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By Dr. G. M. Kostner (auth.), Dr. Maryvonne Rosseneu, Prof. Dr. Kurt Widhalm, Dr. Jochen Jarausch (eds.)

There is expanding proof for the clinicial price of the apo­ lipoprotein measurements. along with ldl cholesterol in plasma and li­ poprotein fractions, that's presently used as a trademark of cardiovascular possibility, the size of the AI and B apolipopro­ teins gives you additional info in regards to the sufferers' scientific prestige. a number of experiences convey that apo B is greater and apo AI is reduce in sufferers with angiographically documented heart dis­ ease than in symptomatic sufferers with no heart affliction. additionally, discriminant research indicated that the focus of Apo AI and B in plasma are greater discriminators than lipo­ protein ldl cholesterol for settling on sufferers with heart ailment. In a few stories the apo Bjapo AI ratio seems to be a extra robust predictor than person lipoproteins. In a up to date examine conducted in males, apolipoproteins AI and B have been higher correlated with the severity of heart problems than HDL and cholesterol. The predictive strength of apolipoproteins may notwithstanding no longer be validated in all reviews and the price of apolipoprotein measurements within the box of scientific chemistry remains to be debatable. this is often most likely because of discrepancies among the result of a number of reviews, bobbing up from adjustments within the kind of immunoassays, the shortcoming of common reference fabrics, range­ ences among research protocols, diversifications within the number of sufferers and within the grading and interpretation of coronary lesions.

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This has subsequently been confirmed by others: Lehtonen et al. [23J found out that apo AI and apo AIjB ratio were the best parameters (± 70% success) to reclassify patients or controls to the correct groups, while in the study of Durrington et al. [12J, apo B levels were the best single discriminating variable between MI survivors and controls (Fig. 1). Kostner [19J found out that MI survivors were classified more accurately by apo AI and B measurements than by LDL-C or HDL-C levels. A possible confounding factor when considering the association of plasma HDL-C and apo AI levels with atherosclerotic disease is the triglyceride (TG) level.

Method comparison: Top: apo AI, turbidimetry/nephelometry; bottom: apo B, turbidimetry/nephelometry Apo AI and apo B in health and metabolic disease Table 2 shows the correlations between HDL-C and apo AI within the above defined subgroups. 20 u. 85 &. 25 (1) S Ei cr £. 28 ::r 1" ::: 0- 175 > ...... 1" x = HD L-cholesterol [mmol/I] 175 Y = apo AI BM apo AI routine [g/I] Median of reI. differences ~ .... , .... 0 "0 0 -5' > £. ) Method comparison Table 1. Apo AI, apo B, HDL-C, LDL-C, method comparison for healthy and diseased individuals on different instruments H.

The apo B levels are increased and the apo AI concentrations decreased in these patients. Different types of liver disease also affect the apolipoprotein levels. Acute hepatitis decreases the apo AI and All levels due to impaired protein synthesis. In chronic hepatitis, the apo AI and All synthesis is normal, but the hepatic lipase activity is decreased. In liver cirrhosis, the apo AI, All and B 100 concentrations are decreased due to impaired liver synthesis of these proteins. Secondary dyslipidemias can also result from diabetes mellitus.

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