Utilidad de la medición de la apolipoproteína B en la práctica clínica

Atherosclerosis is a multifactorial disease influenced by genetic and environmental factors. Besides conventional plasma lipids and lipoproteins, plasma apolipoprotein B (apo B) measurement is being proclaimed for the diagnosis of cardiovascular risk. Apo B is the structural protein of atherogenic lipoproteins and, thus, its concentration reflects the number of blood atherogenic particles present. Some patients maintain high apo B levels despite having relatively normal fasting plasma lipid levels. This has been associated with a high risk of cardiovascular complications, particularly in patients with metabolic syndrome, frequently observed in subjects with premature atherosclerosis. Recent evidence from clinical trial points to apo B as a better therapeutic target than other conventional lipid parameters. However, for its use, stardardisation of its measurement, definition of normal values and therapeutic aim are requiererd.