Comparison of laboratory parameters as risk factors for the presence and the extent of coronary or carotid atherosclerosis: the significance of apolipoprotein B to apolipoprotein all ratio

We compared several "new" risk factors (autoantibodies to oxidatively modif ied low density lipoprotein (LDL), sialic acid content of LDL, bilirubin an d C-reactive protein) with "conventional" risk factors (apolipoprotein (apo ) Al, All and B, lipoprotein(a), triglycerides, and total, LDL and high den sity lipoprotein (HDL) cholesterol) for the presence and the extent of coro nary or carotid atherosclerosis. Forty male patients with angiographically proven coronary atherosclerosis and 31 male patients with ultrasound-proven extracranial carotid atherosclerosis were compared to 40 age matched (53 /- 5 years) healthy males as control subjects, with negative parental histo ry of atherosclerosis, no clinical signs of systemic or organ-related ische mic disease and normal extracranial carotid arteries. The apo B/apo All rat io most powerfully indicated the presence and the extent of coronary or car otid atherosclerosis. Elevated lipoprotein(a) contributed significant addit ional information in the assessment of the atherosclerotic risk. Increase i n C-reactive protein indicated the presence (but not the extent) of coronar y or carotid atherosclerosis with a similar power as lipoprotein(a). Decrea sed values of total bilirubin indicated the presence of atherosclerosis onl y in smokers. Autoantibodies to oxidatively modified LDL additionally descr ibed the atherosclerotic process, but were less important than apolipoprote ins, lipoprotein(a), C-reactive protein or bilirubin. Sialic acid content o f LDL added no information to the parameters discussed above. We demonstrat ed that in male patients apolipoproteins, especially the apo B/apo All rati o, were better indicators of the presence and the extent of coronary or car otid atherosclerosis than C-reactive protein, bilirubin, autoantibodies to oxidatively modified LDL or sialic acid content of LDL.