Improving Assessment of Coronary Heart Disease Risk in Chinese

Scientists report in the November 2007 issue of the Journal of Lipid Research that the concentration of a compound called apolipoprotein B in the blood is better at predicting whether Chinese have coronary heart disease – in which fatty deposits clog arteries that supply blood and oxygen to the heart – than other substances such as blood cholesterol levels. This finding could help improve the diagnostic and treatment of coronary heart disease in Chinese and maybe in other populations as well.

To diagnose the early stages of coronary heart disease, physicians usually measure levels of substances present in the blood, such as high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), total cholesterol, and apolipoprotein B, which act as “markers” of the disease. But these markers are not very accurate and whether some of them are better at predicting the onset of the disease is not clear yet.

Kuo-Liong Chien, Yuan-Teh Lee and colleagues compared the levels of the markers in over 3,500 participants who did not have the disease at the time of recruitment but some of whom (122 individuals) developed the disease 13 years later. The scientists then compared which of the three substances would have best predicted the onset of the disease and found that the risk of developing coronary heart disease was more than three times as high in participants with the highest values of both apolipoprotein B and the ratio of the total cholesterol over HDL-C than patients who did not have the disease.

The scientists conclude that apolipoprotein B is more strongly associated than LDL-C with the risk of developing coronary heart disease. They add that non-HDL cholesterol is an important predictive factor for CHD among Chinese, more so than LDL cholesterol and that the ratio of total cholesterol over HDL cholesterol can strongly predict coronary heart disease.

Based on these results, the researchers recommend that apolipoprotein B should be included in the comprehensive evaluation of risk for this disease in Asian populations.

Article: “Apoliporotein B and non-high-density lipoprotein cholesterol and risk of coronary heart disease in Chinese,” by Kuo-Liong Chien, Hsiu-Ching Hsu, Ta-Chen Su, Ming-Fong Chen, Yuan-Teh Lee, and Frank B. Hu

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