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

The APOB gene makes apolipoprotein B, a protein that is a key part of low density lipoprotein or LDL, commonly called bad cholesterol. Variations in the APOB gene can influence how many LDL particles circulate in the blood. Higher LDL levels can increase the chance that cholesterol will stick to artery walls, forming plaque that raises the risk of coronary artery disease and other cardiovascular problems.

This article explains how different genotypes at rs515135 in APOB relate to LDL cholesterol and heart risk, and outlines practical diet, supplement, lifestyle, and monitoring recommendations to support heart health. PlexusDx does not provide medical advice. Always consult your healthcare provider before making changes to diet, exercise, or starting supplements.

How APOB Variants Affect Cholesterol

APOB influences the structure and number of LDL particles. When a genetic variant causes higher apolipoprotein B production or more LDL particles, circulating LDL cholesterol tends to be higher. Elevated LDL is one of the most important modifiable risk factors for plaque buildup in arteries and coronary artery disease. Your genotype at rs515135 gives a snapshot of one genetic influence on LDL, but overall risk depends on many genes and lifestyle factors.

General Heart Healthy Principles

  • Follow a balanced eating pattern centered on fruits, vegetables, whole grains, legumes, nuts, seeds, and healthy fats such as olive oil, avocado, and fatty fish.
  • Limit intake of saturated fats from fatty meats, full fat dairy, butter, and tropical oils. Avoid trans fats found in some processed foods.
  • Increase soluble fiber from oats, barley, beans, apples, and citrus fruits to help lower LDL.
  • Maintain a healthy weight through calorie balance and regular physical activity.
  • Engage in at least 150 minutes per week of moderate aerobic activity or 75 minutes of vigorous activity plus strength training twice weekly.
  • Manage stress with sleep, mindfulness, social support, and relaxation techniques.
  • Avoid tobacco and limit alcohol intake.

Diet, Supplements, and Monitoring Recommendations

  • Focus on heart healthy fats: replace saturated fat with monounsaturated and polyunsaturated fats including omega 3 fatty acids from fatty fish or algae supplements.
  • Eat more soluble fiber daily to help lower LDL cholesterol.
  • Consider plant sterols or stanols in foods or supplements to reduce LDL when appropriate.
  • Supplements sometimes used to support cardiovascular health include nattokinase and bromelain. These may affect blood flow and clotting. Talk with your healthcare provider before starting them, especially if you take blood thinners or have bleeding risk.
  • Routine blood tests to monitor cardiovascular risk: fasting lipid panel (total cholesterol, LDL, HDL, triglycerides), high sensitivity C reactive protein when indicated, and calculation of apolipoprotein B when your clinician wants a direct measure of atherogenic particle number.
  • When genetics or lipid levels suggest elevated risk, your healthcare provider may discuss prescription therapies such as statins, ezetimibe, or newer agents. Genetic information can help guide early prevention but is not a substitute for clinical evaluation.

Genetic Interpretations for rs515135 (APOB)

Two effect alleles (CC) — Increased LDL and higher coronary artery disease risk

If you have the CC genotype at rs515135, you carry two copies of the effect allele. This genotype is associated with higher LDL cholesterol levels and an increased risk of coronary artery disease. The APOB protein forms the structural backbone of LDL particles. With this genotype you may produce or carry more LDL particles, which can accelerate plaque buildup in artery walls over time.

Recommendations

  • Diet: Emphasize a heart healthy diet that is low in saturated fat and trans fat. Increase intake of soluble fiber from oats, beans, lentils, fruits, and vegetables. Choose lean proteins, plenty of vegetables, whole grains, and healthy fats such as olive oil and nuts.
  • Exercise: Aim for at least 150 minutes of moderate aerobic activity per week plus strength training twice weekly. Physical activity helps raise HDL and lower LDL and triglycerides.
  • Supplements: Discuss nattokinase and bromelain with your provider. Consider omega 3 fatty acids or a plant sterol regimen if appropriate.
  • Monitoring: Have your fasting lipid panel checked regularly. Consider measuring apolipoprotein B if recommended by your clinician to directly assess the number of atherogenic particles.
  • Medical follow up: Because your genotype is associated with elevated LDL and higher heart disease risk, work with your healthcare provider to determine if lifestyle changes are sufficient or if medication is warranted.
One effect allele (CT) — Moderately increased cholesterol risk

If you have the CT genotype at rs515135, you carry one copy of the effect allele. This genotype is associated with a moderate increase in LDL cholesterol compared with the non-effect genotype. Your APOB variation may influence how your body handles LDL, which can contribute to plaque buildup over many years.

Recommendations

  • Diet: Follow a balanced heart healthy eating plan with attention to reducing saturated fat and increasing soluble fiber. Small changes like swapping full fat dairy for low fat or plant alternatives and choosing lean protein can help.
  • Exercise: Maintain regular aerobic activity and strength training to support lipid health and body weight.
  • Supplements: Nattokinase and bromelain may offer supporting benefits. Review all supplements with your healthcare provider before starting.
  • Monitoring: Check your fasting lipid panel periodically. Work with your clinician to interpret lipids in the context of other risk factors such as blood pressure, family history, smoking, and diabetes.
  • Lifestyle: Weight management, smoking cessation, limiting alcohol, and stress reduction remain important.
No effect alleles (TT) — Typical lipid metabolism for this marker

If you have the TT genotype at rs515135, you carry two copies of the non-effect allele. This genotype is not associated with increased LDL through this particular marker and indicates a typical lipid profile risk from this single genetic site. That is positive, but it does not guarantee low cardiovascular risk because many factors influence heart health.

Recommendations

  • Diet: Continue a heart healthy diet rich in fruits, vegetables, whole grains, and healthy fats. Maintain mindful portion sizes.
  • Exercise: Keep regular physical activity consistent to support cardiovascular fitness and healthy body weight.
  • Supplements: Consider general cardiovascular supportive nutrients like omega 3s when appropriate. Discuss any supplement use with your clinician.
  • Monitoring: Continue routine health screening, including periodic lipid panels as advised by your provider. Genetics is one piece of a larger puzzle.

Putting Your Results Into Practice

Your rs515135 genotype provides useful context about one genetic influence on LDL cholesterol. It is not a diagnosis and does not predict outcomes alone. Use this information to start conversations with your healthcare team about targeted lifestyle strategies and appropriate testing. If you already have elevated LDL or other cardiovascular risk factors, your provider may recommend more intensive monitoring or treatments. If your lipids are within a healthy range, continue prevention strategies and routine checks.

PlexusDx does not provide medical advice. The information here is educational and meant to help you understand how an APOB variant may relate to heart health. Always consult your healthcare provider before making changes to your medical care, diet, exercise, or before starting new supplements.