The number of particles is more important than the amount of cholesterol
Each atherogenic particle—LDL, VLDL, lipoprotein(a)—contains exactly one ApoB molecule. Therefore, the concentration of ApoB is directly equal to the number of such particles in the blood. This is fundamental: it is the number of particles penetrating the vascular wall that determines the development of atherosclerosis, and not the amount of cholesterol inside them. In some patients, especially those with diabetes and metabolic syndrome, the particles are small and poor in cholesterol - the LDL level appears acceptable, while the number of particles and the actual risk are high. Current international guidelines suggest ApoB as a more accurate indicator for risk assessment and monitoring of lipid-lowering therapy.
Why preparation is so important
The laboratory result is a number, but the correct number can only be obtained if the rules are followed. Eating changes the levels of glucose, lipids and a number of enzymes significantly; physical activity the day before increases CK and AST; smoking affects hormones; time of day is critical for cortisol and testosterone.
Therefore, a “bad analysis” often turns out to be a consequence of impaired preparation, and not an illness, and leads to unnecessary examinations and prescriptions.
General rules for donating blood
- on an empty stomach 8–12 hours, you can drink water
- Eliminate alcohol and intense exercise per day
- no smoking in an hour
- donate blood before physiotherapy, x-rays and massage
- Take medications in advance by agreeing with your doctor
- for hormones in women, take into account the day of the cycle
How to read the result
Reference values depend on the method and equipment of the laboratory, so it is correct to compare results only within the same laboratory. A deviation of a few percent from the normal limit in itself rarely matters - the overall picture and dynamics are important. It is up to the physician to interpret the analysis: an isolated indicator without a clinical context is often misleading.