In this article, CARE will provide you with an overview of apolipoprotein B so that you can classify and understand the results of your blood test in the best possible way. You will also learn about your lipid metabolism and how to optimize your heart health.

Are you ready? Then, let's take a journey through your blood vessels.

What Is Apolipoprotein B?

Apolipoprotein B-100 is a protein that is produced in the liver by the apoB gene and plays a central role in lipoprotein metabolism – a part of your fat metabolism. [1]

Lipoprotein metabolism is a complex biological process that regulates the production, transport, and breakdown of lipoproteins in your body. Incidentally, lipoprotein particles are a complex of proteins and fats, and they transport fats, especially cholesterol, in a water-soluble form because fats are hardly soluble in water and, therefore, in our blood. [1] Did you know that 90% of our blood consists of water?

Lipoprotein metabolism, therefore, plays a crucial role in the regulation of cholesterol metabolism and has a significant impact on your heart health. [1] But in what way exactly?

ApoB-100 is a crucial component of the so-called LDL, low-density lipoprotein. LDL is a type of lipoprotein that transports cholesterol in the bloodstream to various tissues and cells in the body. ApoB-100 binds to LDL receptors in multiple tissues, allowing cholesterol to be absorbed from the bloodstream into cells. [1]

But isn't cholesterol actually harmful to us?

Cholesterol is basically a vital building block for cell membranes and is required for various biological processes. The problem with LDL particles occurs when they are present in the blood in too high a concentration.

ApoB-100 is, therefore, a central component of LDL particles. Apolipoprotein B can tend to form cholesterol deposits in your artery walls if the particle number of these is too high in your blood. A high level of LDL cholesterol and apoB-100 in the blood is associated with an increased risk of cholesterol deposits in the artery walls and can indicate arteriosclerosis, which increases the risk of a heart attack and coronary heart disease.

Interestingly enough, the apoB protein value is now considered a more reliable risk marker for heart attacks than LDL cholesterol. [2]

High levels of ApoB-100 in the blood can indicate an increased risk of cardiovascular disease, and controlling this protein is crucial to maintaining your heart health. [2]

There are two main forms of apolipoprotein.

ApoB and ApoA – In correlation with LDL and HDL

ApoB-100 is a major component of LDL (low-density lipoproteins) and is often referred to as “bad cholesterol” because it tends to transport cholesterol into the artery walls and can cause buildups there.

ApoA, in turn, is referred to as “good cholesterol” and is a component of HDL (high-density lipoprotein). ApoA plays an important role in removing excess cholesterol from the arteries and returning it to the liver.

While ApoB is associated with an increased risk of cardiovascular disease, ApoA supports heart health by removing excess cholesterol from the arteries. [2]

Therefore, the balance between ApoA and ApoB is critical. A higher level of ApoA relative to ApoB is beneficial, as it indicates the effective removal of cholesterol from the arteries and, consequently, reduces the risk of atherosclerosis and cardiovascular disease. [2]

And when should I generally have an apolipoprotein B test performed?

When Should I Make an Apolipoprotein B Test?

An apolipoprotein B-100 test is usually recommended when a doctor wants to assess your cardiovascular risk and uses this test as a predictor of heart disease and heart attacks.

This may be the case if you already suffer from cardiovascular disease or if you have risk factors. Risk factors for cardiovascular disease include high cholesterol, high blood pressure, diabetes, a family history of heart disease or obesity.

Apart from potential risk factors, it is generally advisable to have a blood test 1–2 times a year, preferably at one of your CARE Health Checkups. This allows you to check whether your lipid metabolism is healthy and efficient or whether you have too many lipids (fats that circulate in your blood).

And how is an apolipoprotein test carried out?

How Is an Apolipoprotein B-100 Test Carried Out?

The apolipoprotein B-100 test is usually carried out with a blood sample. A simple blood sample is taken, and the serum is tested for ApoB-100 in a clinical laboratory. [3]

The result is usually expressed in milligrams per deciliter (mg/dL) or milligrams per liter (mg/L) and is considered in correlation with other biomarkers, such as HDL-C and apolipoprotein A. [3]

And what should your values look like at best?

What is the Normal Value for Apolipoprotein B? — ApoB Normal Range

The normal reference values for apolipoprotein B can vary depending on the laboratory, country of origin, test method used, and your individual health status.

In general, however, lower apoB values are better, as increased apo B levels in the blood can indicate an increased risk of cardiovascular disease.

Too much apoB in your blood indicates that your fat metabolism is not keeping up with the removal of cholesterol from your blood.

