All the major lipid guidelines have maintained low-density lipoprotein cholesterol (LDL-C) as the primary measure to judge the adequacy of therapy, notwithstanding that all recognize that nonhigh-density lipoprotein cholesterol (non-HDL-C) and apolipoprotein B (apoB) are more accurate measures of cardiovascular risk than LDL-C. Indeed, the 2019 European Society of Cardiology and the European Atherosclerosis Society (ESC/EAS) guidelines (1) also state apoB is a more accurate measure of cardiovascular risk and the adequacy of lipid lowering therapy than non-HDL-C and that apoB can be measured more accurately than LDL-C or non-HDL-C. Nevertheless, the status quo persists. A recent paper by Camilla Johannesen and her colleagues adds powerfully to the already powerful accrued evidence in favor of apoB (2). This essay will address this new evidence, but I am afraid it will not matter because guidelines seem more committed to continuity with cholesterol than to evidence about apoB.

中文翻译：

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ApoB 与非 HDL-C 与 LDL-C 作为心血管疾病的标志物

所有主要的血脂指南都将低密度脂蛋白胆固醇 (LDL-C) 作为判断治疗是否充分的主要指标，尽管都承认非高密度脂蛋白胆固醇 (non-HDL-C) 和载脂蛋白 B (apoB) ) 比 LDL-C 更准确地衡量心血管风险。事实上，2019 年欧洲心脏病学会和欧洲动脉粥样硬化学会 (ESC/EAS) 指南 (1) 也指出 apoB 比非 HDL-C 更准确地衡量心血管风险和降脂治疗的充分性，并且 apoB 可以比 LDL-C 或非 HDL-C 更准确地测量。尽管如此，现状依然存在。Camilla Johannesen 和她的同事最近发表的一篇论文有力地增加了已有的有力证据支持 apoB (2)。本文将探讨这一新证据，