Nutrient Patterns are Associated with Discordant Apolipoprotein B and Low-Density Lipoproteins: A Population-Based Analysis

Individuals with discordantly high ApoB to LDL-C levels carry a higher risk of atherosclerotic cardiovascular disease compared to those with average or discordantly low ApoB to LDL-C. We aimed to determine associations between ApoB and LDL-C discordance in relation to nutrient patterns (NPs) using National Health and Nutrition Examination Survey data. Participants were grouped by established LDL-C and ApoB cut-offs (Group 1: Low ApoB/Low LDL-C, Group 2: Low ApoB/High LDL-C, Group 3: High ApoB/Low LDL-C, Group 4: High ApoB/High LDL-C). Principle component analysis was used to define NPs. Machine learning (ML) and structural equation models were applied to assess associations of nutrient intake with ApoB/LDL-C discordance using the combined effects of ApoB and LDL-C. Three NPs explained 63.2% of variance in nutrient consumption. These consisted of NP1 rich in saturated fatty acids, carbohydrate and vitamins, NP2 high in fibre, minerals, vitamins and PUFA and NP3 rich in dietary cholesterol, protein, and sodium. The discordantly high ApoB to LDL-C group had the highest consumption of the NP1 and the lowest consumption of the NP2. ML showed nutrients which had the greatest unfavourable dietary contribution to individuals with discordantly high ApoB to LDL-C were total fat, saturated fatty acids and thiamine and the greatest favourable contributions were MUFA, folate, fibre and selenium. Individuals with discordantly high ApoB in relation to LDL-C had greater adherence to NP1, whereas those with lower levels of ApoB, irrespective of LDL-C, are more likely to consume NP3.