ApoB Test & Atherosclerosis Risk Screening in Bangkok, Thailand

• Atherosclerosis is the most common form of coronary artery disease and a major cause of death and disability worldwide. This disease is often caused by fat buildup in the arterial wall along with chronic inflammation of the arterial wall.
• Currently, blood tests are available to screen for the risk of atherosclerosis.
• ApoB testing helps predict the risk and progression of vascular diseases better than LDL-cholesterol and can be used to detect hereditary causes of high blood lipid levels.

Atherosclerotic cardiovascular disease (ASCVD) is the most common coronary artery disease and a major cause of death and disability worldwide.

Atherosclerosis is caused by the accumulation of fat in the arterial walls along with chronic inflammation of the arterial walls. Early lesions and fatty streak formation may be found as early as in the womb and gradually progress until they cause symptoms, typically in middle age or later in life. Over time, changes in the lesions may lead to arterial narrowing or complications such as atherothrombosis due to rupture of the inner vessel wall in contact with the blood. In some cases, arterial wall fragility may lead to an arterial aneurysm, which can rupture and cause sudden bleeding, potentially resulting in disability or death.

If atherosclerosis presents with symptoms but is left untreated, it may lead to disability and often results in death within a short period. Numerous studies now indicate that treating atherosclerosis risk factors before symptoms occur can reduce the likelihood of developing the disease, lower the risk of complications, and result in a better quality of life compared to treating the disease after symptoms have appeared. For this reason, identifying risk factors and assessing risk levels are key to preventing symptoms caused by atherosclerosis.

Atherosclerosis risk assessment includes reviewing risk factor history, measuring blood pressure, waist circumference, body mass index, and blood tests. These components are essential for identifying risk factors and evaluating the level of risk for atherosclerosis. Furthermore, blood test results can be used to measure treatment outcomes and to set treatment goals.

Examples of blood tests used to assess risk factors and levels of atherosclerosis risk include:

1. Blood lipid levels
   Lipoproteins are complex compounds made up of lipids and proteins called apolipoproteins. Most lipoproteins in the body are produced by the liver and small intestine. There are several types of lipoproteins, including chylomicrons, chylomicron remnants, very low-density lipoprotein (VLDL), low-density lipoprotein (LDL), intermediate-density lipoprotein (IDL), high-density lipoprotein (HDL), and lipoprotein A (Lp(a)). Abnormalities in the synthesis, transport, breakdown, and clearance of these lipoproteins by the liver can result in various types of dyslipidemia, such as:

• Hypercholesterolemia
• Hypertriglyceridemia
• Mixed hyperlipidemia
• Low HDL levels

These abnormalities can be identified through blood tests, and most cases are linked to unhealthy lifestyle choices, such as consuming high-fat foods and lack of exercise, or inherited genetic disorders. Currently, dyslipidemia can be treated by dietary control, exercise, and medication when indicated to reduce the risk of developing atherosclerosis.

2. Special lipid blood tests
2.1 Apolipoprotein A1 
Apolipoprotein A-I (ApoA-I) is synthesized in both the liver and intestines. It is associated with the amount of HDL cholesterol. Measuring ApoA-I is useful in predicting the risk of coronary artery disease (CAD) in high-risk individuals.
2.2. Apolipoprotein B (ApoB)
ApoB testing helps predict the risk and progression of vascular diseases better than LDL-cholesterol. It can also be used to identify genetic causes of high blood lipid levels
2.3. Lipoprotein(a) (Lp(a))
Lipoprotein(a) circulates in the blood and is not regulated by the same mechanisms as LDL-cholesterol. Elevated levels are a significant risk factor for atherosclerosis. Lipoprotein(a) levels are largely determined by genetic factors and cannot be controlled by diet or lifestyle changes.
3. Homocysteine
Homocysteine is a diet-related risk factor for atherosclerosis. It is a byproduct of protein metabolism and is normally present at low levels. Elevated homocysteine levels can damage small blood vessels, such as those in the heart and brain, increasing the risk of arterial narrowing and blockage.
4. High Sensitivity C-Reactive Protein (hs-CRP)
This test measures protein levels that reflect inflammation in the body, such as inflammation in the arterial walls.
5. High Sensitivity Troponin-I
High sensitivity troponin-I testing measures cardiac biomarkers that are specific to heart muscle cells. It can be used for screening in healthy individuals without heart disease symptoms to assess future risk of cardiovascular disease.

At Samitivej Srinakarin Hospital in Bangkok, Thailand, we offer comprehensive wellness and preventive health programs designed to support long-term health and enhance quality of life. These programs include advanced risk-reducing health screenings to help slow down degeneration and promote proactive care before disease occurs.

• Hallmarks of Aging Program 
  A specialized health program at Samitivej Srinakarin Hospital designed to detect cellular-level aging factors. This innovative approach to preventive medicine in Bangkok aims to promote longevity and strength by thoroughly identifying abnormal cellular signals.
• Social Butterfly Wellness Program 
  A targeted health check-up program for individuals who consume alcohol. Conducted at our Bangkok hospital, it assesses physical condition, helps reduce the impact of alcohol, slows liver degeneration, and includes a personalized recovery plan.
• Lung Vitality Care Program 
  This wellness screening is ideal for individuals exposed to cigarette smoke or air pollution in urban environments like Bangkok. The program examines organs affected by smoking or environmental pollutants, supporting long-term respiratory health.

All programs at Samitivej Srinakarin Hospital in Bangkok, Thailand include lipid level tests and offer personalized healthcare plans tailored to individual lifestyles.