Apo B Test

What is an Apo B blood test?

An Apo B or Apolipoprotein B-100 test is a blood test that can tell you about your risk for cardiovascular (heart and blood vessel) disease. To do this, it measures the amount of Apo B, which carries substances in your blood that help make plaque, a waxy fat that can block your arteries.

Apolipoprotein B takes lipids where they’re going. But it only gives rides to the kind of lipids that have a bad reputation: low-density lipoprotein (LDL), very low-density lipoprotein (VLDL) and others. You won’t find the good cholesterol, high-density lipoproteins (HDL), hanging around with Apo B. When you see Apo B, you can be sure LDL is there, too.

Some healthcare providers believe an Apo B test is more accurate than a lipid panel (which measures all those cholesterol types) to estimate cardiovascular disease risk.

When is an Apo B test performed?

Healthcare providers can order an Apo B test when they want an additional way to measure your cardiovascular disease risk. Having another option can give them more information if you didn’t come out high or low in the usual risk factors. Also, they may want to order the test after you start taking a statin to lower your bad cholesterol.

Researchers have found that measuring Apo B may predict heart and blood vessel disease risk better than a lipid panel test. This is because each Apo B molecule carries one of the bad lipoproteins. They can get an accurate count because of the one-to-one ratio.

Providers can subtract your HDL cholesterol from your total cholesterol from lipid panel results as a way to predict cardiovascular disease. But this isn’t accurate for everyone. Apo B testing can be a better risk predictor for people with metabolic syndrome or diabetes because their LDL may be denser or smaller.

How do I prepare for an apolipoprotein B blood test?

You don’t have to fast before Apo B testing. But you should avoid eating or drinking for 12 hours before it if you’re getting a lipid panel test at the same time. Drinking water is OK. Staying hydrated before your blood test can make it easier for a provider to find and puncture your vein.

It’s helpful to wear a shirt with short sleeves on the day of your blood test. That way, you don’t have to roll up a long sleeve.

What to expect during Apo B testing

During an Apo B test, a healthcare provider will:

1. Seat you in a chair and ask you to lay your arm out in front of you. You can rest it on the arm of the chair.
2. Tie a stretchy band tightly around your upper arm so your blood flow slows down and your vein puffs up a bit.
3. Clean the area where they’ll insert a needle. This is usually a quick swipe with an alcohol pad.
4. Put a small needle into your vein.
5. Use the needle to pull blood into a tube that holds blood.

What to expect after an Apo B test

After taking your blood sample, a provider will:

1. Remove the stretchy band from your arm.
2. Remove the needle from your arm.
3. Use gauze or a cotton ball to press on the spot where they took the needle out.
4. Put on a bandage. (You can take this off later in the day.)

What are the risks of an Apo B test?

After a blood test, most people feel fine and go on with their day. But some people feel dizzy or lightheaded. If that happens to you, sit for a few minutes until you feel better. It may help to put your head between your knees while you’re sitting or to drink some water or juice.

If you get lightheaded every time you get a blood test, you may want to ask someone to drive you to those appointments.

You may have a bruise on your arm for a couple of days. Try not to bump your arm until the bruise goes away.

What type of results do you get and what do the results mean?

Your Apolipoprotein B -100 test results can range from 20 to 400 milligrams per deciliter (mg/dL).

If your Apo B is higher than 130 mg/dL, you’re at a higher risk of heart and blood vessel disease.

Some cardiology guidelines recommend a target of less than 65 or 80 mg/dL of Apo B. They suggest these goals for people between ages 40 and 75 who take statins.

What is a normal Apo B level?

A normal Apo B level is:

• 66 to 133 mg/dL for a man or adult assigned male at birth (AMAB).
• 60 to 117 mg/dL for a woman or adult assigned female at birth (AFAB).

Conditions that can make your Apo B test results higher

Your Apo B test results may be higher if you have:

• A pregnancy.
• High cholesterol.
• Nephrotic syndrome, a kidney issue.

Conditions that make your Apo B test results lower

Your Apo B test results may be lower if you:

• Have sepsis.
• Have liver disease.
• Take estrogen.

When should I know the results of an Apo B test?

It’ll take several days to get your Apo B test results. Every lab is different, so ask your provider when you can expect results.

If the results are abnormal, what are the next steps?

If you have a high Apo B level, your provider will recommend the same treatments they would for high LDL cholesterol.

These include:

• Exercising for 30 minutes or more each day.
• Eating plenty of fruits and vegetables.
• Limiting saturated fats in your diet.
• Staying at a weight that’s right for you.
• Avoiding tobacco products.
• Taking a cholesterol-lowering drug.

When should I call my doctor?

Contact your healthcare provider if you have questions about your results or treatment.

Is Apo B the same as LDL?

No, Apo B isn’t the same as LDL. But knowing how much Apo B you have can tell you how much LDL (bad cholesterol) you have.

How much does an Apo B test cost?

Independent labs in the United States offer this test for less than $100. Check with your provider or insurer to find out how much it would cost in your area.

A note from Cleveland Clinic

Knowing your risk for a heart attack or stroke can help you make more informed decisions about your health. If your provider needs more information about your risk than a lipid panel can give, they may order an Apo B test. It’s an easy test that can give you the facts you need to live a healthier life or just make a few adjustments.