Apolipoprotein B (ApoB)
Measures apolipoprotein B levels to assess cardiovascular disease risk through particle count, often considered more accurate than traditional cholesterol tests.
Select Lab Partner
What this test measures
Apolipoprotein B (ApoB) is a protein found on the surface of atherogenic lipoproteins --- particles that can contribute to plaque buildup in arteries. Each harmful lipoprotein particle, including LDL, VLDL, IDL, and lipoprotein(a), carries exactly one ApoB molecule. This makes ApoB testing essentially a particle counter, providing a direct measure of how many potentially dangerous cholesterol-carrying particles are circulating in the bloodstream.
Unlike traditional cholesterol tests that measure the mass of cholesterol, ApoB testing counts the actual number of atherogenic particles in the blood, which research shows is a better predictor of heart disease risk. If LDL particles are predominantly small and dense, individuals will have a greater number of these particles for any given LDL cholesterol level compared to someone with larger particles. The more particles traveling through blood, the more likely they are to become stuck inside artery walls. This is why some individuals may have normal LDL cholesterol levels but elevated ApoB levels, indicating hidden cardiovascular risk.
Who should consider this test
You might consider this test if you are experiencing any of the following:
- Individuals with metabolic conditions such as diabetes, prediabetes, or metabolic syndrome, as these conditions often involve small, dense LDL particles that may not be detected by standard cholesterol tests.
- Those with a family history of premature heart disease or stroke, particularly if family members had cardiovascular events despite seemingly normal cholesterol levels.
- Patients whose traditional lipid panel results don't align with their overall risk profile, such as those with normal LDL cholesterol but other cardiovascular risk factors.
- People with elevated triglycerides (above 150 mg/dL), as high triglyceride levels are often associated with increased numbers of atherogenic particles that ApoB can detect.
- Individuals already taking cholesterol-lowering medications who want to monitor their residual cardiovascular risk beyond standard lipid measurements.
- Those with fatty liver disease, obesity, or insulin resistance, as these conditions are associated with altered lipoprotein particle composition that ApoB testing can reveal.
What to expect
Preparation
Fast for 12-14 hours before the blood draw. Only water is permitted during the fasting period. Continue taking regular medications unless specifically instructed otherwise by a healthcare provider.
Sample Type
A simple blood draw from a vein in the arm, similar to other routine blood tests. The procedure typically takes less than five minutes.
Collection
Visit a participating lab location where a trained phlebotomist will collect the blood sample. No special equipment or extended procedures are required.
Turnaround
Results are typically available within 1-3 business days and will be delivered securely through the online patient portal.
Understanding your results
ApoB test results are reported in milligrams per deciliter (mg/dL) and can range from 20 to 400 mg/dL. Generally, levels higher than 130 mg/dL indicate increased risk of heart and blood vessel disease. In healthy people, ApoB values less than 90 mg/dL are typically considered acceptable, while values between 90 and 129 mg/dL are considered borderline high to moderately elevated.
| Population | Reference Range | Notes |
|---|---|---|
| Adults (general) | Less than 90 mg/dL | Optimal level for cardiovascular health |
| Adults (borderline risk) | 90-129 mg/dL | Borderline high to moderately elevated risk |
| Adults (high risk) | 130 mg/dL or higher | Significantly increased cardiovascular risk |
Reference ranges may vary by laboratory and individual factors. Results should be interpreted by a healthcare provider in the context of your overall health.
What does a “Low” result mean?
Low ApoB levels (below 40-50 mg/dL) are less common but may result from conditions such as hyperthyroidism, liver cirrhosis, or malnutrition. Very low levels may occasionally indicate rare genetic conditions like Bassen-Kornzweig syndrome (abetalipoproteinemia), characterized by apolipoprotein B deficiency. However, most cases of low ApoB are associated with other underlying health conditions that require separate evaluation and diagnosis.
What does a “High” result mean?
Elevated ApoB levels (above 130 mg/dL) may indicate an increased risk of cardiovascular disease, as higher levels suggest more atherogenic particles circulating in the bloodstream. High ApoB levels can indicate decreased cholesterol removal from the blood, suggesting the body cannot effectively clear excess cholesterol. This reduced clearance may lead to plaque buildup that constricts arteries and increases heart disease risk. Other factors that can elevate ApoB include diabetes, metabolic syndrome, kidney disease, pregnancy, hypothyroidism, or certain medications.
Privacy & confidentiality
Your ApoB test results are completely confidential and protected under HIPAA regulations. Results are not shared with your personal physician unless you specifically request it, are not added to your medical records, and do not appear on insurance explanation of benefits statements.
Frequently asked questions
Related tests
Lipid Panel
$39Standard cholesterol test that complements ApoB measurement for comprehensive cardiovascular risk assessment
View TestC-Reactive Protein (CRP)
$49Measures inflammation that contributes to cardiovascular disease risk alongside particle measurement
View TestHomocysteine
$69Additional cardiovascular risk marker that works synergistically with ApoB for comprehensive heart disease screening
View TestInsulin
$39Insulin resistance often correlates with elevated ApoB levels and small, dense LDL particles
View TestRelated conditions
CPT Code: 82172
This test may not be available in: NY, NJ, RI
This page is for informational purposes only and does not constitute medical advice. Always consult with a healthcare provider regarding any health concerns. LevelPanel does not diagnose, treat, or prescribe.
Select Lab Partner
Not sure if this is the right test? Contact our care team for guidance.