Your standard cholesterol test sometimes misses something. LDL measures how much cholesterol your particles carry, not how many particles you have. Markers like ApoB, hs-CRP, homocysteine and Lp(a) add information about your heart risk. For most people a regular cholesterol test is enough, but in doubt these markers can help.
What is ApoB?
ApoB counts the actual number of harmful cholesterol particles. Each LDL particle carries exactly one ApoB protein, so ApoB measures particle count, not just cargo. In some people it predicts heart risk better than LDL alone (Sniderman et al., 2019).
What is hs-CRP?
Hs-CRP is a sensitive measure of CRP, an inflammation protein. A mildly raised hs-CRP may point to low-grade vascular inflammation linked to heart risk (Ridker, 2016).
What is homocysteine?
Homocysteine is an amino acid your body breaks down using vitamin B12, B6 and folate. A raised value is sometimes linked to vascular damage, though the link is weaker than once thought (Humphrey et al., 2008).
What is Lp(a)?
Lp(a) is a largely inherited variant of LDL that barely changes with lifestyle. A high Lp(a) may raise your risk even if your regular cholesterol is fine (Kamstrup et al., 2009). It's usually measured once.
When are these markers useful?
For many people a regular lipid profile gives enough to go on. These extra markers can help with a family history or an unexpected profile. Some people choose to measure them once. They're included in our extended health checkup. The balance between your regular LDL and HDL stays the basis. Discuss these values with your GP. Every blood test result includes a professional assessment from a BIG-registered doctor. For treatment decisions, discuss your results with your GP.
References
- Sniderman AD, et al. Apolipoprotein B particles and cardiovascular disease. JAMA Cardiol. 2019. PMID: 31642874.
- Ridker PM. A test in context: high-sensitivity C-reactive protein. J Am Coll Cardiol. 2016. PMID: 26868696.
- Humphrey LL, et al. Homocysteine level and coronary heart disease incidence. Mayo Clin Proc. 2008. PMID: 18990318.
- Kamstrup PR, et al. Genetically elevated lipoprotein(a) and increased risk of myocardial infarction. JAMA. 2009. PMID: 19509380.
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