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Why does my ApoB disagree with my LDL-C?

Asked 21 Jul 2026Modified 8 days agoViewed 3.5k times
11

I have the full paper rather than the abstract, and the supplementary appendix.

I have the document in front of me and I can read the numbers. What I cannot do is interpret them.

I am reasonably comfortable with statistics and completely uncomfortable with chromatography, or vice versa.

Which parts of this are informative and which are decoration?

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askedbea_forsberg11k1721 Jul 2026
Which equation produced the eGFR? They disagree by enough to matter at the margins. – g_paskevicius 5 months ago
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1 Answer

Accepted answer first, then by votes
53

Accepted answer

This is answerable from the trial data, but the effect sizes are modest enough that individual variation dominates.

Triglyceride reductions of twenty to thirty per cent are commonly reported in the trials in this class, with the largest reductions in those starting highest, which is the usual regression pattern plus a real effect.

Relative to absolute, worked

QuantityValueDerivation
Control-arm event rate8.0 %From the trial table, not the abstract
Hazard ratio0.80Reported
Treated event rate6.4 %8.0 × 0.80
Absolute risk reduction1.6 pp8.0 − 6.4
Number needed to treat631 ÷ 0.016
Relative risk reduction20 %1 − 0.80

The last two rows describe the same finding. Only one of them is used in headlines.

HDL cholesterol rises modestly with weight loss, and the outcome evidence for raising HDL pharmacologically is poor enough that the number is best treated as a marker rather than a target.

The Friedewald equation's bias at elevated triglycerides is well documented, and several corrected equations exist for exactly this reason.

Ask for apolipoprotein B alongside the standard panel. It costs little and it is the number that tracks risk.

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answered · acceptedDr_Colm_Fitzhenry69k24722 Jul 2026
3Small correction: eGFR is an estimate derived from creatinine, not a measurement, and the equation used matters. – tandem_gradient 2 months ago
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