Assessment of cardiovascular risk
Follow-up studies in individuals with basic lipid measures inconsistent with risk factors or clinical presentation
Definitive studies of cardiac risk factors in individuals with significant family histories of coronary artery disease or other increased risk factors
Test Id | Reporting Name | Available Separately | Always Performed |
---|---|---|---|
RBAA1 | Apolipoprotein B/A1 ratio | No | Yes |
APOA1 | Apolipoprotein A1, S | Yes | Yes |
APOLB | Apolipoprotein B, S | Yes | Yes |
Automated Turbidimetric Immunoassay
APOAB
Apo A
Apo A-I
Apo A1
Apo Al
Apo B
ApoA
ApoA-I
ApoA1
ApoAl
ApoB
Apolipoprotein A
Apolipoprotein A-I
Apolipoprotein A1
Apolipoprotein A1 and B-100, Plasma
Apolipoprotein AI
Apolipoprotein B
Apolipoprotein B-100
Apolipoprotein B/A1 ratio
Apolipoprotein B100
RBAA1
Serum
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Plastic vial
Specimen Volume: 1 mL
Collection Instructions: Centrifuge and aliquot 1 mL of serum.
If not ordering electronically, complete, print, and send a Cardiovascular Test Request Form (T724) with the specimen.
0.5 mL
Gross hemolysis | Reject |
Gross lipemia | OK |
Gross icterus | Reject |
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Serum | Refrigerated (preferred) | 8 days | |
Frozen | 60 days | ||
Ambient | 24 hours |
Assessment of cardiovascular risk
Follow-up studies in individuals with basic lipid measures inconsistent with risk factors or clinical presentation
Definitive studies of cardiac risk factors in individuals with significant family histories of coronary artery disease or other increased risk factors
Apolipoprotein B (ApoB) is the primary protein component of low-density lipoprotein (LDL). Apolipoprotein A1 (ApoA1) is the primary protein component of high-density lipoprotein (HDL). Elevated ApoB and decreased ApoA1 are associated with increased risk of cardiovascular disease. Multiple studies have reported that ApoB and ApoA1 are more strongly associated with cardiovascular disease than the corresponding lipoprotein cholesterol fraction (see APOA1 / Apolipoprotein A1, Serum and APOLB / Apolipoprotein B, Serum).
ApoB is present in all atherogenic lipoproteins including LDL, Lp(a), intermediate-density lipoprotein (IDL), and very low-density lipoprotein (VLDL) remnants. ApoA1 is the nucleating protein around which HDL forms during reverse cholesterol transport. The ApoB:ApoA1 ratio represents the balance between atherogenic and antiatherogenic lipoproteins. Several large prospective studies have shown that the ApoB:ApoA1 ratio performs as well, and often better, than traditional lipids as an indicator of risk.(1-3)
Males
Age | Apolipoprotein A (mg/dL) | Apolipoprotein B (mg/dL) | Apolipoprotein B/A1 ratio |
<24 months | Not established | Not established | Not established |
2-17 years | Low: <115 Borderline low: 115-120 Acceptable: >120 | Acceptable: <90 Borderline high: 90-109 High: > or =110 | <0.8 |
>18 years | > or =120 | Desirable: <90 Above Desirable: 90-99 Borderline high: 100-119 High: 120-139 Very high: > or =140 | Lower Risk: <0.7 Average Risk: 0.7-0.9 Higher Risk: >0.9 |
Females
Age | Apolipoprotein A (mg/dL) | Apolipoprotein B (mg/dL) | Apolipoprotein B/A1 ratio |
<24 months | Not established | Not established | Not established |
2-17 years | Low: <115 Borderline low: 115-120 Acceptable: >120 | Acceptable: <90 Borderline high: 90-109 High: > or =110 | <0.8 |
>18 years | > or =140 | Desirable: <90 Above Desirable: 90-99 Borderline high: 100-119 High: 120-139 Very high: > or =140 | Lower Risk: <0.6 Average Risk: 0.6-0.8 Higher Risk: >0.8 |
Elevated apolipoprotein B (ApoB) confers increased risk of atherosclerotic cardiovascular disease, even in a context of acceptable LDL cholesterol concentrations.
Extremely low values of ApoB (<48 mg/dL) are related to malabsorption of food lipids and can lead to polyneuropathy.
Reduced apolipoprotein A1 (ApoA1) confers an increased risk of coronary artery disease. Extremely low ApoA1 (<20 mg/dL) is suggestive of liver disease or a genetic disorder.
Elevated ApoB:ApoA1 ratio confers increased risk of atherosclerotic cardiovascular disease, independently of LDL and HDL cholesterol concentrations.
In very rare cases, gammopathy, in particular type IgM (Waldenstrom macroglobulinemia), may cause unreliable results.
1. Reiner Z, Catapano AL, De Backer G, et al: ESC/EAS Guidelines for the management of dyslipidaemias: The task force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS). Eur Heart J 2011;32(14):1769-1818
2. McQueen MJ, Hawken S, Wang X, et al: Lipids, lipoproteins, and apolipoproteins as risk markers of myocardial infarction in 52 countries (the INTERHEART study): a case-control study. Lancet 2008;372:224-233
3. Thompson A, Danesh J: Associations between apolipoprotein B, apolipoprotein AI, the apolipoprotein B/AI ratio and coronary heart disease: a literature-based meta-analysis of prospective studies. J Intern Med 2006;259:481-492
4. Jacobson TA, Ito MK, Maki KC, et al: National Lipid Association recommendations for patient-centered management of dyslipidemia: Part 1-executive summary. J Clin Lipidol 2014 Sep-Oct;8(5):473-488
5. Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents: summary report. Pediatrics 2011 Dec;128 Suppl 5:S213-S256
Antiapolipoprotein B antibodies react with the antigen in the sample to form antigen:antibody complexes which, following agglutination, can be measured turbidimetrically.(Package Insert: Tina-quant Apolipoprotein B, Roche Diagnostics. Indianapolis, IN. 05/2019)
Antiapolipoprotein A-1 antibodies react with the antigen in the sample to form antigen:antibody complexes which, following agglutination, can be measured turbidimetrically.(Package Insert: Tina-quant Apolipoprotein A-1, Roche Diagnostics. Indianapolis, IN. 05/2019)
APOA1: Monday through Sunday
APOLB: Monday through Saturday
This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.
82172 x 2
Test Id | Test Order Name | Order LOINC Value |
---|---|---|
APOAB | Apolipoprotein A1 and B, S | 55724-9 |
Result Id | Test Result Name |
Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
|
---|---|---|
APOLB | Apolipoprotein B, S | 1884-6 |
APOA1 | Apolipoprotein A1, S | 1869-7 |
RBAA1 | Apolipoprotein B/A1 ratio | 1874-7 |