Lipoprotein (a) and diet: consuming sugar-sweetened beverages lowers lipoprotein (a) levels in obese and overweight adults

Abstract

Lipoprotein (a) [Lp(a)] is a risk factor for cardiovascular disease. A size polymorphism in the apo(a) gene, determined by the number of Kringle (K) repeats, inversely regulates Lp(a) levels. Nongenetic factors including dietary saturated fat influence Lp(a) levels. However, less is known about the effects of carbohydrates including dietary sugars. In this double-blind, parallel-arm study among 32 overweight/obese adults, we investigated the effect of consuming glucose- or fructose-sweetened beverages providing 25% of energy requirements for 10 weeks on Lp(a) level and assessed the role of the apo(a) size polymorphism. The mean (±SD) age of participants was 54 ± 8 years, 50% were women, and 75% were of European descent. At the end of the 10-week intervention, Lp(a) level was reduced by an average (±SEM) of −13.2% ± 4.3% in all participants (P = 0.005); by −15.3% ± 7.8% in the 15 participants who consumed glucose (P = 0.07); and by −11.3% ± 4.5% in the 17 participants who consumed fructose (P = 0.02), without any significant difference in the effect between the two sugar groups. The relative changes in Lp(a) levels were similar across subgroups of lower versus higher baseline Lp(a) level or carrier versus noncarrier of an atherogenic small (≤22K) apo(a) size. In contrast, LDL-C was increased. In conclusion, in older, overweight/obese adults, consuming sugar-sweetened beverages reduced Lp(a) levels by ∼13% independently of apo(a) size variability and the type of sugar consumed. The Lp(a) response was opposite to that of LDL-C and triglyceride concentrations. These findings suggest that metabolic pathways might impact Lp(a) levels.