Evidence map›Paper›PMID 41549954›Full record

ArticleLiver international : official journal of the International Association for the Study of the Liver2026

Low Cholesterol due to APOB Variants: Exploring the Balance Between Liver and Cardiovascular Risk.

Alessia Di Costanzo, Ilaria Pirona, Silvia Buonaiuto, Stella Covino, Carlo Maiorca, Simone Bini, Daniele Tramontano, Ilenia Minicocci, Francesco Baratta, Vincenza Colonna and 3 more

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Article in Liver international : official journal of the International Association for the Study of the Liver, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Low Cholesterol due to APOB Variants: Exploring the Balance Between Liver and Cardiovascular Risk.Liver international : official journal of the International Association for the Study of the Liver · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Alessia Di CostanzoDepartment of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy.
Ilaria PironaIstituto di Patologia Speciale Medica, Catholic University of the Sacred Heart, Rome, Italy.
Silvia BuonaiutoDepartment of Genetics, Genomics and Informatics, University of Tennessee Health Science Center, Memphis, Tennessee, USA.
Stella CovinoDepartment of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy.
Carlo MaiorcaDepartment of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy.ORCID 0000-0002-1142-1041
Simone BiniDepartment of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy.
Daniele TramontanoDepartment of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy.
Ilenia MinicocciDepartment of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy.
Francesco BarattaGeriatric Unit, Department of Internal Medicine and Medical Specialties, AOU Policlinico Umberto I, Rome, Italy.
Vincenza ColonnaDepartment of Genetics, Genomics and Informatics, University of Tennessee Health Science Center, Memphis, Tennessee, USA.
Allegra ViaDepartment of Biochemical Sciences "A. Rossi Fanelli", Sapienza University of Rome, Rome, Italy.
Laura D'ErasmoDepartment of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy.
Marcello ArcaDepartment of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND &

aimsLifelong APOB gene inactivation lowers LDL-C and cardiovascular risk, but impairs hepatic lipoprotein export, predisposing to chronic liver disease (CLD). The extent to which common steatogenic factors modulate this risk remains unclear. Moreover, the balance between long-term cardiovascular protection and CLD risk in APOB variant carriers has never been evaluated.

methodsUsing UK Biobank data, we analysed 241 APOB loss-of-function (LoF) carriers and 410 721 non-carriers, stratified by steatogenic risk factors, including age, sex, diabetes, BMI, alcohol intake and the PNPLA3-rs738409 genotype. Associations with transaminase levels, CLD and cardiovascular (ASCVD) outcomes were assessed using Python and R packages.

resultsAPOB carriers had ~35% lower LDL-C and apoB levels, along with reduced total triglycerides and Lp(a) (all p < 0.001). Baseline ALT and AST were higher in carriers than in non-carriers (P

conclusionsLong-term exposure to low LDL-C levels due to APOB LoF variants has opposite consequences, reducing ASCVD risk but increasing CLD risk, especially in the presence of diabetes and obesity. These findings highlight the importance of balancing cardiovascular benefit with hepatic safety when considering apoB-targeting therapies.

Indexed as

Apolipoprotein B-100Apolipoproteins BCardiovascular DiseasesCholesterol, LDLAdultAgedFemaleHeart Disease Risk FactorsHumansIncidenceMaleMiddle AgedObesityPrevalenceRisk FactorsTriglyceridesAPOB protein, humanApolipoprotein B-100Apolipoproteins BCholesterol, LDLTriglyceridesAPOB genecardiovascular protectiondrug targetsinactivating variantsliver disease risk

Identifiers

PMID41549954
PMCPMC12813735

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.