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Apolipoprotein CII

Definition

Apolipoprotein CII (apoCII) is a protein found in large fat particles that the gastrointestinal tract absorbs. It is also found in very low density lipoprotein (VLDL), which is made up of mostly triglycerides (a type of fat in your blood).

This article discusses the test used to check for apoCII in a sample of your blood.

Patient Education Video: Cholesterol and triglyceride test

Alternative Names

ApoCII; Apoprotein CII; ApoC2; Lipoprotein lipase deficiency - apolipoprotein CII; Chylomicronemia syndrome - apolipoprotein CII

How the Test is Performed

A blood sample is needed.

How to Prepare for the Test

You may be told not to eat or drink anything for 4 to 6 hours before the test.

How the Test will Feel

When the needle is inserted to draw blood, you may feel some pain, or only a prick or stinging. Afterward, there may be some throbbing where the needle was inserted.

Blood test
Blood is drawn from a vein (venipuncture), usually from the inside of the elbow or the back of the hand. A needle is inserted into the vein, and the blood is collected in an air-tight vial or a syringe. Preparation may vary depending on the specific test.

Why the Test is Performed

ApoCII measurements can help determine the type or cause of high blood fats. It is not clear whether the test results improve treatment. Because of this, most health insurance companies will not pay for the test. If you do not have high cholesterol or heart disease or a family history of these conditions, this test may not be recommended for you.

Normal Results

The normal range is 3 to 5 mg/dL. However, apoCII results are usually reported as present or absent.

The examples above are common measurements for results of these tests. Normal value ranges may vary slightly among different laboratories. Some labs use different measurements or test different samples. Talk to your doctor about the meaning of your specific test results.

What Abnormal Results Mean

High levels of apoCII may be due to a family history of lipoprotein lipase deficiency. This is a condition in which the body does not break down fats normally.

Low ApoCII levels are also seen in people with a rare condition called familial apoprotein CII deficiency. This causes chylomicronemia syndrome, another condition in which the body does not break down fats normally.

Risks

Risks associated with having blood drawn are slight but may include:

  • Excessive bleeding
  • Fainting or feeling lightheaded
  • Hematoma (blood accumulating under the skin)
  • Infection (a slight risk any time the skin is broken)

Considerations

Apolipoprotein measurements may provide more detail about your risk for heart disease, but the added value of this test beyond a lipid panel is unknown.

Gallery

Blood test
Blood is drawn from a vein (venipuncture), usually from the inside of the elbow or the back of the hand. A needle is inserted into the vein, and the blood is collected in an air-tight vial or a syringe. Preparation may vary depending on the specific test.

References

Bredefeld CL, Lau R, Hussain MM. Lipids and dyslipoproteinemia. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 24th ed. St Louis, MO: Elsevier; 2022:chap 18.

Fazio S, Linton MF. Regulation and clearance of apolipoprotein B-containing lipoproteins. In: Ballantyne CM, ed. Clinical Lipidology: A Companion to Braunwald's Heart Disease. 2nd ed. Philadelphia, PA: Elsevier; 2015:chap 2.

Genest J, Mora S, Libby P. Lipoprotein disorders and cardiovascular disease. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 27.

Libby P. The Vascular biology of atherosclerosis. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 24.

Meeusen JW, Ueda M, Nordestgaard BG, Remaley AT. Lipids and lipoproteins. In: Rifai N, Chiu RWK, Young I, Burnham C-A D, Wittwer CT, eds. Tietz Textbook of Laboratory Medicine. 7th ed. St Louis, MO: Elsevier; 2023:chap 36.

Robinson JG. Disorders of lipid metabolism. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 195.

Last reviewed May 8, 2022 by Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team..

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