Metabolic And Cardiovascular Obesity Scores

ApoB/ApoA1 Ratio Calculator

Clinical calculation support · Verify results before clinical use

Calculate the ratio

Enter both apolipoprotein concentrations in mg/dL.

—Ratio
A marker of the number of atherogenic lipoprotein particles.
mg/dL
Enter a numeric value greater than or equal to zero.
The principal apolipoprotein in HDL particles.
mg/dL
Must be greater than zero to calculate the ratio.
—ApoB/ApoA1
Interpretation based on thresholds in the original tool
Enter values to calculate
The result will appear here after valid values are entered.

The ratio is a risk marker, not a stand-alone diagnosis or a substitute for comprehensive cardiovascular risk assessment.

Clinical context

The ApoB/ApoA1 ratio expresses the balance between apolipoprotein B, which is present on atherogenic lipoproteins, and apolipoprotein A-I, the principal protein component of HDL. A higher ratio is associated with greater cardiovascular risk in epidemiological studies.

The INTERHEART case-control study, involving participants from 52 countries, found that the ApoB/ApoA1 ratio was strongly associated with acute myocardial infarction and performed better than conventional cholesterol ratios in that study population.

How to use this result

  • Confirm that ApoB and ApoA1 values use the same concentration unit.
  • Interpret the ratio alongside the patient's overall clinical profile and established risk assessment methods.
  • Consider ApoB and other lipid parameters individually when making treatment decisions; do not use this ratio alone to determine therapy.

Threshold note

The original calculator classifies ratios below 0.60 as low, 0.60–0.90 as moderate, and above 0.90 as high cardiovascular risk. These categories are retained for continuity with the supplied code, but should be treated as tool-specific thresholds rather than universal guideline cutoffs. Published studies and reference intervals vary by population and sex.

References

Walldius G, Jungner I.The apoB/apoA-I ratio: a strong, new risk factor for cardiovascular disease and a target for lipid-lowering therapy—a review of the evidence. J Intern Med. 2006;259(5):493–519. DOI: 10.1111/j.1365-2796.2006.01643.x.
McQueen MJ, Hawken S, Wang X, et al.Lipids, lipoproteins, and apolipoproteins as risk markers of myocardial infarction in 52 countries (the INTERHEART study): a case-control study. Lancet. 2008;372(9634):224–233. PMID: 18640459.
Walldius G, Jungner I, Aastveit AH, et al.The apoB/apoA-I ratio is better than the cholesterol ratios to estimate the balance between plasma proatherogenic and antiatherogenic lipoproteins and to predict coronary risk. Clin Chem Lab Med. 2004;42(12):1355–1363. DOI: 10.1515/CCLM.2004.254.
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