Fasting plasma of apolipoprotein (apo) B48 concentrations in adolescents were found to be associated with measures of adiposity and features of the metabolic syndrome in adolescents, according to a study published in Atherosclerosis.

ApoB-remnant lipoproteins are associated with early cardiovascular disease (CVD) risk and the incidence of end-stage CVD-related events. In this cross-sectional study, researchers examined the association between the concentration of fasting plasma apoB-lipoprotein remnants, apoB48, and cardiometabolic risk factors in adolescents.

Participants were recruited from the population-based pregnancy cohort in Western Australia study. Adolescent boys and girls (n=1045; 48% girls; 85% with both parents Caucasian) aged 17 years with complete fasting plasma apoB48, biochemical, and anthropometry data were enrolled. In this cohort, 21% of participants were smokers, 50% had consumed alcohol in the past week, and 31% of the girls were using an oral contraceptive. Measures such as body mass index (BMI), homeostasis model assessment index of insulin resistance (HOMA-IR), fasting plasma triglycerides, and systolic blood pressure were used to define the high-risk metabolic cluster variable.

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The mean fasting plasma apoB48 concentration was 19% higher in boys vs girls (15.28 ± 2.95 μg/mL vs 12.45 ± 2.43 μg/mL, respectively;P =.0003), 21% higherin the high–risk metabolic cluster group(3.60 μg/mL; P = 0.0000), and this increase in the high-risk metabolic cluster group was more prominent in boys vs girls (increase: 31% or 6.15 μg/mL; P =.0000).

Girls had higher levels of total cholesterol, low- and high-density lipoprotein-cholesterol (LDL-C and HDL-C, respectively), as well higher levels of fasting plasma insulin, leptin, and adiponectin compared with boys.

After adjusting for sex, oral contraceptive use in girls, and BMI, fasting plasma apoB48 was found to be positively associated with fasting plasma triglycerides, total-cholesterol (but not LDL-C), insulin, leptin, HOMA-IR, waist-circumference, and skinfold-thickness in a multivariable regression analysis. Fasting plasma apoB48 was inversely associated with fasting plasma HDL-C, and adiponectin. Alcohol and smoking had no effect on outcomes, nor was there any significant effect of sex on the association between fasting plasma apoB48 concentration and outcome variables.

Limitations of the study include potential retention bias as well as lack of generalizability to adolescents of other ethnicities or of lower socio-economic status.

The authors conclude that the study results “provide evidence that remnant lipoproteins (and possibly remnant cholesterol) maybe useful to identify CVD risk in adolescents and youth.”


Krysa JA, Vine DF, Beilin LJ, Burrows S, Huang R, Mori TA, et al. ApoB48-remnant lipoproteins are associated with increased cardiometabolic risk in adolescents. Atherosclerosis. 2020; V 302, pg 20-26.