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As stated in the societies below:

  • American Academy of Clinical Chemistry
  • Canadian Cardiovascular Society
  • European Society of Cardiology
  • European Atherosclerosis Society
  • American College of Cardiology
  • American Academy of Clinical Endocrinologists
  • American Diabetes Association
  • National Lipid Association
In patients with Diabetes, Pre-diabetes, or Metabolic Syndrome:

41% of patients with an LDL-cholesterol <70 (formerly considered at lowest  5% of risk) had an LDL Particle number >1300 actually placing them in the top 50% percentile for risk.

(The LDL-cholesterol actually underestimated their risk by a factor of 10!)

W. Cromwell and J. Otvos  American Journal of Cardiology 2006; 98: 1599-1602

In typically “healthy” patients:

LDL-Particle number was twice as sensitive in detecting risk as was LDL-cholesterol.

Framingham Offspring Study Comwell Journal of Clinical Lipidology 2007; 1: 583-592

“Given the central causal role of apoB containing lipoproteins in the initiation and progression of atherosclerosis, direct measurement of … apoB containing lipoproteins to both estimate risk and guide treatment decisions would be ideal.”

– European Heart Journal (2019) 00, 1-78

“ApoB measurements are superior to the measurement or calculation of LDL-Cholesterol and Non-HDL-Cholesterol.”

–  EAS/EFLM Consensus Initiative: Quantifying atherogenic lipoproteins.  Clin Chem (2018); 64: 1006-1033.