Non-HDL and Apo B
Non-HDL cholesterol is the total of VLDL and LDL cholesterol, both of which contain atherogenic apolipoprotein B (apo B) particles. Because it approximates the amount of apo B particles, non-HDL cholesterol is a better predictor of the risk of coronary heart disease than a simple measure of LDL cholesterol.
It's a useful measurement in people with triglyceride levels between 200 mg/dL and 500 mg/dL who likely have substantially more apo B particles. Howerver, for those with triglyceride levels above 500 mg/dL, non-HDL cholesterol may not accurately predict the risk of coronary heart disease because not all of the cholesterol contained in VLDLs has atherogenic effects.
To calculate non-HDL cholesterol, subtract HDL cholesterol from the total cholesterol. When LDL cholesterol is at goal, non-HDL cholesterol should be lowered to 30 mg/dL greater than the LDL-cholesterol goal.
Although the measure of non-HDL cholesterol is considered to be an acceptable substitute for the direct measure of apo B, a direct measure of apo B may be useful in people who are at high risk of coronary heart disease, including those with characteristics of metabolic syndrome such as high triglycerides, low HDL cholesterol, and obesity.
In addition, a measure of apolipoprotein A-1 (apo A1) may be useful as well. The INTERHEART Study found that the ratio of apo B to apo A1 predicts the risk of heart attack better than the traditional cholesterol test. This particular measurement costs extra but does not require fasting.
When reporting your test results, your doctor might refer to a cholesterol ratio. On the next page, learn what is behind these numbers.
- Cholesterol Levels: We all know there's "good" and "bad" cholesterol. Find out why you need more of one kind of cholesterol and less of the other.
- Consequences of High Cholesterol: High cholesterol can lead to a heart attack. Learn more about high cholesterol and heart attack and what other conditions high cholesterol contributes to.
- Causes of High Cholesterol: Diet and DNA are the main causes of high cholesterol. Learn why the numbers might be high in your case.
- How to Lower Cholesterol: Like many conditions, eating right and exercising helps control cholesterol. Learn what that means for you.
- How Cholesterol Works: Cholesterol is essential to the body. Find out why we need it and how much is too much.
This information is solely for informational purposes. IT IS NOT INTENDED TO PROVIDE MEDICAL ADVICE. Neither the Editors of Consumer Guide (R), Publications International, Ltd., the author nor publisher take responsibility for any possible consequences from any treatment, procedure, exercise, dietary modification, action or application of medication which results from reading or following the information contained in this information. The publication of this information does not constitute the practice of medicine, and this information does not replace the advice of your physician or other health care provider. Before undertaking any course of treatment, the reader must seek the advice of their physician or other health care provider.