High levels of cholesterol in the blood have been shown to b

High levels of cholesterol in the blood have been shown to be positively correlated with the incidence of artherosclerosis. Recently, the LDL:HDL ratio has been shown to be an even better indicator of this obstruction of coronary arteries. Why?

Solution

Ans:

The LDL/HDL cholesterol ratio appears to be as useful as the total/HDL cholesterol ratio. Their similarity can be explained by the fact that approximately two thirds of plasma cholesterol are found in LDL and, consequently, total and LDL cholesterol are closely related. Like the total/HDL cholesterol ratio, LDL/HDL cholesterol may have more predictive power if triglyceridemia is taken into account. Although, the increase in these ratios predicted a greater cardiovascular risk in a wide range of cholesterol or triglyceride concentrations, the risk is significantly higher when hypertriglyceridemia is present and levels of apolipoprotein (apo) B and the ratio of apo B/apo A-I are more accurate predictors of CVD risk.

The total/high-density lipoprotein (HDL) cholesterol ratio, known as the atherogenic or Castelli index and the LDL/HDL cholesterol ratio are two important components and indicators of vascular risk Llipoprotein ratios are under-used in cardiovascular prevention, but can also add to risk assessment. Therefore can be employed in cardiovascular risk factors analysis in clinical practice, specifying their cut-off risk levels and can target for lipid-lowering therapy.

Apolipoprotein (apo) B represents most of the protein content in LDL and is also present in intermediate-density lipoproteins (IDL) and VLDL. ApoA-I is the principal apolipoprotein in HDL. Both apolipoproteins, therefore, separately provide information for detecting high-risk individuals. ApoA-I is also believed to be a more reliable parameter for measuring HDL than cholesterol content since it is not subject to variation. Therefore, the apoB/apoA-I ratio is also highly valuable for detecting atherogenic risk.The apoB/apoA-I ratio was stronger than the total cholesterol/HDL holesterol and LDL/HDL cholesterol ratios in predicting risk.