Serum Lp Levels Research Articles

Lipoprotein(a) levels in acute myocardial infarction patients and their associations with prior events and coronary artery disease severity: a real-world cohort study

Abstract Introduction Circulating lipoprotein(a) [Lp(a)] has been associated with the risk of atherosclerotic coronary artery disease (CAD) and is an emergent therapeutic target. The objective of this study is to explore the association between serum levels of Lp(a) and previous myocardial infarction (MI) and/or coronary revascularization and the extension of obstructive CAD in patients with acute MI undergoing coronary angiography. Methods All consecutive patients with MI who underwent coronary angiography and Lp(a) measurement between May and November 2023 were included. Patient data were either registered prospectively or completed retrospectively using electronic health records. Lp(a) was measured using the Immunoturbidimetric Assay method with reaction intensification by particles, employing the World Health Organization/International Federation of Clinical Chemistry and Laboratory Medicine (WHO/IFCC) International Reference Reagent (SRM2B), on the "Roche Cobas C702" chemistry analyzer. The number of major coronary arteries (left main, left anterior descending, left circumflex and right coronary arteries) with stenosis >50% on the coronary angiography were registered. In the primary analysis we explored the association between Lp(a) levels using tertiles and previous occurrence of MI/revascularization, as well as the extension of obstructive CAD. In the secondary analysis we compared Lp(a) levels in patients with and without previous MI/revascularization and patients with 3-4 major vessels CAD vs. 0-2 vessels. Results A total of 116 patients were enrolled, with a mean age of 62±13 years, 79% males, 29% with known coronary artery disease, 71% with dyslipidemia, 24% with diabetes, 65% with hypertension, and 58% were either active or former smokers. The median Lp(a) level was 72 (20-183) nmol/L. In the primary analysis (table 1), the number of previous MI/revascularizations was significantly higher in the third tertile of Lp(a) (T3) versus T1 (p=0.044). No significant differences were found for the remaining analyses. In the secondary analysis (figure 1) the level of Lp(a) was significantly higher in patients with 3-4 vessel CAD vs. 0-2 vessel (158.4±145.2 nmol/L vs. 103.16±104.6 p=0.044). Conclusion In this small real-world cohort population with acute MI, the number of previous MI or coronary revascularization was higher in patients with increased levels of Lp(a) and this marker of atherosclerotic disease was greater in patients with more extensive CAD.

A-216 Prevalence and status of Lipoprotein(a) in the Korean population visiting local clinics and hospitals

Abstract Background Lipoprotein a (Lp(a)) is a risk factor for cardiovascular disease (CVD) and has pro-atherogenic and pro-inflammatory effects. According to the Justification for the Use of Statins in Prevention: an Intervention Trial Evaluating Rosuvastatin (JUPITER) study, a sub-analysis was published showing that the risk of residual CVD after sufficiently lowering low-density lipoprotein cholesterol can be explained by Lp(a) concentration. The purpose of this study is to determine the prevalence of elevated Lp(a) and to analyze the characteristics of Lp(a) results by age, gender, and region in the Korean population visiting local clinics and hospitals. Methods We retrospectively reviewed Lp(a) test results from the Korean population who visited 117 local clinics and hospitals nationwide between February 2023 and January 2024. Serum levels of Lp(a) were measured by immunoturbidimetric assay. Lp(a) was analyzed to three age groups (<20, 20-59, ≥60 years) according to Lp(a) values (<30 or ≥30 mg/dl). One hundred seventeen local clinics and hospitals across the country were reclassified into 7 regions. Results A total of 15,523 patients (7,702 males and 7,821 females), aged 12-104 years, were included. The median (interquartile range, IQR) age of the population was 59 (49-69) years; the median (IQR) Lp(a) concentration was 9.7 (4.2-21.6) mg/dl. The prevalence of elevated Lp(a) levels (≥30 mg/dl) in this study was 16.7% (13.9% for males, 19.5% for females, p <0.001). Prevalence of elevated Lp(a) levels by age groups were as follows: <20 (8.9%, 5/56), 20-59 (13.9%, 1,071/7,724), ≥60 years (19.6%, 1,516/7,743). The correlation coefficient r between Lp(a) and age was 0.139 (p <0.001). No significant relationship was found between Lp(a) and region. Among 15,523 patients, the number of patients with Lp (a) level ≥100 mg/dl was 174 (n=70 for males, n=104 for females, p=0.128), and median (IQR) Lp(a) concentration was 115.1 (106.8-131.6) mg/dl. Of them, four patients showed extremely high Lp(a) levels (>180 mg/dL). Conclusions The prevalence of elevated Lp(a) in our population visiting local clinics and hospitals nationwide was 14.4% and differed by gender and age group. For successful management and establishment of the policy of CVD, it is important to identify the prevalence of elevated Lp(a). Future study is needed including the clinical information to confirm the present findings.

