The cholesterol number we read first, and why it can be high when your LDL looks fine.
Cholesterol does not travel on its own. It rides in particles, and every particle that can lodge in an artery wall carries exactly one protein called ApoB. Count the ApoB and you have counted the particles.
Why not just LDL?
LDL cholesterol tells you how much cholesterol is being carried, not how many particles carry it. Two people with the same LDL can have very different particle counts. The one with more particles has the higher risk.
This happens most often in people with insulin resistance or high triglycerides, which is exactly the group a normal cholesterol test reassures.
What we do with it
We read ApoB alongside Lp(a), blood pressure and the carotid scan. If it is high, the plan usually starts with food and training, and we measure again at three months. If it does not move enough, we talk about medication.
