Table 3.

Comparison of measurements for cardiometabolic risk

Measurement sourceLDL cholesterol onlyCholesterol in all Apo B–based particlesApo B lipoproteins
CompositionLDL cholesterol onlyLDL, IDL, VLDL cholesterolNumber of Apo B particles of all sizes
FastingYes; calculated using TG levelNoNo
AvailabilityLipid panelLipid panelSeparate laboratory order if available
Accurate at high TG levelsNoYesYes
Canadian guidelinesThresholds* and targets well definedThresholds* and targets defined for TC/HDL ratio; non-HDL levels can be calculated from recommended LDL targetsThresholds* and targets similar for medium and high risk
ATP III guidelinesThresholds* and targets well definedNon-HDL only; secondary thresholds* and targets derived from LDL targetsNot considered
European guidelinesNo thresholds* defined; targets well definedNon-HDL only; secondary targets derived from LDL targetsNo thresholds* defined; different targets for high and very high risk
Detects increased cardiometabolic risk of atherogenic dyslipidemiaMisleading when HDL levels are low and TG levels are highYes; this is the preferred measure in current office practiceYes; 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