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APOB and Cholesterol: What Your rs693 Genotype Means for Heart Health

Cholesterol is an essential fat that helps build cell membranes, make hormones, and support digestion. But when certain types of cholesterol, especially low density lipoprotein LDL, become too high, the risk of heart disease increases. The APOB gene plays a central role in moving cholesterol through the body. It encodes apolipoprotein B, a major component of LDL particles that deliver cholesterol from the liver to cells. Small differences in the APOB gene can affect how many LDL particles are produced, how they are processed, and ultimately your blood cholesterol and triglyceride levels.

This article explains the meaning of the rs693 genetic result in the APOB gene, how each genotype may affect cholesterol, and practical, evidence informed steps you can take to support heart health. PlexusDx does not provide medical advice. This information is educational and you should always consult your healthcare provider before making changes to medication, supplements, or major lifestyle choices.

How APOB Affects Cholesterol

  • APOB makes the protein that forms the core structure of LDL particles. Think of LDL particles as delivery trucks carrying cholesterol. More apolipoprotein B can mean more trucks circulating in the blood.
  • Higher numbers of LDL particles and higher triglycerides increase the chance cholesterol will deposit in artery walls, raising cardiovascular risk.
  • Variants like the rs693 A allele have been associated with increased apolipoprotein B levels, and in some people this corresponds with higher LDL cholesterol and triglycerides.

Everyday Steps That Help Maintain Healthy Cholesterol

Regardless of genotype, lifestyle has a major influence on cholesterol and heart disease risk. Consider the following heart healthy strategies:

  • Diet: Focus on a pattern rich in vegetables, fruits, whole grains, legumes, nuts, seeds, and fatty fish. Replace saturated fats from processed meats and full fat dairy with unsaturated fats from olive oil, avocado, and nuts. Limit refined carbohydrates, sugary beverages, and trans fats.
  • Fiber: Aim for a variety of soluble fiber sources such as oats, barley, beans, lentils, apples, and psyllium. Soluble fiber can help lower LDL cholesterol.
  • Omega 3 fats: Include fatty fish like salmon, mackerel, and sardines twice per week or discuss omega 3 supplements with your provider if fish intake is low.
  • Physical activity: Aim for at least 150 minutes of moderate intensity aerobic activity each week plus two strength training sessions. Exercise helps raise HDL, lower triglycerides, and improve overall cardiovascular fitness.
  • Healthy weight: Losing excess weight improves LDL, triglycerides, blood pressure, and insulin sensitivity.
  • Quit smoking and limit alcohol: Smoking raises cardiovascular risk. If you drink alcohol, do so in moderation.
  • Stress and sleep: Manage chronic stress with strategies like mindfulness, social support, and regular sleep. Poor sleep and chronic stress can worsen metabolic health.
  • Routine monitoring: Have periodic lipid panels and discuss results with your healthcare provider, especially if you have a family history of heart disease or other risk factors.

Diet, Supplements, and Tests to Discuss With Your Provider

  • Consider a heart healthy dietary pattern such as the Mediterranean or DASH style diet for overall cardiovascular benefit.
  • Soluble fiber supplements, such as psyllium, can be helpful for lowering LDL when combined with dietary changes.
  • Omega 3 supplements high in EPA and DHA may lower triglycerides. Dosing and need should be assessed by your provider.
  • Plant stanols and sterols can reduce LDL when used as recommended in fortified foods or supplements.
  • Regular labs: fasting lipid panel including LDL, HDL, triglycerides, and total cholesterol. Consider apolipoprotein B testing if your provider wants a more direct measure of LDL particle number.
  • If you have elevated readings or a family history of early heart disease, your provider may discuss additional testing, risk calculators, or prescription medications.

Genetic Interpretation: rs693 in APOB

Two effect alleles (AA) — Increased apolipoprotein B, higher LDL and triglycerides

If your genotype is AA at rs693, you carry two copies of the A variant associated with higher apolipoprotein B levels. This can translate into more LDL particles in the bloodstream and higher triglycerides for some people. Over time, that pattern can increase risk for atherosclerosis and heart disease.

What to do

  • Ask your healthcare provider about a fasting lipid panel and apolipoprotein B test to measure current levels and track changes.
  • Prioritize a heart healthy diet focused on soluble fiber, unsaturated fats, plenty of vegetables and whole grains, and minimal processed foods and added sugars.
  • Maintain or increase regular physical activity and aim for a healthy body weight.
  • Discuss omega 3 supplementation if triglycerides are high, and consider fiber or plant stanol interventions if LDL remains elevated despite diet changes.
  • If lifestyle steps do not bring lipids to target, your provider may discuss prescription options to lower cardiovascular risk.

Remember, a genetic predisposition is a risk factor not a certainty. Lifestyle and clinical monitoring are powerful ways to manage risk.

One effect allele (AG) — Moderately increased apolipoprotein B, possible higher LDL

If your genotype is AG at rs693, you carry one copy of the A variant. This genotype is associated with modest increases in apolipoprotein B and may contribute to higher LDL cholesterol or triglycerides in combination with other genetic or lifestyle factors.

What to do

  • Get routine lipid testing to understand your baseline and long term trends.
  • Adopt the heart healthy habits described above. Even modest improvements in diet and activity can reduce LDL and triglycerides.
  • Monitor weight, stress, sleep, and other metabolic risk factors like blood pressure and blood sugar.
  • Talk to your provider about supplements or targeted therapies if your lipid panel shows elevations.

This genotype often interacts with diet and lifestyle. Proactive management can minimize long term risk.

No effect alleles (GG) — Typical APOB function

If your genotype is GG at rs693, you do not carry the A variant associated with increased apolipoprotein B. This result suggests typical APOB related lipid transport function for this specific genetic location.

What to do

  • Continue standard heart healthy practices: balanced diet, regular exercise, healthy weight, not smoking, and routine health checks.
  • Have periodic lipid testing as recommended by your provider, especially if you have family history or other risk factors.
  • Even with a common genotype, lifestyle choices remain the primary modifiable influence on cholesterol and cardiovascular risk.

Final Notes and Important Disclaimer

Genetic results provide information about predisposition, not diagnosis. Multiple genes, environment, lifestyle, and medications all influence cholesterol and heart disease risk. PlexusDx does not provide medical advice. Always share genetic findings with your healthcare provider and work together to decide on testing, lifestyle changes, supplements, or treatments tailored to your health history and goals.