Clinical Science (2008) 114, 149–155 - A.D. Sniderman and others - ApoB and non-HDL-C in dyslipoproteinaemia

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Clinical Science (2008) 114, (149–155) (Printed in Great Britain)

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Non-HDL cholesterol and apoB in dyslipidaemia

Allan D. SNIDERMAN*, Jean-Charles HOGUE*, Jean BERGERON†, Claude GAGNÉ† and Patrick COUTURE†

*The Mike Rosenbloom Laboratory for Cardiovascular Research, McGill University Health Centre, Royal Victoria Hospital, Montreal, QC, Canada H3A 1A1, and †Lipid Research Centre, Laval University Medical Centre, Quebec City, QC, Canada G1V 4G2

Key words: apolipoprotein B (apoB), dyslipidaemia, lipoprotein, low-density lipoprotein (LDL), non-high-density lipoprotein cholesterol (non-HDL-C), triacylglycerol, very-low-density lipoprotein (VLDL).

Abbreviations: apo, apolipoprotein; CM, chylomicron; HDL, high-density lipoprotein; LDL, low-density lipoprotein; LDL-C, LDL cholesterol; HDL-C, HDL cholesterol; ROC, receiver operating characteristic; TG, triacylglycerol; VLDL, very-LDL.

Correspondence: Professor Allan D. Sniderman (email allansniderman@hotmail.com) or Dr Patrick Couture (email patrick.couture@crchul.ulaval.ca).

On the basis of a high correlation, non-HDL-C (non-high-density lipoprotein cholesterol) and apoB (apolipoprotein B) have been suggested to be of equivalent value for clinical practice; however, the strength of this relationship has not been examined in detail in patients with dyslipidaemia. The present study examines the variance of non-HDL-C compared with apoB in 1771 consecutive patients evaluated in a lipid clinic. These patients were divided into normolipidaemic subjects (n=407), type I hyperlipoproteinaemia (n=16), type IIa (n=736) and IIb (n=231) hyperlipoproteinaemia, type III hyperlipoproteinaemia (n=38), type IV hyperlipoproteinaemia (n=509) and type V hyperlipoproteinaemia (n=101). The relationship between non-HDL-C and apoB was examined both in terms of correlation and concordance. Correlation was high, but concordance was only moderate in the normolipidaemic subjects and in those with type IIa and type IIb hyperlipoproteinaemia. Correlation and concordance were both low in the subgroups with type III and type V hyperlipoproteinaemia. In those with type IV hyper-lipoproteinaemia, correlation was moderately high (r=0.74), but concordance was only fair. In conclusion, our results indicate that there is substantial variance of apoB for given values of non-HDL-C in many dyslipidaemic subjects. It follows that correlation is not adequate as a sole judge of equivalence of laboratory parameters.