Other names: Apolipoprotein A-1 on HDL Particles
AALP ApoA1 measures the main protein on HDL—often called the “good cholesterol.” It’s part of the HDL Function Panel, which looks at how well your HDL works, not just how much HDL cholesterol you have.
This test uses an advanced lab method and reports results in nmol/L (not mg/dL like the standard ApoA1 test).
HDL helps protect your heart by picking up extra cholesterol from artery walls and carrying it to the liver for removal (this is called cholesterol efflux). ApoA1 is the “workhorse” protein that helps HDL do that job.
Higher AALP ApoA1 generally suggests HDL is working better.
Lower AALP ApoA1 can mean HDL isn’t removing cholesterol as effectively—even if your regular HDL cholesterol number looks “normal.”
Men: 181–359 nmol/L
Women: 215–421 nmol/L
These values use a different method and cannot be compared to the standard ApoA1 test reported in mg/dL.
The lab enriches HDL particles that carry ApoA1 and then measures the proteins on them with a precise mass-spectrometry method. The results contribute to models that estimate HDL function and a heart artery disease risk score (HDLfx pCAD Score).
If your AALP ApoA1 is higher (within or above the reference range):
This often points to better HDL function and lower heart disease risk, especially when other markers agree (healthy LDL/ApoB, lower triglycerides, good blood sugar, and a favorable HDL Function Panel score).
If your AALP ApoA1 is lower:
This may reflect less effective HDL function. It’s commonly seen with insulin resistance, extra weight around the middle, higher triglycerides, or ongoing inflammation. Your clinician will look at AALP ApoA1 alongside your LDL/ApoB, triglycerides, blood pressure, blood sugar, and the rest of the HDL Function Panel.
Metabolic health: Insulin resistance, central weight gain, and high triglycerides can weaken HDL’s performance.
Inflammation or illness: Ongoing inflammation can reduce HDL’s protective effects.
Medications & lifestyle: Statins, fibrates, niacin, GLP-1/weight-management therapies, exercise, and nutrition changes can shift HDL function (effects vary by person).
AALP ApoA1 is one of several HDL-related proteins measured together. These results help calculate:
Predicted cholesterol efflux (pCEC): an estimate of how well your HDL removes cholesterol.
HDLfx pCAD Score: a score that helps your clinician judge artery-disease risk even when standard cholesterol looks okay.
No single result diagnoses heart disease. Your provider interprets this marker in context with your history, exam, and other tests.
Bring your report to your clinician and review AALP ApoA1 with your LDL/ApoB, triglycerides, blood pressure, blood sugar (A1c), and the full HDL Function Panel.
Ask about targets and follow-up: Should you focus on weight management, triglyceride reduction, or inflammation control?
Lifestyle basics that support HDL function:
Routine aerobic + resistance exercise
Weight management (especially waist circumference)
Triglyceride-friendly eating (reduce added sugars and refined carbs; emphasize fiber-rich plants, lean proteins, and unsaturated fats)
Sleep, stress, and smoke-free living
Medication review: If you’re on statins or other therapies, ask whether adjustments could help your overall risk profile.
Is AALP ApoA1 the same as the standard ApoA1 test?
No. The standard test measures all ApoA1 in mg/dL. AALP ApoA1 measures ApoA1 on HDL particles using a different method and reports nmol/L. The numbers can’t be compared.
If my AALP ApoA1 is “good,” am I protected?
It’s a positive sign, but heart risk depends on many factors. Your clinician will interpret this result with your other labs and your overall health picture.
Why would my AALP ApoA1 be low if my HDL cholesterol is normal?
HDL function and HDL quantity don’t always match. This test helps explain that mismatch and can guide more personalized prevention.
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As a PRO member and medical practitioner, Healthmatters.io has been an invaluable tool for tracking my clients' data. The layout is intuitive, making it easy to monitor trends and spot patterns over time. The ability to customize reports and charts helps me present information clearly to my clients, improving communication and outcomes. It's streamlined my workflow, saving me time and providing insights at a glance. Highly recommended for any practitioner looking for a comprehensive and user-friendly solution to track patient labs!
A low AALP ApoA1 result means there is less ApoA1 protein on your HDL particles than expected for your sex. Because ApoA1 helps HDL remove cholesterol from artery walls (a process called cholesterol efflux), lower levels can reflect less effective HDL function. On the Cleveland HeartLab panel, a low AALP ApoA1 often travels with a lower predicted efflux (pCEC) and may contribute to a less favorable HDLfx pCAD Score. It does not diagnose heart disease by itself, but it can signal higher cardiovascular risk when viewed with your other results.
Note: AALP ApoA1 is measured in nmol/L using a different method than the standard ApoA1 test (mg/dL). The two tests use different units and cannot be compared directly.
