What is an Apolipoprotein B test? 

The apolipoprotein B test is a blood test that helps to check the levels of a polypeptide - apolipoprotein B in your body. It is sometimes also referred to as apo B or apolipoprotein B-100 test. 

Lipoproteins are complex molecules composed of lipids and proteins. The protein motifs help the insoluble fats to travel easily through blood. They also help in fat metabolism.

Apolipoprotein B is one of the proteins present in low-density lipoprotein (LDL), the bad cholesterol, and very-low-density lipoprotein (VLDL). VLDL primarily carries cholesterol from the liver to different tissues. Apolipoproteins drive this transport and help unload the cholesterol into the tissues. As the molecule reaches tissue sites, the fat gets transferred and the lipoprotein slowly changes form to become the LDL; apo B, meanwhile, stays the same.

Excess of LDL, if present in the body, gets deposited on the inner walls of blood vessels and narrow their lumen. This restricts the blood flow in the affected area, negatively affecting the surrounding tissues. LDL deposition also leads to hardening of blood vessel walls that then become prone to damage. When this process takes place in the blood vessels that supply the heart, it increases the risk of a heart attack

Since apo B is so closely associated with LDL, the levels of apolipoprotein B in the blood are used to evaluate if you are at risk of a heart disorder.

  1. Why is an Apolipoprotein B test performed?
  2. How do you prepare for an Apolipoprotein B test?
  3. How is an Apolipoprotein B test performed?
  4. Apolipoprotein B test results and normal range

This test is usually done to assess if you are at risk of heart disease. It may also be ordered to check your cholesterol levels. (Read more: High cholesterol symptoms)

Additionally, this test will be ordered if:

  • You have had a heart attack in the past or have heart-related problems
  • You have a family history of heart condition
  • Other blood tests, like triglycerides and cholesterol, show abnormalities
  • To help monitor the progress of treatment in a person with high cholesterol
  • You have a genetic condition that affects the production of apolipoprotein B in the body

It is important to note that apolipoprotein test is not a screening test and is not generally ordered for routine testing.

You may be required to fast for up to 12 hours before this test. Though you may be allowed to drink water during this time. Please inform the doctor if you are taking any medications, vitamins or herbal supplements as they may interfere with the test results. For example, cholesterol-lowering medicines, like statins, may lead to inaccurate results. Your doctor may inform you if they require you to change the course of a few medications.

Discuss with your doctor if you have any health conditions, or have a family history of certain conditions. This can help him/her to evaluate the risks better. 

A doctor or laboratory technician will withdraw a small amount of blood from a vein in your arm and transfer it to a clean and specialised tube. The sample will be immediately sent to the laboratory for testing. Some people tend to feel slight pain when the needle is inserted - it doesn’t last for long. 

After the test, you may notice a small bruise around the area of needle insertion. The bruise should fade away in a few days. If in case your bruise does not fade, please consult your doctor.

Normal results:

Results for the apolipoprotein B test can be given either in terms of g/L or mg/dL. The values differ depending on age, gender, health conditions, etc. The following list shows a normal reference range of values for different age groups:

Age Less than 14 days 15 days to one year One year to six years Six years to  19 years Above 19 years
Apo B (g/L) <0.68 <1.24 <0.94 <0.85 0.4-1.20

Sometimes, when the doctor has ordered other tests, like the apolipoprotein A1, the result may include a ratio of apolipoprotein A1/B. The following table shows a normal range for ratio in men and women:

Risk involved Low risk Borderline/high risk High risk
Female >1.35 0.97-1.35 <0.97
Male >1.11 0.86-1.11 <0.86

 Please consult your doctor to know exactly what the values mean for you.

Abnormal results:

Results are reported as abnormal if they are higher or lower than the normal range. Higher-than-normal values could be related to the following situations: 

Lower than normal levels of apo B could be related to one of the following situations:

Your doctor may request a further test to help corroborate the results of this test.

Disclaimer: All results must be clinically correlated with the patient’s complaints to make a complete and accurate diagnosis. The above information is provided from a purely educational point of view and is in no way a substitute for medical advice by a qualified doctor.

References

  1. Meeusen, J. Apolipoprotein B or Low-Density Lipoprotein Cholesterol: Is It Time for a Twenty-First-Century Lipid Marker? Clin Chem 2018 64 (6), p. 984. DOI: 10.1373/clinchem.2018.286641 Published May 2018
  2. Robert S.Rosenson. Integrated Measure for Atherogenic Lipoproteins in the Modern Era: Risk Assessment Based on Apolipoprotein B. Journal of American College of Cardiology. Volume 67. Issue 2. 19 January 2016, Pages 202-204.
  3. Morita, S. Metabolism and Modification of Apolipoprotein B-Containing Lipoproteins Involved in Dyslipidemia and Atherosclerosis. Biol Pharm Bull 39, 1-24 (2016). https://doi.org/10.1248/bpb.b15-00716
  4. Szternel L. et. al. Non-fasting lipid profile determination in presumably healthy children: Impact on the assessment of lipid abnormalities. PLoS One. 2018 Jun 21;13(6):e0198433. PMID: 29927973.
  5. Kim, S. et. al. The association between the apolipoprotein B/A-I ratio and coronary calcification may differ depending on kidney function in a healthy population. PLoS One. 2017; 12(9): e0185522. PMID: 28957410
  6. University of Rochester Medical Center [Internet]. Rochester (NY): University of Rochester Medical Center; Apolipoprotein B-100
  7. Gloucestershire Hospitals. NHS Foundation trust. National Health Service, U.K. Apolipoproteins (Apo-A1 and Apo B)
  8. Wilson DD. Manual of laboratory & diagnostic tests. Laboratory and diagnostic tests. McGraw Hill. 2008, Pp 66-67.

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