Nuclear Magnetic Resonance Analysis of Lipoprotein and Apolipoprotein Content

Risk for atherosclerotic cardiovascular disease can be assessed using nuclear magnetic resonance.

Lipoprotein fractions and lipid apolipoprotein (apo) content, with the exception of lipoprotein(a), can be quantitatively analyzed in a single serum test via nuclear magnetic resonance (NMR) lipoprotein analysis. This information can then be used to help determine risk for atherosclerotic cardiovascular disease (ASCVD). These findings were presented at the National Lipid Association (NLA) Scientific Sessions 2023, held in Atlanta, Georgia, between June 1 and June 4, 2023.

Investigators sought to analyze all lipoprotein fractions (except lipoprotein[a]) for particle number and lipid apolipoprotein content and validate use of specialized NMR software for measurement of triglycerides (TG), serum total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apoB, and apoA-I concentrations. Outcomes between men and women were compared.

Fasting serum (≥8 hours) from 1076 individuals (53.2% women) was analyzed. The investigators used 600 MHz NMR and Bruker B.I.LISA™ analytical software, as well as New York State testing criteria, for the analysis. They compared LDL-particle (P) and HDL-P via 600 MHz NMR and Numares analytical software; ApoB and apoA-I by immunoturbidimetric assays; and HDL-C, small dense LDL-C, TG, total cholesterol by standardized enzymatic methods.

There was a high correlation (r>0.95) with standardized enzymatic and immunoturbidimetric values for HDL-C, directed LDL-C, TG, total cholesterol, apoB, and apoA-I in the NMR-derived concentrations (P <.00001). There was a high correlation (r=0.920) between LDL-P values derived by Numares software analysis and values derived by Bruker software analysis (P <.0001).

Women had significantly higher large buoyant LDL1-P and LDL2-P and total LDL-P and significantly lower very low-density lipoprotein (VLDL)-P and LDL3-P (P <.00001). They had slightly higher small dense LDL6-P (P =.046), trending towards lower LDL6-C concentration (P =.071).

Women also had higher LDL-C (median percent difference [MPD], +8.89), LDL-TG, LDL-apoB, and LDL6-C (P <.01) and lower VLDL-TG, VLDL-C, and VLDL-apoB (P <.00001) compared with men. This corresponded to LDL and VLDL particle number; lower serum TG concentrations (MPD, -6.99; P =.016); and significantly higher serum apoB, apoA-1, apoA-II, and total cholesterol concentrations (P <.01).


Fernandes M, Flowers SE, Diffenderfer MR, He L, Schaefer EJ. Evaluation of lipid, lipoprotein, and apolipoprotein analysis by nuclear magnetic resonance. Abstract presented at: National Lipid Association (NLA) Scientific Sessions 2023; June 1-4, 2023; Atlanta, GA. Abstract 184.