Association Between Lipid-Lowering Therapy and Differences in the Distribution of LDL-C, apoB and non-HDL-C

Sep 30, 2026

Background: Hypercholesterolemia diagnosis depends on laboratory lipid parameters. This retrospective study assessed how low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (non-HDL-C), and apolipoprotein B (apoB) distributions differ by the presence and type of lipid-lowering therapy (LLT). Methods: Consecutive patients with LDL-C, apoB, and non-HDL-C measurements between March and November 2024 were analyzed using ESC cut-off-based categorizations. Results: 5048 patients were included; among LLT users, 77.3% were on statin monotherapy and 22.7% on combined therapy. Discordance patterns favored fewer discrepancies with combined LLT. Conclusions: Classifying hyperlipidemia by LDL-C, non-HDL-C, and apoB shows significant marker discrepancies, reduced by LLT.

LanguageEnglish

CategoryHealthcare

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Article Association Between Lipid-Lowering Therapy and Differences in the Distribution of LDL-C, apoB and non-HDL-C Marcin Ziółkowski 1,†, Karolina Obo ´nska 2, *,†, Jakub Ratajczak 2, Piotr Adamski 2, Maciej Banach 3,4,5,6, Krzysztof Chlebus 7, Klaudyna Grzelakowska 2, Piotr Jankowski 8,9, Magdalena Krintus 2, Jacek Kry´s 1, Ewa Laskowska 2, Natalia Mrzywka 10, Piotr Niezgoda 2, Małgorzata Ostrowska 2, Przemysław Podhajski 2, Grzegorz Skonieczny 11, Boena Sosnowska 4, Łukasz Szarpak 12,13,14, Małgorzata Topolska 15, Julia Umi ´nska 2, Alicja Rzepka-Cholasi ´nska 2, Eliano Pio Navarese 2 and Jacek Kubica 2 Academic Editor: Cyrus V. DeSouza Received: 31 October 2025 Revised: 10 December 2025 Accepted: 12 December 2025 Published: 20 December 2025 Copyright: © 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license. 1 Antoni Jurasz University Hospital No. 1 in Bydgoszcz, 85-094 Bydgoszcz, Poland; [m.ziolkowski@jurasza.pl](m.ziolkowski@jurasza.pl) (M.Z.); [jacek.krys@gmail.com](jacek.krys@gmail.com) (J.K.) 2 Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, 85-094 Bydgoszcz, Poland; [jakub.ratajczak@cm.umk.pl](jakub.ratajczak@cm.umk.pl) (J.R.); [piotr.adamski@cm.umk.pl](piotr.adamski@cm.umk.pl) (P.A.); [klaudyna.grzelakowska@gmail.com](klaudyna.grzelakowska@gmail.com) (K.G.); [krintus@cm.umk.pl](krintus@cm.umk.pl) (M.K.); [ewa.laskowska@cm.umk.pl](ewa.laskowska@cm.umk.pl) (E.L.); [piotr.niezgoda@cm.umk.pl](piotr.niezgoda@cm.umk.pl) (P.N.); [m.ostrowska@cm.umk.pl](m.ostrowska@cm.umk.pl) (M.O.); [przemyslaw.podhajski@cm.umk.pl](przemyslaw.podhajski@cm.umk.pl) (P.P.); [julia.uminska@cm.umk.pl](julia.uminska@cm.umk.pl) (J.U.); [alicja.rzepka@cm.umk.pl](alicja.rzepka@cm.umk.pl) (A.R.-C.); [elianonavarese@gmail.com](elianonavarese@gmail.com) (E.P.N.); [jkubica@cm.umk.pl](jkubica@cm.umk.pl) (J.K.) 3 Faculty of Medicine, The John Paul II Catholic University of Lublin (KUL), 20-950 Lublin, Poland; [maciej.banach@icloud.com](maciej.banach@icloud.com) 4 Department of Preventive Cardiology and Lipidology, Medical University of Lodz (MUL), 90-419 Lodz, Poland; [bozena.sosnowska@umed.lodz.pl](bozena.sosnowska@umed.lodz.pl) 5 Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD 21218, USA 6 Liverpool Centre for Cardiovascular Science (LCCS), Liverpool L7 8TX, UK 7 First Department of Cardiology, Medical University of Gdansk, 80-210 Gdansk, Poland; [krzysztof.chlebus@gumed.edu.pl](krzysztof.chlebus@gumed.edu.pl) 8 Department of Internal Medicine and Geriatric Cardiology, Medical Centre of Postgraduate Education, 01-813 Warsaw, Poland; [piotrjankowski@interia.pl](piotrjankowski@interia.pl) 9 Department of Epidemiology and Health Promotion, School of Public Health, Centre of Postgraduate Medical Education, 01-826 Warsaw, Poland 10 American Heart of Poland, 64-920 Pila, Poland; [natalia.mrzywka@onet.eu](natalia.mrzywka@onet.eu) 11 Department of Cardiology and Intensive Cardiac Care Unit, District Polyclinic Hospital, 87-100 Torun, Poland; [grzegorz.skonieczny@onet.eu](grzegorz.skonieczny@onet.eu) 12 Institute of Medical Science, Collegium Medicum, The John Paul II Catholic University of Lublin (KUL), 20-950 Lublin, Poland; [lukasz.szarpak@gmail.com](lukasz.szarpak@gmail.com) 13 Department of Clinical Research and Development, LUXMED Group, 02-678 Warsaw, Poland 14 Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, TX 77030, USA 15 American Heart of Poland, 40-028 Katowice, Poland; [malgorzata.topolska@ahop.pl](malgorzata.topolska@ahop.pl) * Correspondence: [k.obonska@cm.umk.pl](k.obonska@cm.umk.pl); Tel.: +48-52-585-40-23 † These authors contributed equally to this work. Abstract Background: The diagnosis of hypercholesterole

FAQs

What was the main purpose of this study?

To evaluate differences in the distribution of LDL-C, non-HDL-C, and apoB concentrations according to the presence and type of lipid-lowering therapy (LLT).

How were participants and lipid measurements selected?

The study retrospectively included consecutive patients with at least one measurement of LDL-C, apoB, and non-HDL-C between March and November 2024 in a tertiary hospital, using ESC guideline cut-offs.

Did LLT affect discrepancies between lipid markers?

Yes. Discordance between on-target apoB and elevated LDL-C occurred in fewer patients among treated groups, and LLT—especially combined therapy—reduced discrepancies more effectively.

Sep 30, 2026

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