Apolipoprotein B is More Strongly Associated with Cardiovascular Risk Factors than Low-Density Lipoprotein Cholesterol in Young-to-Middle Aged Adults
Cardiovascular disease (CVD) is the leading cause of death in the United States. Medical practitioners and public health officials alike consider atherosclerosis, in which plaque buildup leads to the hardening of arteries, to be one of the main culprits in CVD morbidity and mortality. Measuring low-density lipoprotein cholesterol (LDL-C) has been touted as an effective proxy for assessing the risk for atherosclerosis. However, new emerging evidence show that traditional lipid biomarkers, such
... LDL-C, may not be as robust in CVD prediction as previously thought. Apolipoproteins, which are involved in the creation of lipoproteins, have been shown to be effective predictors of CVD events, even more so than LDL-C in some cases, but previous research have also established a non-linear trend with apolipoprotein B (ApoB) distribution when age is involved. Therefore, in light of past research, this study aims to examine potential differential associations between ApoB, LDL-C, and cardiovascular risk factors in the context of age groups. Using the 2013-2014 cycle of the National Health and Nutrition Examination Survey, we observed Spearman correlations and Wilcoxon/Kruskal-Wallis scores between various CVD risk factors (e.g.: body mass index, hypertension, diabetes status, etc.) and ApoB and LDL-C across two age cohorts. We found that ApoB has a special relationship with the younger cohort that does not manifest with LDL-C, and that this relationship attenuates in the older cohort. Based off of these results along with previous studies, assessment of CVD risk among the young would benefit from including ApoB in the already established battery of biomarkers.