What is ApoB? What does it do to depression?

ApoB and Cholesterol: A Link to Mental Health and Longevity

Heart disease is the most common cause of death in the United States, but achieving longevity is not just about optimizing cardiovascular health but also addressing mental health, as both significantly impact overall wellness and lifespan. Recent evidence highlights the key link between lipid profiles, cardiovascular disease (CVD), and mental health conditions like depression, reinforcing the importance of comprehensive heart and brain health management.

What is ApoB?

ApoB (short for apolipoprotein B) is a key protein that attaches to lipids to allow the lipids to dissolve in your bloodstream (it makes the lipids water-soluble). ApoB attaches to LDL cholesterol particles, and therefore the more LDL cholesterol particles, the higher the ApoB level in your blood. The higher the ApoB level, the more LDL cholesterol particles "crash" into your blood vessel walls, increasing the chance of cholesterol plaques and, subsequently, heart attacks and strokes.

As a reminder, "lipids" include triglycerides and steroids (including cholesterol).

High ApoB is one marker of dangerous changes in lipids that may lead to a heart attack or stroke. Other key markers include lipoprotein(a) [Lp(a)], triglycerides, and non-HDL cholesterol.

ApoB, Cholesterol, and Depression

Emerging research also suggests a connection between abnormal lipids and depression:

• ApoB (Apolipoprotein B): This lipoprotein changes with levels of psychosocial stress. Higher levels of ApoB are associated with depression (though it's unclear if it is causal). Furthermore, higher ApoB levels are correlated with worse memory in depressed patients. High levels also indicate greater cardiovascular risk and inflammation.
• Lp(a): A genetically influenced lipid that is particularly dangerous in depositing cholesterol plaques in your blood vessels. It's role in mental health is being actively researched.
• Triglycerides: High triglycerides (TG) come from high carbohydrate and saturated fat intake. High TG correlates with depression (and here) and metabolic syndrome with insulin resistance higher cardiovascular risk.
• Non-HDL cholesterol: Represents all the "bad cholesterol" (including ApoB, and more) and is correlated to increased heart disease risk and depression.

Managing Triglycerides: Lifestyle Interventions

Triglycerides are unique among lipids because we can change the levels with our lifestyle. This means we may also be able to chang our risk of depression with the same lifestyle interventions:

• ‍Exercise: Regular physical activity significantly reduces triglyceride levels, reduces non-HDL cholesterol, and improves mood and cognitive health.‍
• Dietary Choices:‍
  
  • Carbohydrates: Lowering refined carbohydrates and sugars drastically reduces triglyceride production.‍
  • Saturated Fats: Reducing saturated fat intake helps mitigate triglyceride elevation and supports cardiovascular and cognitive health.

How to Lower ApoB

Unlike triglycerides, which are influenced by lifestyle factors, cholesterol is not as easily affected with lifestyle measures. The 4 key medications to lower cholesterol levels are:

• Statins: Inhibit HMG-CoA reductase, the rate-limiting enzyme in hepatic cholesterol synthesis, leading to upregulation of LDL receptors and increased clearance of ApoB-containing lipoproteins.
• PCSK9 inhibitors: Block PCSK9 from degrading LDL receptors, allowing more receptors to recycle and clear LDL particles from circulation.
• Bempedoic Acid: Inhibits ATP citrate lyase, an upstream enzyme in cholesterol biosynthesis, reducing hepatic cholesterol production and increasing LDL receptor activity.
• Ezetimibe: Reduces intestinal cholesterol absorption (from diet and bile) and promotes LDL clearance by the liver.

Ketamine, Stellate Ganglion Block (SGB), and Psychological Stress

Psychological stress significantly exacerbates lipid disorders and cardiovascular disease, amplifying the health impacts of ApoB and related lipids. Treatments such as ketamine infusions and Stellate Ganglion Blocks (SGB) help manage severe stress, depression, and PTSD:

• Ketamine Infusions: Rapidly reduce depressive symptoms and anxiety, diminishing the psychological burden that worsens cardiovascular health. There do not appear to be any long term cardiovascular risks with IV ketamine infusions.
• Stellate Ganglion Block (SGB): pauses the "fight-flight" response (sympathetic nervous system) and can reduce hyperarousal and hyperinflammation seen in PTSD and long COVID. SGB promotes autonomic balance to potentially improve stress levels and heart and brain health both directly and indirectly.

By addressing severe mental stress through these innovative treatments, patients can mitigate a significant source of cardiovascular risk, complementing direct lipid management strategies.

Check Your ApoB and Improve Your Brain and Heart Health Today

Integrating effective lipid management, understanding the roles of ApoB, triglycerides, and other lipids, and addressing mental health through treatments like ketamine and SGB, provides a powerful, holistic approach to enhancing longevity. Emphasizing both cardiovascular and psychological wellness helps ensure better overall health outcomes and sustained quality of life. Speak with a doctor at Clarus Health today to enhance your heart and brain health today.