Insulin resistance / prediabetes / type 2 diabetes
High triglycerides and the “high-TG/low-HDL-C” pattern
Central weight gain (larger waist circumference) or metabolic syndrome
Chronic inflammation or illness (autoimmune conditions, infections, poor oral health)
Lifestyle factors: limited physical activity, smoking, highly refined/high-sugar diet
Hormone/thyroid issues: untreated hypothyroidism can depress HDL quality
Liver or kidney problems that affect lipoprotein protein balance
Medications: some drugs can lower HDL quantity or quality; review your list with your clinician
Genetics: rare variants affecting ApoA1 or HDL metabolism
ApoA1 is the workhorse protein of HDL. When it’s low on HDL particles, the system that pulls cholesterol out of arteries may be less efficient.
In people whose standard cholesterol numbers look “okay,” a low AALP ApoA1 can reveal residual risk that merits attention.
The finding is most useful together with other markers—ApoB/LDL-C, triglycerides, glucose/A1c, blood pressure, hs-CRP, and the rest of the HDL Function Panel.
Within the HDL Function Panel: pCEC (predicted efflux), HDLfx pCAD Score, AALP ApoC1/C2/C3/C4
Atherogenic burden: ApoB, LDL-C, non-HDL-C
Metabolic health: fasting glucose or A1c, triglycerides, waist circumference
Inflammation & thyroid: hs-CRP, TSH (and thyroid panel if indicated)
Liver/kidney tests: to rule out secondary causes
Imaging when appropriate: coronary artery calcium (CAC) or other studies based on overall risk
Lifestyle foundations
Exercise: Aim for 150–300 minutes/week of moderate aerobic activity plus 2–3 days/week of resistance training.
Nutrition for triglyceride control:
Cut back on added sugars and refined carbs; favor high-fiber plants, legumes, nuts, fish, and unsaturated fats.
Emphasize balanced meals to steady blood sugar.
Weight management: Even 5–10% weight loss (if overweight) can improve HDL function.
Inflammation care: Treat gum disease, manage autoimmune flares, and prioritize sleep and stress reduction.
Tobacco: If you smoke, cessation meaningfully improves HDL metrics over time.
Alcohol: If you drink, discuss a reduction plan with your clinician—alcohol can raise triglycerides and impair HDL function in many people.
Medical management (personalized with your clinician)
Lower ApoB/LDL-C to guideline-appropriate targets; this reduces overall risk even if HDL is suboptimal.
If triglycerides are elevated, ask about targeted strategies (nutrition, glucose control; occasionally medications if appropriate).
Screen and treat hypothyroidism or other secondary causes.
Review your medication list for agents that may worsen HDL quality and discuss alternatives if clinically appropriate.
Decide on follow-up testing after changes are made.
Recheck AALP ApoA1 (and the rest of the HDL Function Panel) in 8–12 weeks after meaningful lifestyle or treatment changes.
Use the same lab/method, fast 10–12 hours unless told otherwise, and avoid testing during acute illness, which can temporarily lower HDL-related measures.
My HDL cholesterol is normal. Why is my AALP ApoA1 low?
HDL quantity (HDL-C) and HDL function are not the same. AALP ApoA1 focuses on the protein that enables cholesterol removal; it can be low even when HDL-C looks normal.
Does a low AALP ApoA1 mean I have heart disease?
No. It’s a risk signal, not a diagnosis. Your clinician interprets it with your full risk profile and, if needed, may order follow-up tests.
Can supplements fix a low AALP ApoA1?
Evidence is mixed. Focus first on exercise, nutrition, weight, triglycerides, inflammation, and LDL/ApoB control. Discuss any supplements or medication changes with your clinician.
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Anthony
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I have been using Healthmatters.io since 2021. I travel all over the world and use different doctors and health facilities. This site has allowed me to consolidate all my various test results over 14 years in one place. And every doctor that I show this to has been impressed. Because with any health professional I talk to, I can pull up historical results in seconds. It is invaluable. Even going back to the same doctor, they usually do not have the historical results from their facility in a graph format. That has been very helpful.
Karin
Advanced Plan Member since 2020
What fantastic service and great, easy-to-follow layouts! I love your website; it makes it so helpful to see patterns in my health data. It's truly a pleasure to use. I only wish the NHS was as organized and quick as Healthmatters.io. You've set a new standard for health tracking!
Paul
Healthmatters Pro Member since 2024
As a PRO member and medical practitioner, Healthmatters.io has been an invaluable tool for tracking my clients' data. The layout is intuitive, making it easy to monitor trends and spot patterns over time. The ability to customize reports and charts helps me present information clearly to my clients, improving communication and outcomes. It's streamlined my workflow, saving me time and providing insights at a glance. Highly recommended for any practitioner looking for a comprehensive and user-friendly solution to track patient labs!
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