The case against ApoB and the ApoB:ApoA-I ratio: are they right?

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Based on similar predictive powers, the investigators of the Framingham Offspring Study concluded that the total cholesterol:HDL-cholesterol and the ApoB:ApoA-I ratios were equivalent markers of cardiovascular risk. Since the apolipoprotein ratio offered no advantage, they concluded that neither ApoB nor ApoA-I should be measured in clinical practice. This article critiques their reasoning and study design and illustrates how their data contradict their conclusion. My objective is to demonstrate the problem in using ratios to estimate risk.

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