I heard on a doctor podcast that it's the Apo B that's the killer. "Apo B" is considered the "killer LDL" because it represents the protein component of all atherogenic lipoprotein particles, including LDL, and is a more accurate indicator of cardiovascular risk compared to just measuring LDL cholesterol levels alone; essentially, a higher Apo B level indicates a higher number of potentially harmful LDL particles circulating in the blood, making it a better marker for atherosclerosis development.
Key points about Apo B:
What it is:
Apolipoprotein B (Apo B) is a protein found on the surface of all atherogenic lipoproteins, including LDL, VLDL, and IDL.
Why it's important:
Since each lipoprotein particle carries only one Apo B molecule, measuring the level of Apo B gives a more accurate picture of the total number of potentially harmful particles in the bloodstream, even if the LDL cholesterol level appears normal.
Clinical implications:
High levels of Apo B are strongly associated with an increased risk of cardiovascular disease, even when LDL cholesterol levels are seemingly within normal range.
https://www.jacc.org/doi/10.1016/j.jacc.2020.11.079.