What is Apolipoprotein B?
ApoB is a protein that surrounds lipid particles, giving them stability and allowing them to circulate through the bloodstream.
All “bad” cholesterol particles contain exactly one ApoB molecule, so measuring your ApoB level is a direct count of how many “bad” cholesterol particles are circulating in your blood (something a standard cholesterol test can’t tell you).
Why Does ApoB Matter?
- Transports lipids such as cholesterol and triglycerides to cells and tissues
- Reveals cardiovascular risks that LDL-C alone may not detect, because it reflects particle count rather than cholesterol concentration
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How to Interpret ApoB
(Ranges may vary slightly by lab)
Standard reference ranges represent the middle 95% of healthy individuals but don’t necessarily reflect levels associated with longevity. Optimal ranges are derived from clinical guidelines, peer-reviewed research, and real-world outcomes data, with an emphasis on levels associated with peak functioning and reduced disease risk.
Benefits of Optimizing ApoB
- Lower risk of major cardiovascular events such as heart attack and stroke
- Reduced risk of all-cause and cardiovascular mortality
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Low ApoB Levels
Low ApoB levels are usually associated with lower cardiovascular risk and rarely require medical intervention.
High ApoB Levels
Elevated ApoB is usually asymptomatic but indicates a higher risk of cardiovascular disease even when LDL appears normal.
Symptoms:
- Usually none
Causes:
- A diet high in saturated/trans fats
- Metabolic conditions (e.g.: diabetes, insulin resistance)
- Hypothyroidism
- Obesity
- Lack of physical activity
- Genetic lipid disorders (familial hypercholesterolemia)
Healthspan Impacts:
- Increased risk of heart attack, stroke, and peripheral artery disease
- Higher risk of cardiovascular and all-cause mortality
How Hone Treats Out of Range ApoB
Hone takes a proactive approach to heart health by identifying cardiovascular risk early through comprehensive biomarker testing. ApoB is evaluated alongside LDL, HDL, triglycerides, inflammatory markers, and metabolic health indicators to measure the number of atherogenic lipoprotein particles and better assess cardiovascular risk. Treatment focuses on reducing ApoB levels and lowering your risk of heart disease.
- Statins (e.g. Rosuvastatin)* – to reduce ApoB by lowering LDL
- Cholesterol absorption inhibitors (e.g. Ezetimibe)* – to reduce ApoB by lowering LDL
- Metformin – to lower ApoB in people with insulin resistance
- GLP-1 receptor agonists — to improve glucose regulation and improve insulin sensitivity
- PCSK9 inhibitors* – to lower ApoB and LDL
- Bempedoic acid* – to lower ApoB by reducing cholesterol synthesis
*Your Hone Physician does not prescribe these treatments but will recommend further evaluation and help coordinate care with your primary care provider when medical treatment is indicated.
- Berberine2
- Omega-3 fatty acid3
- Red yeast rice4
- Adopt a heart-healthy diet such as the Mediterranean diet
- Participate regularly in aerobic and resistance training
- Limit alcohol intake
- Manage stress
- Get at least 7-8 hours of quality sleep per night
Richardson, T.G., et al. (2021). Effects of apolipoprotein B on lifespan and risks of major diseases including type 2 diabetes: a mendelian randomisation analysis using outcomes in first-degree relatives. The Lancet Healthy Longevity.
↑Blais, J. E., Huang, X., & Zhao, J. V. (2023). Overall and Sex-Specific Effect of Berberine for the Treatment of Dyslipidemia in Adults: A Systematic Review and Meta-Analysis of Randomized Placebo-Controlled Trials. Drugs.
↑Skulas-Ray, A.C., et al. (2014). Dose Response Effects of Marine Omega-3 Fatty Acids on Apolipoproteins, Apolipoprotein-Defined Lipoprotein Subclasses, and Lp-PLA2 in Individuals with Moderate Hypertriglyceridemia. Journal of Clinical Lipidology.
↑Minamizuka, T., et al. (2021). Low dose red yeast rice with monacolin K lowers LDL cholesterol and blood pressure in Japanese with mild dyslipidemia: A multicenter, randomized trial. Asia Pacific Journal of Clinical Nutrition.
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Reviewed for Accuracy by Our Medical Review Board
This biomarker information has been reviewed by a member of Hone’s medical review board. As part of the medical review team, physicians fact-check this content against the latest research and their own experience treating their patients.
Ashley Winter, M.D., is a board-certified urogynecologist trained at Weill Cornell and Cleveland Clinic. She specializes in female and male sexual dysfunction, urinary issues, genital pain, and hormone therapy.
James Staheli, D.O., is the Medical Director for Broad Health, Hone Health’s affiliated medical practice and a family medicine doctor in Atlanta, Georgia.
