ApoB/ApoA1 ratio and its significance to CHD - Chris M.

[Guest guest]

I just came across the INTERHEART study which reviewed 15,000 cases of MI (vs.

approx.

the same number of controls) in more than 50 countries to determine what the

most

significant risk factors for CHD across populations and sex.

The strongest risk factor globally was the ApoB/ApoA1 ratio. Persons with a

high ratio of

ApoB/ApoA1 have a 3.2x higher risk of heart attack compared to those whose ratio

is low.

From what I understand, ApoB is the carrier protein for the small, dense LDL

particles that

have been proven to be atherogenic (because of their vulnerability to oxidation

and ability

to penetrate the endothelium?), whereas ApoA1 is the carrier protein for the

larger, more

buoyant LDL that is actually protective. Is this correct?

The next question is, what causes higher levels of ApoB in relation to ApoA1?

Since ApoB

is elevated in people with diabetes and Syndrome X, I'm guessing that

hyperglycemia,

hyperinsulemia and insulin resistance must have something to do with it.

Can you shed any light on this?

Thanks,

Chris