The following levels of apolipoprotein A and B are considered healthy and “normal” [4]:

For Women:
Apolipoprotein A: 125 – 215 mg/dl
Apolipoprotein B: 55 – 125 mg/dl

For Men:
Apolipoprotein A: 110 – 205 mg/dl
Apolipoprotein B: 55 – 140 mg/dl

Do you have no previous illnesses in your family and are wondering about your high apolipoprotein B levels? There are several factors and life circumstances that can influence your apoB levels. [5]

It is also very important for people who suffer from a lipid metabolism disorder to keep their apolipoprotein B-100 levels low in order to protect their heart health and cardiovascular system.

The good news is that you can actively do something to improve your levels and reduce the lipids in your blood.

What Factors Can Affect My Apolipoprotein B Test?

Several factors can influence your apoB test results. Apart from genetic factors, you can keep the balance of apolipoprotein B to apolipoprotein A or HDL to LDL in balance by eating a balanced diet, getting enough exercise, and maintaining a healthy lifestyle. [5]

Avoiding alcohol or tobacco consumption can also have a positive effect on your lipid metabolism. There are also beneficial medications for people with metabolic disorders to help them lower their apolipoprotein B levels. [5]

We have summarized the most common factors that can influence your apoB-100 test and, consequently, the levels of apolipoprotein B in your blood serum:

Your Diet – A Decisive Factor for Your Blood Lipids

Your diet is an essential factor for the health of your lipid metabolism.

A diet rich in fiber, unsaturated fatty acids, and omega-3 fatty acids can help lower your apoB levels, as these nutrients reduce the formation of LDL (low-density lipoprotein) and VLDL (very-low-density lipoprotein), which contain apoB. [5]

On the other hand, an unhealthy diet rich in saturated fats, trans fats, and sugary foods can increase the formation of apoB-containing LDL particles and, therefore, increase your risk of cardiovascular disease. [5]

A balanced diet that focuses on fruits, vegetables, whole grains, and lean proteins is crucial to maintaining healthy apoB levels and preserving your heart health.

Medication – A Boon for Lipid Metabolism Disorders

Certain medications can affect apolipoprotein B (ApoB) levels, especially when treating dyslipidemia and cardiovascular disease. So, if you already suffer from dyslipidemia, specific medications can help you keep your blood lipids in check and regulate your lipid metabolism. [6]

Statins, a commonly prescribed class of drugs, lower apoB levels by reducing the production of LDL (low-density lipoprotein). Many people with advanced cardiovascular disease are prescribed statins to help them protect their heart health and reduce their risk of heart attacks.

Fibrate medications, Fibrates, can also lower apoB levels by reducing triglyceride levels and VLDL (very low-density lipoprotein), which contain apoB. They are a medication regularly used in the management and treatment of dyslipidemia

On the other hand, certain medications, such as oral contraceptives or glucocorticoids, can increase your apoB levels even though you may otherwise be eating a healthy diet and getting plenty of exercise.

The use of medication to control apolipoprotein B levels should always be under medical supervision and in conjunction with other approaches to heart health, such as a healthy lifestyle.

Your Lifestyle – Live Healthy and Be Active

Your lifestyle has a significant impact on your apolipoprotein B (apoB) levels.

A healthy lifestyle consisting of regular physical activity and a balanced diet emphasizing whole grains, fruits, vegetables, and healthy fats can help keep your apolipoprotein B levels healthy. [5]

In contrast, an unhealthy lifestyle characterized by inactivity and a diet rich in saturated fats, trans fats, and industrial sugar can increase the formation of apoB-containing LDL particles and increase the risk of cardiovascular disease. Smoking and excessive alcohol consumption can also have unfavorable effects on your apolipoprotein B levels and your CVD risk. [5]

Maintaining a healthy lifestyle is, therefore, crucial to improving your apolipoprotein B levels and your overall heart health. [5]

Genetics – Lipid Metabolism Disorders

Genetic predispositions can affect how your body produces and metabolizes LDL (low-density lipoprotein) and VLDL (very-low-density lipoprotein). Some genetic variants can cause your body to produce more apoB-rich lipoproteins, leading to higher apolipoprotein B levels. [7]

In addition, genetic factors can influence your body's response to certain foods. For example, some people may respond more strongly to dietary intake of saturated fats, which can lead to increased apoB levels, while others may be less affected. [7]

It is important to note that while genetic predispositions play a role, they are not the sole determinant of ApoB levels.

Despite genetic predispositions, a healthy lifestyle and balanced diet can help control your apolipoprotein B levels and reduce cardiovascular disease risk.

What Do My Apolipoprotein B-100 Test Results Mean?

An elevated apoB level can signal an increased risk of cardiovascular disease and is an indicator that something needs to be changed to balance and regulate your values again.

A high particle number of apolipoprotein B in your blood suggests that your lipid metabolism cannot remove enough cholesterol from your blood – this can lead to plaque buildup in your arteries. [1] [2]

Your apolipoprotein B test results are a risk assessment for heart disease that should always be considered in conjunction with other factors such as your overall lipid profile, your total cholesterol levels, and your individual health status. [2]