Apolipoprotein B-48 to triglyceride ratio is a novel and useful marker for detection of type III hyperlipidemia after antihyperlipidemic intervention

Aim: remnant lipoproteins are atherogenic and are accumulated in patients with type iii hyperlipidemia (hl). although type iii hl is diagnosed by phenotyping apolipoprotein (apo) e,this procedure is time-consuming and inconvenient for routine clinical use. clinical indices for screening type iii hl in untreated hl patients have been proposed; however,in clinical settings,hl patients are promptly treated with lipid-lowering agents without diagnosing the underlying cause. we investigated whether existing clinical indices for screening type iii hl as well as the apo b-48/triglyceride (tg) ratio,which was suggested to be related to the accumulation of small chylomicron (cm) remnants,are useful after the initiation of lipid-lowering therapies. methods: in 25 normolipidemic subjects and 191 treated hl patients (type <,n = 6; iia,62; iib,66; iii,12; <,22; and <,23) from osaka university hospital and related hospitals,fasting low-density lipoprotein cholesterol (ldl-c),high-density lipoprotein cholesterol (hdl-c),tg,and apolipoproteins were measured and clinical indices were evaluated statistically. results: apo b-48 levels were significantly higher in patients with type <,iii,and < hl,and tg levels were significantly higher in patients with type and < hl. the apo b-48/tg ratio was significantly higher only in patients with type iii hl compared with other types of hl (p<0.001),and was statistically significant among the other clinical indices (auc-roc value,0.895; cut-off value,0.110). conclusion: the apo b-48/tg ratio is a novel and useful marker for detecting type iii hl even after the initiation of lipid-lowering interventions.