Test ID: APLB
Apolipoprotein B, Plasma
Secondary ID 
A test code used for billing and in test definitions created prior to November 2011
NY State Approved Indicates the status of NY State approval and if the test is orderable for NY State clients.
Useful For Suggests clinical disorders or settings where the test may be helpful
Definitive studies of cardiac risk factors in individuals with significant family histories of coronary artery disease or other increased risk factors
Follow-up studies in individuals with abnormal LDL cholesterol values
Confirmation of suspected abetalipoproteinemia or hypobetalipoproteinemia
Method Name A short description of the method used to perform the test
Automated Turbidimetric Immunoassay
Reporting Name A shorter/abbreviated version of the Published Name for a test; an abbreviated test name
Aliases Lists additional common names for a test, as an aid in searching
APOB
APOB-100
Apolipoprotein B+A1 ORDER 80318
Apolipoprotein B-100
Specimen Type Describes the specimen type needed for testing
Specimen Required Defines the optimal specimen. This field describes the type of specimen required to perform the test and the preferred volume to complete testing. The volume allows automated processing, fastest throughput and, when indicated, repeat or reflex testing.
Collection Container/Tube: Lavender top (EDTA)
Submission Container/Tube: Plastic vial
Specimen Volume: 1 mL
Collection Instructions:
1. Fasting-overnight (12-14 hours)
2. Patient must not consume any alcohol for 24 hours before the specimen is drawn.
Specimen Minimum Volume Defines the amount of specimen required to perform an assay once, including instrument and container dead space. Submitting the minimum specimen volume makes it impossible to repeat the test or perform confirmatory or perform reflex testing. In some situations, a minimum specimen volume may result in a QNS (quantity not sufficient) result, requiring a second specimen to be collected.
Reject Due To Identifies specimen types and conditions that may cause the specimen to be rejected
| Hemolysis | Mild OK; Gross reject |
| Lipemia | Mild OK; Gross OK |
| Icterus | Mild OK; Gross reject |
| Other | NA |
Specimen Stability Information Provides a description of the temperatures required to transport a specimen to the laboratory. Alternate acceptable temperature(s) are also included.
| Specimen Type | Temperature | Time |
|---|---|---|
| Plasma EDTA | Refrigerated (preferred) | 8 days |
| Frozen | 60 days |
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Apolipoprotein B (Apo B) is a major protein component of low-density lipoprotein (LDL) comprising >90% of the LDL proteins and constituting 20% to 25% of the total weight of LDL. Apo B exists in 2 forms. Apo B-100, the most abundant form of Apo B, is found in lipoproteins synthesized by the liver including LDL, very low-density lipoprotein, and IDL. Apo B-48 consists of the N-terminal 2152 amino acids (48%) of Apo B-100, is produced by the gut, and is found primarily in chylomicrons.
Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
> or =18 years: 48-124 mg/dL
Reference values have not been established for patients that are less than 18 years of age.
Interpretation Provides information to assist in interpretation of the test results
It is well established that increased plasma concentration of Apo B-containing lipoproteins is associated with an increased risk of developing atherosclerotic disease. Case control studies have found plasma Apo B concentrations to be more discriminating than other plasma lipids and lipoproteins in identifying patients with coronary heart disease (CHD). The utility of Apo B in determining CHD risk has been confirmed by prospective studies, although the extent to which Apo B concentrations were better than serum lipids in predicting risk was variable. Apo B measurement offers greater precision than low-density lipoprotein (LDL) cholesterol determination which is most often derived by calculation.
Abetalipoproteinemia and severe hypobetalipoproteinemia can cause malabsorption of food lipids and polyneuropathy. In patients with hyperapobetalipoproteinemia (HALB), a disorder associated with increased risk of developing CHD and with an estimated prevalence of 30% in patients with premature CHD, Apo B is increased disproportionately in relation to LDL cholesterol. Apo B quantitation is required to identify these patients and is necessary in distinguishing HALB from another common lipoprotein abnormality, familial combined hyperlipidemia.
Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
Fasting for <12 hours or intake of alcohol during the 24 hours prior to specimen collection may invalidate test results.
Clinical Reference Provides recommendations for further in-depth reading of a clinical nature
1. Bhatnagar D, Durrington PN: Measurement and clinical significance of apolipoprotein A-1 and B. In Handbook of Lipoprotein Testing. Edited by N Rifai, GR Warnick, MH Dominiczalc. Washington, DC, AACC Press, 1997, pp 177-198
2. Stein EA, Myers GL: Lipids, lipoproteins, and apolipoproteins. In Tietz Textbook of Clinical Chemistry, second edition. Edited by CA Burns, ER Ashwood, Philadelphia, PA, WB Saunders Company, 1994, pp 1002-1093
3. Kwiterovich PO Jr, Coresh J, Smith HA, et al: Comparison of the plasma levels of apolipoproteins B and A-1, and other risk factors in men and women with premature coronary artery disease. Am J Cardiol 1992;69:1015-1021
4. Stampfer MJ, Sacks FM, Salvini S, et al: A prospective study of cholesterol, apolipoproteins, and the risk of myocardial infarction. N Engl J Med 1991;325:373-381
5. Genest J, Marlin-Munley SS, McNamara JR, et al: Familial lipoprotein disorders in patients with premature coronary artery disease. Circulation 1992;85:2025-2033
6. Sniderman A, Shapiro S, Marpole D, et al: Association of coronary atherosclerosis with hyperapobetalipoproteinemia [increased protein but normal cholesterol levels in human plasma low density (beta) lipoproteins]. Proc Natl Acad Sci USA. 1980;77:604-608
Method Description Describes how the test is performed and provides a method-specific reference
Antibody to human Apo B is added to a diluted aliquot of plasma or serum. The increase in light scatter resulting from the antigen-antibody reaction is measured and is a function of the concentration of Apo B. A multi-point standard curve is used for calculation of Apo B concentrations from the light scattering values. (Contois J, McNamara JR, Lammi-Keefe C, et al: Reference intervals for plasma apolipoprotein B determined with a standardized commercial immunoturbidimetric assay: results from the Framingham Offspring Study. Clin Chem 1996;42:515-523)
Day(s) and Time(s) Test Performed Outlines the days and times the test is performed. This field reflects the day and time the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time required before the test is performed. Some tests are listed as continuously performed, which means assays are performed several times during the day.
Monday through Friday; Continuously
Analytic Time Defines the amount of time it takes the laboratory to setup and perform the test. This is defined in number of days. The shortest interval of time expressed is "same day/1 day," which means the results may be available the same day that the sample is received in the testing laboratory. One day means results are available 1 day after the sample is received in the laboratory.
Maximum Laboratory Time Defines the maximum time from specimen receipt at Mayo Medical Laboratories until the release of the test result
Specimen Retention Time Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
Performing Laboratory Location The location of the laboratory that performs the test
Test Classification Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer's instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR), Investigation Use Only (IUO) product, or a Research Use Only (RUO) product.
CPT Code Information Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Medical Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
82172
LOINC® Code Information Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the result codes returned for this test or profile.
| Result ID | Reporting Name | LOINC Code |
|---|---|---|
| APLB | Apolipoprotein B, P | 1884-6 |
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