Association of Lipoprotein(a) With Severe Degenerative Aortic Valve Stenosis

BackgroundLipoprotein(a) (Lp[a]) is associated with the development of aortic valve calcification. ObjectivesThe aim of this study was to evaluate the association between the serum level of Lp(a) and the development of severe degenerative aortic stenosis (AS) and subsequent aortic valve replacement (AVR). MethodsA total of 44,742 patients with Lp(a) measurements and echocardiography at baseline evaluation between 2000 and 2020 were included from a single tertiary heart center. The primary outcome was the development of severe degenerative AS, defined as a transaortic maximal velocity of ≥4.0 m/s. ResultsDuring a median follow-up period of 6.8 years (Q1-Q3: 2.3-12.4 years), severe degenerative AS was diagnosed in 472 patients (1.1%), and subsequent AVR was performed in 387 patients (0.9%). Lp(a) levels were associated with risk for severe degenerative AS, with levels of 30 to 50, 50 to 100, and >100 mg/dL demonstrating adjusted HRs of 1.02 (95% CI: 0.78-1.34; P = 0.88), 1.18 (95% CI: 0.91-1.53; P = 0.22), and 1.96 (95% CI: 1.31-2.94; P = 0.001) compared to <30 mg/dL. Similarly, the risk for AVR due to severe degenerative AS was significantly associated with higher levels of Lp(a) (>100 mg/dL) (adjusted HR: 2.05; 95% CI: 1.31-3.19; P = 0.002). Such associations were not observed in the development of severe bicuspid (P = 0.63) or rheumatic (P = 0.96) AS. ConclusionsLp(a) levels >100 mg/dL were significantly associated with risk for severe degenerative AS and subsequent AVR, regardless of the baseline severity of AS. Such associations were not observed in other etiologies of severe AS.

Lipoprotein(a) and Lung Function Are Associated in Older Adults: Longitudinal and Cross-Sectional Analyses.

While numerous studies have confirmed a causal association between lipoprotein(a) [Lp(a)] and cardiovascular diseases, only a few studies have assessed the relationship between Lp(a) and pulmonary health, with inconsistent findings regarding this topic. This study's aim was to examine whether levels of serum Lp(a) are associated with lung function in a dataset of relatively healthy older adults. We used longitudinal data collected at two time points 7.4 ± 1.5 years apart from 679 participants (52% women, 68 [65-71] years old) from the Berlin Aging Study II (BASE-II). Multiple linear regression models adjusting for covariates were applied to examine the association between Lp(a) and lung function. The forced expiratory volume in one second (FEV1) and the forced vital capacity (FVC) were higher in both men and women with higher Lp(a) levels. However, since this association between lung function parameters and Lp(a) was not supported by Mendelian randomization analyses using recent genome-wide association study data, these relationships should be investigated in future work, as the observed differences are, in part, considerable and potentially clinically relevant.

The association between circulating lipoprotein subfractions and lipid content in coronary atheromatous plaques assessed by near-infrared spectroscopy.

