VARIABLE | LDL | NON-HDL OR TC/HDL RATIO | APO B |
---|---|---|---|
Measurement source | LDL cholesterol only | Cholesterol in all Apo B–based particles | Apo B lipoproteins |
Composition | LDL cholesterol only | LDL, IDL, VLDL cholesterol | Number of Apo B particles of all sizes |
Fasting | Yes; calculated using TG level | No | No |
Availability | Lipid panel | Lipid panel | Separate laboratory order if available |
Accurate at high TG levels | No | Yes | Yes |
Canadian guidelines | Thresholds* and targets† well defined | Thresholds* and targets† defined for TC/HDL ratio; non-HDL levels can be calculated from recommended LDL targets | Thresholds* and targets† similar for medium and high risk |
ATP III guidelines | Thresholds* and targets† well defined | Non-HDL only; secondary thresholds* and targets† derived from LDL targets | Not considered |
European guidelines | No thresholds* defined; targets† well defined | Non-HDL only; secondary targets† derived from LDL targets | No thresholds* defined; different targets† for high and very high risk |
Detects increased cardiometabolic risk of atherogenic dyslipidemia | Misleading when HDL levels are low and TG levels are high | Yes; this is the preferred measure in current office practice | Yes; probably the most accurate measure, but often unavailable |
Apo B—apolipoprotein B, ATP—Adult Treatment Panel, HDL—high-density lipoprotein, IDL—intermediate-density lipoprotein, LDL—low-density lipoprotein, TC—total cholesterol, TG—triglyceride, VLDL—very low–density lipoprotein.
↵* Thresholds: Test levels at which drug treatment might be considered.
↵† Targets: Test levels used as goals of therapy.
Data from Genest et al,6 Anderson et al,7 Grundy et al,28 and Reiner et al.29