Lipid Panel Test: Cholesterol and Triglyceride Results

Apo B : Apo A-1

Other names: ApoB/ApoA-1, ApoB:ApoA1 Ratio, ApoB/A1 Ratio, Ratio ApoB/ApoA

Optimal result: 0 – 0.8 Ratio

By Healthmatters Editorial Team

Peer-reviewed sources

Elevated ApoB:ApoA1 ratio confers increased risk of atherosclerotic cardiovascular disease, independently of LDL and HDL cholesterol concentrations.

A high ratio of apo B to apo-A1 is a very strong risk factor for CVD and acute myocardial infraction. Apo B levels provide a direct indication of the particle number of all atherogenic non-HDL lipoproteins, including VLDL, IDL, Lp(a) and LDL. Apo-A1 provides a direct indication of anti-atherogenic HDL particles. Therefore the apo B to apo-A1 ratio provides functional insight into so called cholesterol balance, or estimation of net reverse cholesterol transport.

Studies have shown that the ratio of apolipoprotein A-1:apolipoprotein B may correlate better with increased risk of coronary artery disease (CAD) than total cholesterol, and LDL:HDL ratio.

Apolipoprotein Evaluation - Apolipoprotein A1 is the primary protein associated with HDL cholesterol. Like HDL cholesterol, increased concentrations are associated with reduced risk of cardiovascular disease. Apolipoprotein B-100 is the primary protein associated with LDL cholesterol and other lipid particles. Like LDL cholesterol, increased concentrations are associated with increased risk of cardiovascular disease. The ratio of these two apolipoproteins correlates with risk of cardiovascular disease.

Apolipoprotein B/A1 Ratio

Male	<0.77
Female	<0.63
Risk Category	Male	Female
Optimal	<0.77	<0.63
Moderate	0.77-0.95	0.63-0.78
High	>0.95	>0.78

Cardiovascular event risk category cut points (optimal, moderate, high) are based on the AMORIS study, Walldius G et al. J Intern Med. 2004;255:188-205.

References:

- Reiner Z, Catapano AL, De Backer G, et al: ESC/EAS Guidelines for the management of dyslipidaemias: The task force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS). Eur Heart J 2011;32(14):1769-1818

- McQueen MJ, Hawken S, Wang X, et al: Lipids, lipoproteins, and apolipoproteins as risk markers of myocardial infarction in 52 countries (the INTERHEART study): a case-control study. Lancet 2008;372:224-233

- Thompson A, Danesh J: Associations between apolipoprotein B, apolipoprotein AI, the apolipoprotein B/AI ratio and coronary heart disease: a literature-based meta-analysis of prospective studies. J Intern Med 2006;259:481-492

- Jacobson TA, Ito MK, Maki KC, et al: National Lipid Association recommendations for patient-centered management of dyslipidemia: Part 1-executive summary. J Clin Lipidol 2014 Sep-Oct;8(5):473-488

- Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents: summary report. Pediatrics 2011 Dec;128 Suppl 5:S213-S256

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Clinical Sources & References

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Written by Healthmatters Editorial Team

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