title: Apolipoprotein B100 is a better treatment target than calculated LDL and non-HDL cholesterol in statin-treated patients.
abstract: BACKGROUND
  Clinical trials have shown that apolipoprotein B100 (apoB) is better than calculated low-density lipoprotein cholesterol (c-LDL-C) or non-high-density lipoprotein cholesterol (non-HDL-C) as a target for statin treatment. However, there are no published reports of how well these targets are reached in patients with more severe hyperlipidaemias than represented in trials, as seen in lipid clinics.
  
  
  METHODS
  We audited 195 patients attending a tertiary centre lipid clinic, who had been treated with a statin for more than one year. We measured total cholesterol, HDL-cholesterol (HDL-C) and triglyceride and from these calculated LDL-cholesterol (LDL-C) and non-HDL-C. We determined the average measured apoB values, at critical target values of LDL-C and non-HDL-C, by linear regression and compared them with values of apoB considered equivalent to these cholesterol indexes by expert groups. We also assessed the number of patients, both before and after treatment, in whom c-LDL-C and non-HDL-C could not be calculated due to hypertriglyceridaemia.
  
  
  RESULTS
  At the LDL-C target of 2.6 mmol L(-1) and the non-HDL-C target of 3.4 mmol L(-1), the measured apoB values were significantly higher than consensus apoB target values. The difference was most marked for c-LDL-C in hypertriglyceridaemic subjects and for non-HDL-C in patients without hypertriglyceridaemia. A similar pattern was seen using centile-derived consensus values but the differences were accentuated because this approach generates lower equivalent consensus apoB values.
  
  
  CONCLUSIONS
  ApoB offers a more consistent treatment target independent of hypertriglyceridaemia and would obviate technical problems related to high triglycerides.
authors: Cardiovascular Research Group, School of Biomedicine, Core Technology Facility, 3rd Floor, University of Manchester, 46 Grafton Street, Manchester M13 9NT, UK. Handrean.Soran@cmft.nhs.uk
authors: Handrean
authors: H
authors: Soran
authors: Michael W
authors: MW
authors: France
authors: See
authors: S
authors: Kwok
authors: Sanjaya
authors: S
authors: Dissanayake
authors: Valentine
authors: V
authors: Charlton-Menys
authors: Nahla N
authors: NN
authors: Younis
authors: Paul N
authors: PN
authors: Durrington
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D053299:Apolipoprotein B-100 / Q000097:blood*; D000069059:Atorvastatin; D008076:Cholesterol, HDL / Q000097:blood*; D008078:Cholesterol, LDL / Q000097:blood*; D002986:Clinical Trials as Topic; D005464:Fluorobenzenes / Q000627:therapeutic use; D006538:Heptanoic Acids / Q000627:therapeutic use; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D006949:Hyperlipidemias / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy; D008875:Middle Aged; D017035:Pravastatin / Q000627:therapeutic use; D011743:Pyrimidines / Q000627:therapeutic use; D011758:Pyrroles / Q000627:therapeutic use; D012016:Reference Values; D012044:Regression Analysis; D000068718:Rosuvastatin Calcium; D019821:Simvastatin / Q000627:therapeutic use; D013449:Sulfonamides / Q000627:therapeutic use; D014280:Triglycerides / Q000097:blood; D055815:Young Adult
chemical_list: D053299:Apolipoprotein B-100; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D005464:Fluorobenzenes; D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011743:Pyrimidines; D011758:Pyrroles; D013449:Sulfonamides; D014280:Triglycerides; D000068718:Rosuvastatin Calcium; D000069059:Atorvastatin; D019821:Simvastatin; D017035:Pravastatin