Webb RJ, Mazidi M, Lip GYH, et al. - Findings revealed increased discordance between apolipoprotein B (ApoB) and low-density lipoprotein cholesterol (LDL-C) was related to cardiometabolic, clinical and dietary abnormalities. Elevated body fat percentage was found to be causal of increased levels of ApoB.

• In this study using the National Health and Nutrition Examination Survey, machine learning (ML) and structural equation models (SEMs), and Mendelian randomization (MR), the goal was to investigate the effect of adiposity, diet and inflammation upon ApoB and LDL-C discordance.

• In those with low LDL-C and high ApoB, following were revealed as the most strongly associated variables in ML: BMI, dietary saturated fatty acids (SFA), dietary fibre, serum C-reactive protein and uric acid.

• A significant link of fiber and SFA with the outcome (joined effect of ApoB and LDL-C) was noted.

• In MR analysis, a significant causal impact of genetically higher body fat percentage on ApoB but not on LDL-C was identified.

• Discordantly high apolipoprotein B was linked with a poor quality diet.