Apo lipoprotein B, Total Cholesterol, HDL-C, Non HDL-C, LDL-C and Triglycerides as Risk factors of Atherosclerotic Vascular disease

Objective: To find out the relative significance of serum levels of Apolipoprotein B versus Total Cholesterol, HDL cholesterol, Non HDL cholesterol, LDL cholesterol and Triglycerides in atherosclerotic vascular disease as risk factors Methods: Design: Observational case control study Setting: Medical College Chest Hospital, ThrissurKerala We measured fasting serum Apolipoprotein B and conventional fasting lipid profile in 59 clinically normal subjects (mean age 38 years) and 39 patients with atherosclerotic vascular disease admitted to Medical College Chest Hospital (mean age 59 years) .Patients on lipid lowering drugs were excluded in the study.The currently used ATP III guidelines 9 was used to select the cut off values of Total cholesterol (TC->200 mg %), HDL (<40 mg %), LDL-C (>100mg %) Non HDL (>130 mg %) and TG (>150 mg %) and cut off value for apo B (105 mg%) adopted from a previous study done by of Sakurabayashi, I, etal12which is close to the third quartile of our study (104mg%).Chi square test was used to test the significance of association of different study variables with the outcome (atherosclerotic vascular disease). Odds ratio was used to find out the degree of association of each parameter with the disease process. Result:In the present study serum Apolipoprotein B levels ?105mg% were strongly associated with atherosclerotic vascular accidents (P < 0.001). Conclusion: Among various fasting lipid parameters – Total cholesterol, HDL-C, Non HDL-C, LDL-C, Triglycerides and Apolipoprotein B, ?105mg% of Apolipoprotein B (P < 0.001) is found to be most significantly associated with atherosclerotic vascular disease. Hence measurement of Apolipoprotein B levels is highly recommendable in the risk assessment of atherosclerotic vascular disease for the early recognition of the problem and the institution of appropriate preventive treatment strategy.