Apolipoprotein B and Cardiovascular Disease Risk: Position Statement from the AACC Lipoproteins and Vascular Diseases Division Working Group on Best Practices
Apolipoprotein B and Cardiovascular Disease Risk: Position Statement from the AACC Lipoproteins and Vascular Diseases Division Working Group on Best Practices
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DOI：
10.1373/clinchem.2008.118356
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发表时间：
2009-03-01
影响因子：
9.3
通讯作者：
Warnick, Russell
中科院分区：
文献类型：
--
作者：
Contois, John H.;McConnel, Joseph P.;Warnick, Russell
背景技术背景：近20年来，低密度脂蛋白胆固醇（LDL-C）一直是评估心血管风险的基石指标。最近的数据表明，载脂蛋白B（apo B）是循环LDL颗粒数（LDL-P）浓度的更好指标，并且是比LDL-C更可靠的风险指标，越来越多的人支持在常规血脂检查中增加载脂蛋白B测定以评估和监测心血管疾病（CVD）风险患者将增强患者管理的想法。在这份报告中，我们回顾了载脂蛋白B和低密度脂蛋白-P的研究报告的日期，讨论其测量的潜在优势，低密度脂蛋白-C，并提出相关的信息standardizations.CONCLUSIONS：符合最近通过的加拿大指南，除了载脂蛋白B是一个合乎逻辑的下一步国家胆固醇教育计划成人治疗小组III（NCEP ATP III）和其他指南在美国。考虑到教育医生和患者使用LDL-C已经花了多年时间，改变观念和实践并不容易。因此，在apo B的优效性得到普遍认可之前，考虑将apo B与LDL-C沿着用于评估中期LDL相关风险似乎是谨慎的。(C)2008年美国临床化学协会
BACKGROUND: Low-density lipoprotein cholesterol (LDL-C) has been the cornerstone Measurement for assessing cardiovascular risk for nearly 20 years.CONTENT: Recent data demonstrate that apolipoprotein B (apo B) is a better measure of circulating LDL particle number (LDL-P) concentration and is a more reliable indicator of risk than LDL-C, and there is growing support for the idea that addition of apo B measurement to the routine lipid panel for assessing and monitoring patients at risk for cardiovascular disease (CVD) would enhance patient management. In this report, we review the studies of apo B and LDL-P reported to date, discuss potential advantages of their measurement over that of LDL-C, and present information related to standardization.CONCLUSIONS: In line with recently adopted Canadian guidelines, the addition of apo B represents a logical next step to National Cholesterol Education Program Adult Treatment Panel III (NCEP ATPIII) and other guidelines in the US. Considering that it has taken years to educate physicians and patients regarding the use of LDL-C, changing perceptions and practices will not be easy. Thus, it appears prudent to consider using apo B along with LDL-C to assess LDL-related risk for an interim period until the superiority of apo B is generally recognized. (C) 2008 American Association for Clinical Chemistry