An ABC of apolipoprotein C-III: a clinically useful new cardiovascular risk factor?

Chan, D. C.; Chen, M. M.; Ooi, E. M. M.; Watts, G. F.

doi:10.1111/j.1742-1241.2007.01678.x

Cited by 85Lipid metabolism and disordersLipoproteins and Cardiovascular HealthDiabetes, Cardiovascular Risks, and Lipoproteins

An ABC of apolipoprotein C-III: a clinically useful new cardiovascular risk factor?

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Chan, D. C., Chen, M. M., Ooi, E. M. M., Watts, G. F.·2008·International Journal of Clinical Practice

DOI 10.1111/j.1742-1241.2007.01678.x

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Abstract

BACKGROUND: Hypertriglyceridaemia, commonly found in subjects with obesity and type 2 diabetes mellitus, is associated with increased risk of coronary heart disease (CHD). Apolipoprotein C-III (apoC-III) plays an important role in regulating the metabolism of triglyceride-rich lipoproteins (TRLs) and may provide a new approach to assessing hypertriglyceridaemia. AIMS: We review the role of apoC-III in regulating TRL metabolism and address the potential importance of apoC-III in clinical practice. DISCUSSION: Hypertriglyceridaemia is chiefly a consequence of alterations in the kinetics of TRLs, including overproduction and delayed clearance of very-low density lipoprotein (VLDL). ApoC-III is an inhibitor of lipoprotein lipase and of TRLs remnant uptake by hepatic lipoprotein receptors. Elevated apoC-III, usually resulting from hepatic overproduction of VLDL apoC-III, may cause accumulation of plasma TRLs leading to hypertriglyceridaemia. The results from recent observational studies demonstrate that apoC-III is a strong predictor of risk for CHD, but this chiefly relates to apoC-III in apoB-containing lipoproteins. Lifestyle and pharmacological intervention can correct hypertriglyceridaemia by a mechanism of action that regulates apoC-III transport. CONCLUSIONS: Targeting apoC-III metabolism may therefore be an important, new therapeutic approach to managing dyslipidaemia and CHD risk in obesity, insulin resistance and type 2 diabetes mellitus. However, further work is required to establish the practical aspects of measuring apoC-III in routine laboratory service and the precise therapeutic targets for serum total apoC-III and/or apoC-III in apoB-containing lipoproteins. While showing much promise as a potentially useful cardiovascular risk factor, apoC-III is not yet ready for prime time use in clinical practice.

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ApoC-I, apoC-II, and apoC-III are involved in the uptake or degradation of triglycerides, chylomicron remnants, and cholesterol-rich lipoproteins by regulation of lipoprotein lipase.
“ApoC-I, apoC-II, and apoC-III are involved in the uptake or degradation of triglycerides, chylomicron remnants, and cholesterol-rich lipoproteins by regulation of lipoprotein lipase (4-7) .”
From Automated multiplex LC-MS/MS assay for quantifying serum apolipoproteins A-I, B, C-I, C-II, C-III, and E with qualitative apolipoprotein E phenotyping (2016) · cites this paper as [4]
The ApoC-III: structure and function section says apoC-III inhibits lipoprotein lipase (LPL), while apoC-II is an LPL cofactor; the Review Criteria section links both to VLDL triglyceride breakdown. The paper does not establish an LPL-regulating role for apoC-I. It also describes clearance of cholesterol-rich chylomicron remnants by hepatic receptors, not by LPL. (LLM, conf=0.87)
Experimental — accuracy not yet measured
ApoC-III serves as an independent risk marker for CVD due to its central role in lipid metabolism.
“ApoC-III serves as an independent risk marker for CVD due to its central role in lipid metabolism [164, 165].”
From Established and Emerging Lipid-Lowering Drugs for Primary and Secondary Cardiovascular Prevention (2023) · cites this paper as [164]

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Authors: Chan, D. C., Chen, M. M., Ooi, E. M. M., & Watts, G. F.
Affiliations: The University of Western Australia (AU)
Corresponding author: Watts, G. F.
ORCID: Chan, D. C.
Ooi, E. M. M.
Watts, G. F.
Venue: International Journal of Clinical Practice
Publisher: Hindawi Limited
Published: 2008-01-14
Volume: 62
Issue: 5
Pages: 799-809
ISSN: 1368-5031 (ISSN-L)
DOI: 10.1111/j.1742-1241.2007.01678.x
OpenAlex: W1924220480
Semantic Scholar: 951138a00f487dd2b66d0f0c8973bae3390419cc
Cited by: 85
References: 93
Citations by year: 2026: 3 · 2025: 3 · 2024: 8 · 2023: 10 · 2022: 5 · 2021: 1 · 2020: 7 · 2019: 4 · 2017: 1 · 2016: 3 · 2015: 5 · 2014: 3 · 2013: 9 · 2012: 5
FWCI: 0.91
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: doi.wiley.com/10.1002/tdm_license_1.1 (tdm, 2787 d)
Locations: International Journal of Clinical Practice (publishedVersion)
PubMed (publishedVersion)
UWA Profiles and Research Repository (UWA) (submittedVersion)
eSpace (Curtin University) (submittedVersion)
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipid metabolism and disorders
Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Keywords: apolipoprotein C-III, hypertriglyceridemia, triglyceride-rich lipoproteins, VLDL, lipoprotein lipase inhibition, coronary heart disease risk, cardiovascular risk factors, type 2 diabetes, obesity, insulin resistance, dyslipidemia, apoB-containing lipoproteins
MeSH terms: Cardiovascular Diseases, Humans, Risk Factors, Triglycerides, Hypertriglyceridemia, Biomarkers, Metabolic Syndrome, Apolipoprotein C-III

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An ABC of apolipoprotein C-III: a clinically useful new cardiovascular risk factor?

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