.jacl.2023.05.093.
De Marco D, Pencina K, Pencina M, Dufresne L, Thanassoulis G, Sniderman AD. Is hypertriglyceridemia a reliable indicator of cholesterol-depleted apoB particles? Journal of Clinical Lipidology. 2023 Jan 1;
De Marco, D., et al. “Is hypertriglyceridemia a reliable indicator of cholesterol-depleted apoB particles?Journal of Clinical Lipidology, Jan. 2023. Scopus, doi:10.1016/j.jacl.2023.05.093.
De Marco D, Pencina K, Pencina M, Dufresne L, Thanassoulis G, Sniderman AD. Is hypertriglyceridemia a reliable indicator of cholesterol-depleted apoB particles? Journal of Clinical Lipidology. 2023 Jan 1;
Journal cover image

Published In

Journal of Clinical Lipidology

DOI

EISSN

1876-4789

ISSN

1933-2874

Publication Date

January 1, 2023

Related Subject Headings

  • Cardiovascular System & Hematology
  • 1102 Cardiorespiratory Medicine and Haematology
  • 1101 Medical Biochemistry and Metabolomics