Apolipoprotein CII
ApoCII; Apoprotein CII; ApoC2; Lipoprotein lipase deficiency - apolipoprotein CII; Chylomicronemia syndrome - apolipoprotein CII
Apolipoprotein CII (apoCII) is a protein found in large fat particles that the gastrointestinal tract absorbs. It is also found in very low density lipoprotein (VLDL), which is made up of mostly triglycerides (a type of fat in your blood).
This article discusses the test used to check for apoCII in a sample of your blood.
Blood is drawn from a vein (venipuncture), usually from the inside of the elbow or the back of the hand. A needle is inserted into the vein, and the blood is collected in an air-tight vial or a syringe. Preparation may vary depending on the specific test.
Maybe you've been eating fast food more often than you should, or you're not getting your recommended two-and-a-half hours of exercise each week. Or, it could be that you smoke, or your blood pressure is too high. Well, for whatever reason, you may be concerned about your risk of getting heart disease. Well, a few tests can help you learn that risk, so you can start making healthy lifestyle changes to reduce it. A coronary risk profile is a group of blood tests that measure your cholesterol and triglyceride levels. Why is it important to know these levels? Because if you have too much of these substances in your blood from eating foods like burgers and French fries, they can clog your arteries. Eventually your arteries can become so clogged that you'll have a heart attack or stroke. Men should have their cholesterol tested by the time they're 35. Women should have it checked by age 45. If you have a condition like diabetes, heart disease, stroke, or high blood pressure, have your cholesterol checked now, no matter what your age. To measure your cholesterol, your doctor will give you a blood test. If you're also having your triglyceride level checked, you may be told not to eat or drink anything for 8 to 12 hours before the test. Depending upon your heart risk, the doctor may measure just your total cholesterol level, or your total cholesterol along with your LDL, or bad cholesterol, HDL, or good cholesterol, and triglycerides. If you're of average risk of getting heart disease, your goal is to have total cholesterol of less than 200 milligrams per deciliter, LDL cholesterol lower than 130 milligrams per deciliter, HDL cholesterol higher than 40 milligrams per deciliter if you're a man, or 50 if you're a woman -- the higher the better, and triglycerides of less than 150 also, the lower the better. Although some illnesses, like arthritis, can raise your cholesterol level, generally having high cholesterol means that you're at increased risk for heart disease and stroke. It's a sign you need to work harder to keep your heart healthy. If your cholesterol levels are normal, that's great! That means that you're eating right, you're exercising, and you're taking good care of your health. You don't need to have another cholesterol test for about five years. But if your cholesterol level is high, or you've already got heart disease, high blood pressure, or diabetes, you'll need to have your cholesterol levels checked more often. Keeping close tabs on your cholesterol and triglyceride levels is one way that you can take charge of your health, and change it for the better.
How the Test is Performed
How to Prepare for the Test
You may be told not to eat or drink anything for 4 to 6 hours before the test.
How the Test will Feel
When the needle is inserted to draw blood, you may feel some pain, or only a prick or stinging. Afterward, there may be some throbbing where the needle was inserted.
Why the Test is Performed
ApoCII measurements can help determine the type or cause of high blood fats. It is not clear whether the test results improve treatment. Because of this, most health insurance companies will not pay for the test. If you do not have high cholesterol or heart disease or a family history of these conditions, this test may not be recommended for you.
Normal Results
The normal range is 3 to 5 mg/dL. However, apoCII results are usually reported as present or absent.
The examples above are common measurements for results of these tests. Normal value ranges may vary slightly among different laboratories. Some labs use different measurements or test different samples. Talk to your health care provider about the meaning of your specific test results.
What Abnormal Results Mean
High levels of apoCII may be due to a family history of lipoprotein lipase deficiency. This is a condition in which the body does not break down fats normally.
Low ApoCII levels are also seen in people with a rare condition called familial apoprotein CII deficiency. This causes chylomicronemia syndrome, another condition in which the body does not break down fats normally.
Risks
Risks associated with having blood drawn are slight but may include:
- Excessive bleeding
- Fainting or feeling lightheaded
- Hematoma (blood accumulating under the skin)
- Infection (a slight risk any time the skin is broken)
Considerations
Apolipoprotein measurements may provide more detail about your risk for heart disease, but the added value of this test beyond a lipid panel is unknown.
References
Bredefeld CL, Lau R, Hussain MM. Lipids and dyslipoproteinemia. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 24th ed. St Louis, MO: Elsevier; 2022:chap 18.
Genest J, Mora S, Libby P. Lipoprotein disorders and cardiovascular disease. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 27.
Libby P. The Vascular biology of atherosclerosis. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 24.
Meeusen JW, Ueda M, Nordestgaard BG, Remaley AT. Lipids and lipoproteins. In: Rifai N, Chiu RWK, Young I, Burnham C-A D, Wittwer CT, eds. Tietz Textbook of Laboratory Medicine. 7th ed. St Louis, MO: Elsevier; 2023:chap 36.
Mora S, Martin SS. Measurement of low-density lipoprotein cholesterol, non–high-density lipoprotein cholesterol, apolipoprotein B, and low-density lipoprotein particle concentration. In: Ballantyne CM, ed. Clinical Lipidology: A Companion to Braunwald's Heart Disease. 3rd ed. Philadelphia, PA: Elsevier; 2024:chap 3.
Robinson JG. Disorders of lipid metabolism. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 190.
Version Info
Last reviewed on: 5/8/2024
Reviewed by: Thomas S. Metkus, MD, Assistant Professor of Medicine and Surgery, Johns Hopkins University School of Medicine, Baltimore, MD. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
