title: Applying apoB to the diagnosis and therapy of the atherogenic dyslipoproteinemias: a clinical diagnostic algorithm.
abstract: OBJECTIVE
  The first objective is to present the most recent evidence relating to the efficacy of apolipoprotein B as a diagnostic index of the risk of vascular disease and a therapeutic target for statin therapy. The second is to present a diagnostic algorithm for the apolipoprotein B100 dyslipidemias based on triglyceride and apoB.
  
  
  RESULTS
  The results from several recent prospective epidemiological studies demonstrate apoB to be superior to any of the cholesterol indices to estimate the risk of vascular disease. Similarly, the results of several of the major statin clinical trials demonstrate that apoB is a more adequate index of the adequacy of statin therapy than any of the cholesterol indices. Recent studies of lipoprotein subclass distribution in subjects with familial combined hyperlipidemia are reviewed. They demonstrate the limitations of the original lipid-based criteria and point to the necessity of using apoB as a fundamental diagnostic criterion for the disorder. A diagnostic algorithm for an apoB100 atherogenic dyslipoproteinemias is presented and the limitations of the lipid-based system described.
  
  
  CONCLUSIONS
  The evidence supporting the clinical use of apoB is solid, its measurement is standardized, and automated, inexpensive laboratory testing could easily be widely available. However, clinical benefit will only follow clinical application.
authors.affiliation: Laboratory for Cardiovascular Research, Royal Victoria Hospital, Montreal, Quebec, Canada. allan.sniderman@muhc.mcgill.ca
authors.forename: Allan D
authors.initials: AD
authors.lastname: Sniderman
mesh_terms: D000465:Algorithms; D053299:Apolipoprotein B-100; D001055:Apolipoproteins B / Q000235:genetics*; D001161:Arteriosclerosis / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology / Q000235:genetics*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D050356:Lipid Metabolism; D014280:Triglycerides / Q000378:metabolism
chemical_list: D053299:Apolipoprotein B-100; D001055:Apolipoproteins B; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D014280:Triglycerides