TY - JOUR
AU - Stern, Ralph, H
AB - To the Editor: In the recent special report on the assessment of apolipoprotein B (apoB)1 and nuclear magnetic resonance particle number (1), the authors recommended that measurement of particle number be incorporated into the guidelines for the assessment of cardiovascular disease (CVD) risk. However, the literature reviewed provides no basis for this recommendation. Searching the literature using the key terms apo B and LDL-P (LDL particle number) and the name Otvos, the authors identified 25 studies evaluating association with CVD or events, metabolic syndrome, diabetes mellitus or diabetic complications, plasma lipids and lipoproteins, or miscellaneous events. Not only were different associations studied, but adjustment for other risk factors varied considerably and hardly ever included lipid panel components. This information only supports the conclusion that apo B and LDL-P are risk factors. In addition, the disclosures inadequately inform the reader of a substantial conflict of interest. Four, not 3, of the authors are affiliated with HDL, which is Health Diagnostic Laboratory, Inc. The company's website (www.hdlabinc.com) indicates it offers “the most comprehensive laboratory test menu of risk factors and biomarkers for cardiovascular and related diseases.” Because, as the authors mention, 216 000 000 lipid panels are performed annually in the US, implementation of their recommendation would have huge financial implications. Recommending measurement of particle number will become plausible only when clinically significant improvement in risk stratification can be demonstrated over that based on conventional risk factors. The references cited do not document such improvement, and the comparison of single risk factors, e.g., LDL cholesterol vs particle number, does not adequately address this question. 1 Nonstandard abbreviations: apoB apolipoprotein B CVD cardiovascular disease LDL-P LDL particle number. " Author Contributions:All authors confirmed they have contributed to the intellectual content of this paper and have met the following 3 requirements: (a) significant contributions to the conception and design, acquisition of data, or analysis and interpretation of data; (b) drafting or revising the article for intellectual content; and (c) final approval of the published article. " Authors' Disclosures or Potential Conflicts of Interest:No authors declared any potential conflicts of interest. Reference 1. Cole TG , Contois JH, Csako G, McConnell JP, Remaley AT, Devaraj S et al. Association of apolipoprotein B and nuclear magnetic resonance spectroscopy-derived LDL particle number with outcomes in 25 clinical studies: assessment by the AACC Lipoprotein and Vascular Diseases Division Working Group on Best Practices . Clin Chem 2013 ; 59 : 752 – 70 . Google Scholar Crossref Search ADS PubMed WorldCat © 2013 The American Association for Clinical Chemistry This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model)
TI - Apolipoprotein B and Nuclear Magnetic Resonance Particle Number
JO - Clinical Chemistry
DO - 10.1373/clinchem.2013.208058
DA - 2013-08-01
UR - https://www.deepdyve.com/lp/oxford-university-press/apolipoprotein-b-and-nuclear-magnetic-resonance-particle-number-ouriurdry0
SP - 1276
VL - 59
IS - 8
DP - DeepDyve
ER -