Introducing the New Cholesterol Test—Apo B

INTRODUCING THE NEW CHOLESTEROL TEST—APO B

Yesterday, I came across a short article in the April/May issue of AARP magazine about a cholesterol test many of us haven’t heard of—Apo B, short for Apolipoprotein B. It’s a simple blood test that offers a more accurate assessment of cholesterol-related risk than traditional tests.

That’s promising news for those of us in our senior years, so I decided to dig a little deeper. I found an excellent article on ClevelandClinic.org titled Apo B Test. I’m sharing highlights with you below.

What is an Apo B blood test?

An Apo B test is a blood test that can help you know your risk of heart and blood vessel disease. Healthcare providers are finding that this test is more accurate than a lipid panel test, especially for people with certain conditions. Ask your provider if an Apo B test is right for you.

An Apo B or Apolipoprotein B-100 test can tell you about your risk for cardiovascular (heart and blood vessel) disease. To do this, it measures the amount of Apo B, which carries substances in your blood that help make plaque, a waxy fat that can block your arteries.

Apolipoprotein B takes lipids where they’re going. But it only gives rides to the kind of lipids that have a bad reputation: low-density lipoprotein (LDL), very low-density lipoprotein (VLDL) and others. You won’t find the good cholesterol, high-density lipoproteins (HDL), hanging around with Apo B. When you see Apo B, you can be sure LDL is there, too.

Some healthcare providers believe an Apo B test is more accurate than a lipid panel(which measures all those cholesterol types) to estimate cardiovascular disease risk.

When is an Apo B test performed?

Healthcare providers can order an Apo B test when they want an additional way to measure your cardiovascular disease risk. Having another option can give them more information if you didn’t come out high or low in the usual risk factors. Also, they may want to order the test after you start taking a statin to lower your bad cholesterol.

Researchers have found that measuring Apo B may predict heart and blood vessel disease risk better than a lipid panel test. This is because each Apo B molecule carries one of the bad lipoproteins. They can get an accurate count because of the one-to-one ratio.

Providers can subtract your HDL cholesterol from your total cholesterol from lipid panel results as a way to predict cardiovascular disease. But this isn’t accurate for everyone. Apo B testing can be a better risk predictor for people with metabolic syndrome or diabetes because their LDL may be denser or smaller.

How do I prepare for an apolipoprotein B blood test?

You don’t have to fast before Apo B testing. But you should avoid eating or drinking for 12 hours before it if you’re getting a lipid panel test at the same time. Drinking water is OK. Staying hydrated before your blood test can make it easier for a provider to find and puncture your vein.

It’s helpful to wear a shirt with short sleeves on the day of your blood test. That way, you don’t have to roll up a long sleeve.

What to expect during Apo B testing

During an Apo B test, a healthcare provider will:

1. Seat you in a chair and ask you to lay your arm out in front of you. You can rest it on the arm of the chair.
2. Tie a stretchy band tightly around your upper arm so your blood flow slows down and your vein puffs up a bit.
3. Clean the area where they’ll insert a needle. This is usually a quick swipe with an alcohol pad.
4. Put a small needle into your vein.
5. Use the needle to pull blood into a tube that holds blood.

 

What type of results do you get and what do the results mean?

Your Apolipoprotein B -100 test results can range from 20 to 400 milligrams per deciliter (mg/dL).

If your Apo B is higher than 130 mg/dL, you’re at a higher risk of heart and blood vessel disease.

Some cardiology guidelines recommend a target of less than 65 or 80 mg/dL of Apo B. They suggest these goals for people between ages 40 and 75 who take statins.

What is a normal Apo B level?

A normal Apo B level is:

• 66 to 133 mg/dL for males
• 60 to 117 mg/dL for females

Conditions that can make your Apo B test results higher

Your Apo B test results may be higher if you have:

• A pregnancy.
• High cholesterol.
• Nephrotic syndrome, a kidney issue.

Conditions that make your Apo B test results lower

Your Apo B test results may be lower if you:

• Have sepsis
• Have liver disease
• Take estrogen

When should I know the results of an Apo B test?

It’ll take several days to get your Apo B test results. Every lab is different, so ask your provider when you can expect results.

If the results are abnormal, what are the next steps?

If you have a high Apo B level, your provider will recommend the same treatments they would for high LDL cholesterol.

These include:

• Exercising for 30 minutes or more each day.
• Eating plenty of fruits and vegetables.
• Limiting saturated fats in your diet.
• Staying at a weight that’s right for you.
• Avoiding tobacco products.
• Taking a cholesterol-lowering drug.

How much does an Apo B test cost?

Independent labs in the United States offer this test for less than $100. Check with your provider or insurer to find out how much it would cost in your area.