The headline is broadly defensible, but the qualifications matter. Effect sizes vary by population, the strongest claims rest on shorter trials, and credible voices push back on how it's typically framed.
my apob is also going to be high because my ldl is high and as you know if you listen to the lipids cholesterol podcasted a few weeks ago apob is on ldl also vldl and other apolipa proteins so this is just reflecting the fact that i have a quote high ldl
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I don't worry about APO B that is just a metric for LDL that I discussed earlier
ApoB is a lipoprotein found on low density lipoprotein LDL cholesterol which is a lipoprotein sort of balloon it's a bus that carries cholesterol and triglycerides throughout the body but apoB is also contained on a few other particles different types of apoB on chylomicrons VLDL etc. But so when we're talking about apoB it's essentially synonymous with LDL at a high level
it gives us no information on vldls it's an LDL particle metric you can't use it for anything else so don't call me up and say my a PO B is high cuz I got too many V LDL particles unless you have a rare lipid disorder where there are no LDL particles the type 3 this beta lipoprotein emia that's the only time in April B is measuring it's a VLDL measurement or a remnant measurement it's not an LDL measurement
so it's not a surrogate of particle our particle measurements april-b or LDL P so april-b is an LDL particle metric what too many people get lost there a VLDL particles are in April B particle
The realization that a poby 100 if you knew that concentration you had a proxy for how many particles you had
remember april b is a lipoprotein metric not a lipid metric
when we talk about whatever apob metric you're doing technically you are measuring vldls they're remnants their smaller vldls idls plus ldls plus lp little a but because of the half-life 90 to 95 of your apob particles are ldl particles so that's why many people say hey april b is just another way of getting an ldo particle count and that's true even in people who might have a lot of remnants the remnant particle number is quite small it is still way more ldl particles floating around in these people who might have these remnant vldls that cause issue
by measuring the concentration of apob you can completely and accurately measure the concentration of the atherogenic particles the majority of which are ldl and the reason for that is twofold the first is that every ldl has one and only one apob 100 particle on it the second is that all apob's are the same size therefore they have a molar weight and by knowing the mass you know the number
with the uh vldl particles you measuring apob B tells you nothing about the number of vldls have because although they can be particle for particle more a enic there's not very many of them
this is where I think apob by itself can be a bit misleading in other words you could have two people that both have an apob concentration that's identical but if one of them has it in the context of basically it's all LDL cholesterol and some vldl yeah they're okay um and then the other person might actually have a disproportionately high LP ltil a Andor Remnant concentration and you won't know that unless you're doing some of this additional analysis
you have the majority of them which are ldls you have vldls your garden variety vldls you have your LP little a if you have too many of those and then you might have too many Remnant vldls and of these four it's that Remnant vldl in the lp little a that pack more of a punch than their counterparts the regular Garden vldl and the LDL