# Apolipoproteins and high-density lipoprotein phospholipids as indicators of atherosclerotic cardiovascular disease in Nigeria

## TL;DR

This study shows that changes in apolipoproteins and HDL phospholipids are linked to early signs of heart disease in Nigeria.

## Contribution

The apolipoprotein B/A1 ratio is identified as a superior early marker for atherosclerotic cardiovascular disease in Nigeria.

## Key findings

- ASCVD patients had significantly higher apolipoprotein B and lower apolipoprotein A1 and HDL phospholipids compared to controls.
- The apolipoprotein B/A1 ratio emerged as a strong early marker for atherosclerotic cardiovascular disease risk.
- Elevated atherogenic lipid indices and triglycerides were observed in ASCVD patients.

## Abstract

Altered apolipoproteins and high-density lipoprotein (HDL) phospholipids are linked to premature atherosclerotic cardiovascular disease (ASCVD).

This study investigated associations between plasma apolipoprotein A1, apolipoprotein B, HDL phospholipids, and ASCVD risk in Nigeria, assessing their potential as early diagnostic markers.

This cross-sectional case-control study was conducted from November 2021 to November 2022 at Lagos State University Teaching Hospital in Nigeria. Atherosclerotic cardiovascular disease patients and healthy controls were randomly selected. The plasma apolipoprotein A1 and B levels were determined via a sandwich enzyme-linked immunosorbent assay, and the lipid profile was measured via spectrophotometry. Statistical analyses included t-tests, analysis of variance, analysis of covariance, and Pearson’s correlation.

In total, 172 confirmed ASCVD patients (mean age: 54.01 ± 8.70 years) and 55 healthy controls (mean age: 44.55 ± 11.60 years) were included in the analyses. Compared with the control values, ASCVD patients showed significantly elevated apolipoprotein B, apolipoprotein B/A1 ratio, atherogenic lipid indices, total cholesterol, low-density lipoprotein cholesterol, non-HDL cholesterol, and triglycerides (p ≤ 0.001). In contrast, plasma HDL phospholipids, apolipoprotein A1, and HDL cholesterol were markedly lower (p ≤ 0.001).

These findings indicate that altered apolipoproteins and HDL phospholipids are associated with premature ASCVD risk, with the apolipoprotein B/A1 ratio emerging as a superior marker for disease stratification.

This study identifies the apolipoprotein B/A1 ratio as a strong early marker of ASCVD risk in Nigeria.