Heart Health
LDL-C / ApoB Ratio
What This Marker Tells Us
Compares cholesterol content within LDL particles to particle number, revealing whether you have many small dense LDL particles or fewer large buoyant ones.
Why It Matters
Determines LDL particle size and density, which profoundly affects cardiovascular risk. Each ApoB represents one LDL particle. When LDL-C is high but ApoB is even higher, you have many small dense particles. Small dense LDL penetrates artery walls easily, oxidizes readily, and drives aggressive plaque formation. Large buoyant LDL is less atherogenic. This ratio reveals whether your cardiovascular risk is higher or lower than LDL cholesterol alone suggests.
How to Interpret Your Trends
Low ratios (below 1.2) indicate small dense LDL particles, which points to high cardiovascular risk with enhanced arterial penetration and oxidation. Typical ratios (1.2-1.4) suggest mixed particle sizes with moderate risk. High ratios (above 1.4) indicate large buoyant LDL particles which indicates a lower cardiovascular risk per particle. However, very high LDL-C with high ratio still poses risk from sheer particle number.
What Influences This Marker
High triglycerides and insulin resistance drive small dense LDL formation, lowering the ratio. Refined carbohydrates and added sugars worsen this pattern dramatically. Low-carb diets, weight loss, and exercise shift particles toward larger sizes, raising the ratio. Metabolic syndrome and diabetes favor small dense particles. Genetics influence baseline particle size distribution significantly.
How Your Team Uses It
Your coach uses this ratio to refine cardiovascular risk assessment and tailor interventions. Low ratios emphasize triglyceride reduction, carbohydrate moderation, and metabolic optimization over simple LDL lowering. It explains why some people with high LDL have minimal plaque while others with moderate LDL have extensive disease.
Related Signals We Also Review
LDL-C, ApoB, triglycerides, HDL, LDL particle size testing, insulin resistance markers, and inflammatory markers complete the cardiovascular risk phenotyping.