Risk-weighted Apolipoprotein B (Risk-weighted ApoB)

Elevated ApoB is the primary driver of atherosclerotic cardiovascular disease (ASCVD), as each atherogenic lipoprotein particle carries exactly one ApoB molecule.

Common causes: diets high in saturated fat and refined carbohydrates, insulin resistance, metabolic syndrome, type 2 diabetes, familial hypercholesterolemia, hypothyroidism, nephrotic syndrome, and obesity.

Medications: androgens, progestins, diuretics, beta blockers.

Lp(a) is mostly genetically determined and stays remarkably stable across a lifetime, so an elevated level is almost always inherited rather than acquired through lifestyle.

Non genetic factors: growth hormone therapy and pregnancy (2x increase); peritoneal dialysis (2x increase versus controls); nephrotic syndrome (3-5x increase);

Low Triglycerides is seen in low carbohydrate intake / calorie deficit.

Elevated Triglycerides is seen in insulin resistance and pre-diabetes.

High Triglycerides is seen in diabetes.