Overview of the pertinence of LDL, HDL, ApoB, and Triglycerides for South Asians.

What Is ApoB?

​

Apolipoprotein B (ApoB) is a protein found on lipoprotein particles that carry fats through the blood. These include LDL (low-density lipoprotein), VLDL (very-low-density lipoprotein), and Lp(a). Each particle carries exactly one ApoB molecule. That means measuring ApoB tells you how many of these cholesterol-carrying particles are circulating. High ApoB levels mean you have a lot of these particles, which can stick to artery walls and trigger plaque buildup.

In South Asians, ApoB levels tend to be higher even when LDL cholesterol levels seem normal. This creates a hidden risk because individuals may appear healthy on a basic lipid test but actually carry more harmful lipoprotein particles not reflected in traditional cholesterol measures. (1)

​

​

What Is LDL?

​

LDL (low-density lipoprotein) is often called “bad cholesterol.” It delivers cholesterol from the liver to the body’s tissues. While your body needs some LDL, too much can lead to deposits in arteries, raising the risk of heart attacks and strokes. The problem isn't just how much LDL cholesterol (LDL-C) you have, it's how many LDL particles (LDL-P) are present. Smaller, denser LDL particles are more likely to enter the artery wall and get stuck. These particles are also more likely to oxidize or clump together, which accelerates plaque formation.

South Asians tend to have more of these small, dense LDL particles. On a cholesterol test, their LDL-C might look normal, but their actual LDL particle count (reflected by ApoB) is often high. (2)

​

What Is HDL?

​

HDL (high-density lipoprotein) is often called “good cholesterol.” It picks up extra cholesterol from tissues and arteries and returns it to the liver for recycling or disposal. HDL also has antioxidant and anti-inflammatory effects that help protect arteries. In South Asians, HDL levels are usually lower than in other groups, often by about 10 mg/dL on average. HDL particles are also smaller and therefore less effective. So even if HDL-C is within the normal range, its protective function may be reduced. (3) 

​

What Are Triglycerides?

​

Triglycerides are the main type of fat in the body. When you eat more calories than your body needs, it converts them into triglycerides and stores them in fat cells. They’re also packaged into VLDL particles by the liver and released into the blood.

Triglycerides are usually measured alongside cholesterol in a standard lipid panel. High triglyceride levels can contribute to small, dense LDL particles and lower HDL levels. This pattern, known as atherogenic dyslipidemia, is especially common in South Asians.

Studies show that 40–70% of South Asians have elevated triglycerides. This is far higher than in most Western populations and is strongly tied to insulin resistance and early-onset diabetes. (4) (5)

​

What Can Be Done?

For South Asians, relying only on total cholesterol and LDL-C can be risky. You can talk to your health care provider about getting the following tests to gain a fuller picture.

• ApoB – shows total particle count

• LDL-P – measures number of LDL particles

• Lp(a) – a genetically influenced particle that raises risk

• HDL particle size and function​