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What Is An ApoB Blood Test?

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The Apolipoprotein B-100 blood test (ApoB for short) is one of the tools that healthcare providers employ to assess an individual’s risk factors for cardiovascular disease. It may be ordered in addition to or instead of traditional lipid panels to evaluate “bad” cholesterol in your blood. Read our article to learn more about the ApoB blood test, including what to expect during and after the procedure.

What does the ApoB Blood Test Measure?

ApoB is a protein that plays a crucial role in lipid metabolism. Specifically, it acts as a protein carrier of fat and cholesterol. There are two subtypes: ApoB-48 and ApoB-100. 48 is produced in the gut and carries fat and cholesterol to the liver, where it is combined with ApoB-100. 100 is the version that circulates throughout the blood and can, therefore, be measured in the ApoB test. 

ApoB-100 binds to and transports several lipoproteins collectively known as “bad” cholesterol for their tendency to build up in artery walls. These include:

  • Very low density lipoproteins (VLDLs)
  • Low density lipoproteins (LDLs)
  • Intermediate-density lipoproteins (IDLs)

The presence of ApoB is certainly an indicator of LDL. But unlike traditional cholesterol tests, which measure the total concentration of LDL in the blood, the ApoB test quantifies the number of LDL particles present. 

Studies have shown that the number of ApoB particles is a better gauge of cardiovascular risk than the concentration of LDL cholesterol alone. This is because the amount of ApoB in the blood does not necessarily correlate with total concentration of LDL. Two patients can have the same LDL concentration but vastly different amounts of ApoB in their blood. High levels of ApoB may thus be present in an individual with a “normal” total concentration of LDLs. 

Procedure for ApoB Blood Test

The procedure for the ApoB blood test is relatively straightforward. A healthcare professional will draw a blood sample from a vein, typically from the arm. The sample is then sent to a laboratory for analysis. Results are usually available within a few days.

In most cases, you do not need to fast before an ApoB blood test. However, your provider may request that you do so if it is ordered in conjunction with a standard lipid profile. 

When Would a Provider Order This Test?

A healthcare provider may order the ApoB blood test in several scenarios:

Assessment of Cardiovascular Risk

For individuals with a family history of cardiovascular disease or other risk factors such as high blood pressure, diabetes, or obesity, the ApoB test provides valuable information about their cardiovascular risk beyond traditional lipid profiles. If standard tests come back normal despite strong family history, for example, the ApoB blood test can offer clarification. 

Monitoring Treatment Efficacy

For patients undergoing lipid-lowering therapy, such as statins, the ApoB test can help monitor the effectiveness of treatment by assessing changes in LDL particle number.

Investigation of High Triglyceride Levels

In cases where individuals have elevated triglyceride levels, measuring ApoB levels can help determine whether the increase is due to an excess of cholesterol-rich LDL particles.

Other Blood Tests Ordered Along with ApoB

In addition to the ApoB blood test, healthcare providers may order complementary tests to provide a comprehensive assessment of cardiovascular risk. Two notable examples are:

The NMR Lipoprofile

This test utilizes Nuclear Magnetic Radiation (NMR) Spectroscopy to provide detailed information about the size, number, and distribution of lipoprotein particles in your blood. Very simply, all nuclei have distinct magnetic properties. The NMR Lipoprofile identifies particles based on these unique properties, offering insights into the specific lipid abnormalities contributing to cardiovascular risk. Individuals with diabetes and metabolic disorder, for example, often have a higher concentration of VLDLs, which are linked to an increased risk of plaque formation in the arteries. NMR can test for the amount of these types of lipoproteins. 

Lp(a) Test 

Lipoprotein(a), or Lp(a), is a type of LDL that is associated with increased risk of cardiovascular disease. Lp(a) increases clotting, which can lead to blockages in the arteries. It also triggers an inflammatory response. If left untreated, this inflammation leads to calcium build-up in the blood vessels, a dangerous condition known as aortic stenosis. Your provider may order this test along with ApoB, especially if you have a family history of heart attacks without known risk factors (i.e. smoking). 

What Happens If My ApoB Levels Are High?

If your ApoB levels come back high, you needn’t panic. Your provider will use this information to develop a wellness program that will get you back to healthy levels. Depending on your exact results, you can expect one or more of the following recommendations:

Dietary and Lifestyle Modifications: Based on individual lipid profiles, providers can recommend specific dietary changes to help naturally improve your cholesterol levels. You will also be given cardiovascular exercises to incorporate several times per week, and advice for good sleep hygiene to boost metabolic health overall. 

Medication: For individuals with persistently elevated LDL particle numbers despite lifestyle modifications, targeted pharmacotherapy may be warranted. This could involve the use of lipid-lowering medications such as statins or newer agents like PCSK9 inhibitors. 

Regular Monitoring and Follow-Up: Periodic reassessment of lipid profiles, including ApoB levels, allows for ongoing evaluation of the effectiveness of interventions and adjustments to treatment plans as needed.

Functional Medicine Provider in Jackson

Functional medicine is one of the few types of practices that evaluates important blood markers, such as ApoB. Despite its proven accuracy in measuring cardiovascular risk, many providers continue to rely on standard lipid profiles. As studies continue to underscore the valuable information this test provides, we hope it will become more commonplace. 

If you have a strong family history of cardiovascular disease or have conditions linked to high cholesterol, such as Type 2 diabetes, a visit with a functional medicine provider is an excellent place to start. We utilize a comprehensive, holistic approach to evaluating and treating medical issues, with the understanding that every patient is different. In Jackson, MS, Modern Health is the area’s top functional medicine provider. We want to give our patients the tools to achieve and sustain their wellness goals. Call or go online today to schedule a free phone consultation. 

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Heart Health