If you've had a lipid panel done, you've probably seen your total cholesterol, LDL, HDL, and triglycerides. Those are the standard numbers. But there's a marker that's increasingly recognized as a better predictor of cardiovascular risk than any of them, and most people have never had it tested.
That marker is Apolipoprotein B, or ApoB.
What ApoB Actually Measures
Every particle in your blood that can contribute to plaque buildup in your arteries (LDL, VLDL, IDL, and Lp(a)) carries exactly one molecule of Apolipoprotein B on its surface. ApoB gives you a direct count of how many of these atherogenic particles are circulating in your blood.
Standard LDL cholesterol measures the total amount of cholesterol carried by LDL particles. But LDL particles vary in size. Two people can have the same LDL cholesterol number but very different numbers of actual particles.
Put simply: LDL cholesterol tells you about the cargo. ApoB tells you about the number of ships. And the number of ships is what matters most.
Why ApoB Is a Better Marker
Research over the past two decades has consistently shown that ApoB is a stronger predictor of cardiovascular events than LDL cholesterol alone. You can have a "normal" LDL number but an elevated ApoB, meaning you have a high particle count despite seemingly normal cholesterol. This is called discordance.
Why Your Doctor Probably Won't Order It
Despite growing recognition of ApoB's value, it's not part of the standard lipid panel ordered by most family doctors in Ontario. Adding ApoB requires a separate order with a specific clinical rationale. Under OHIP, there needs to be a medical indication.
What's a Good ApoB Level?
ApoB is measured in grams per litre (g/L):
- Standard reference range: less than 1.2 g/L
- Moderate risk targets: less than 0.9 g/L
- Aggressive prevention targets: less than 0.7 g/L or even lower
How to Get Your ApoB Tested
With Bespoke Labs, you can order an ApoB test directly. Add ApoB to your cart (you can also add a full lipid panel for complete context), complete a brief health questionnaire at checkout, and a licensed physician reviews your order and issues the requisition. Walk into any Dynacare location in Ontario. No appointment needed.