Plasma apoB (apolipoprotein B) equals the total number of atherogenic lipoprotein particles in plasma. Since trapping of these particles within the arterial wall is fundamental to the pathogenesis of vascular disease, understanding the metabolic determinants of plasma apoB is key in determining the risks and therapy of vascular disease. This article attempts to demonstrate how plasma apoB is determined by the cholesterol content within hepatocytes. It also sets out a hypothesis as to how the need to maintain homoeostasis of an intracellular organelle sets off a chain of events, which ends with the death of the organism.

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