title: Comparison of the measurement of lipids and lipoproteins versus assay of apolipoprotein B for estimation of coronary heart disease risk: a study in familial combined hyperlipidemia.
abstract: We compared in 506 members of families with familial combined hyperlipidaemia (FCH), two approaches to selecting subjects with an apparent increased risk for coronary heart disease: assay of apolipoprotein (apo) B only versus measurement of plasma lipids and lipoproteins. When comparing both criteria, there was an overlap of 81.2% at apo B levels < or = 1250 mg/l and of 86.9% at apo B levels > 1250 mg/l. At apo B < or = 1250 mg/l all subjects were normolipidemic. However, 18.8% of these subjects had sub-normal HDL-cholesterol concentrations (< 0.9 mmol/l) but were not considered to have an increased risk because of very low LDL-cholesterol levels (< 2.5 mmol/l). At apo B concentrations > 1250 mg/l we observed a group with normal plasma lipid levels (13.1%). In this group, defined as normolipidemic hyperapobetalipoproteinemia, and considered to have an increased risk for coronary heart disease, apo B determination was thus most informative. The selection of the subgroup with 'normolipidemic hyperapobetalipoproteinemia' on the basis of the conventional approach could be refined using a cut off limit for plasma triglycerides < 1.5 mmol/l. This limit distinguished optimally between an atherogenic very dense LDL pattern versus a dense and buoyant pattern. Thus, based on the results of our study, the determination of apo B appeared to be, if not superior, at least as effective as the conventional lipid and lipoprotein parameters in classifying subjects at increased risk for coronary heart disease.
authors.affiliation: Department of Medicine, UMC St. Radboud, Nijmegen, The Netherlands. p.demacker@aig.azn.nl
authors.forename: P N
authors.initials: PN
authors.lastname: Demacker
authors.forename: M J
authors.initials: MJ
authors.lastname: Veerkamp
authors.forename: S J
authors.initials: SJ
authors.lastname: Bredie
authors.forename: S M
authors.initials: SM
authors.lastname: Marcovina
authors.forename: J
authors.initials: J
authors.lastname: de Graaf
authors.forename: A F
authors.initials: AF
authors.lastname: Stalenhoef
mesh_terms: D000328:Adult; D001055:Apolipoproteins B / Q000097:blood; D001681:Biological Assay; D003327:Coronary Disease / Q000209:etiology*; D005260:Female; D006801:Humans; D006950:Hyperlipidemia, Familial Combined / Q000097:blood* / Q000150:complications*; D008055:Lipids / Q000097:blood*; D008297:Male; D012307:Risk Factors
chemical_list: D001055:Apolipoproteins B; D008055:Lipids