Lipid content in coronary atheromatous plaques, measured by near-infrared spectroscopy (NIRS), can predict the risk of future coronary events. Biomarkers that reflect lipid content in coronary plaques may therefore improve coronary artery disease (CAD) risk assessment. We aimed to investigate the association between circulating lipoprotein subfractions and lipid content in coronary atheromatous plaques in statin-treated patients with stable CAD undergoing percutaneous coronary intervention. 56 patients with stable CAD underwent three-vessel imaging with NIRS when feasible. The coronary artery segment with the highest lipid content, defined as themaximum lipid core burden index within any4mmlength across the entire lesion (maxLCBI4mm), was defined as target segment. Lipoprotein subfractions and Lipoprotein a (Lp(a)) were analyzed in fasting serum samples by nuclear magnetic resonance spectroscopy and by standard in-hospital procedures, respectively. Penalized linear regression analyses were used to identify the best predictors of maxLCBI4mm. The uncertainty of the lasso estimates was assessed as the percentage presence of a variable in resampled datasets by bootstrapping. Only modest evidence was found for an association between lipoprotein subfractions and maxLCBI4mm. The lipoprotein subfractions with strongest potential as predictors according to the percentage presence in resampled datasets were Lp(a) (78.1 % presence) and free cholesterol in the smallest high-density lipoprotein (HDL) subfractions (74.3 % presence). When including established cardiovascular disease (CVD) risk factors in the regression model, none of the lipoprotein subfractions were considered potential predictors of maxLCBI4mm. In this study, serum levels of Lp(a) and free cholesterol in the smallest HDL subfractions showed the strongest potential as predictors for lipid content in coronary atheromatous plaques. Although the evidence is modest, our study suggests that measurement of lipoprotein subfractions may provide additional information with respect to coronary plaque composition compared to traditional lipid measurements, but not in addition to established risk factors. Further and larger studies are needed to assess the potential of circulating lipoprotein subfractions as meaningful biomarkers both for lipid content in coronary atheromatous plaques and as CVD risk markers.

Lipoprotein (a) is related to In-Stent neoatherosclerosis incidence rate and plaque vulnerability: Optical Coherence Tomography Study

BackgroundIn-stent neoatherosclerosis (ISNA) is an important reason for stent failure. High lipoprotein (a) [Lp (a)] level is an independent predictor of in-stent restenosis (ISR). To date, the relationship between the level of serum Lp (a) and the incidence rate and vulnerability of ISNA has never been verified.MethodsA total of 119 patients with 125 drug-eluting stent ISR lesions who underwent percutaneous coronary intervention guided by optical coherence tomography were enrolled in this study. According to their Lp (a) level, the patients were divided into two groups [high Lp (a) group ≥ 30 mg/dL, n = 47; or low Lp (a) group < 30 mg/dL, n = 72]. The clinical baseline, angiographic characteristics, and optical coherence tomography data of both groups were recorded and analyzed.ResultsNo significant differences in clinical and angiographic characteristics were found between the two groups (P > 0.05). The incidence rate of ISNA in the high Lp (a) group was significantly higher than that in the low Lp (a) group (94.0% [n = 47] vs. 52.0% [n = 39], P < 0.001). The incidence rate of thin-cap fibroatheroma in ISR lesions was significantly higher in the high Lp (a) group than in the low Lp (a) group (42% [n = 21] vs. 5.3% [n = 4], P < 0.001).ConclusionA high Lp (a) level is associated with the high incidence rate and plaque vulnerability of ISNA.

Association between LPA rs6415084 and rs6919346 variants and serum lipoprotein(a) levels amongst apparently healthy individuals

Introduction: Lipoprotein(a) (Lp[a]) synthesised by the liver consists of low-density lipoprotein which contains apoB-100 linked to apolipoprotein(a) (apo[a]) by disulphide bridge. LPA gene codes for highly polymorphic apo(a). The serum Lp(a) levels are highly varied amongst individuals and ethnicities, which could be attributed to the genetic polymorphisms present in LPA gene. Hence, this study aimed to analyse the association between LPA genetic variants, rs6415084 and rs6919346, with serum Lp(a) levels in apparently healthy subjects. Materials and Methods: In this cross-sectional study, 56 apparently healthy subjects were recruited after obtaining informed consent. Serum Lp(a) levels were measured by immunoturbidimetric assay, and the genotyping of the variants was determined by the real-time polymerase chain reaction. Spearman's correlation test was used to find the association between single-nucleotide polymorphism and serum Lp(a). P < 0.05 is considered statistically significant. Results: The median level of serum Lp(a) amongst the study subjects was found to be 26.75 mg/dL, which is higher in males (35.50 mg/dL) when compared to females (21.85 mg/dL). The analysis of LPA gene variant rs6415084 showed 58.9% of the subjects with computed tomography (CT) genotype, 17.85% with CC and 5.3% with TT genotype. In the case of the rs6919346 variant, 80% of the subjects had CC genotype, 8.9% with CT and 5.3% with TT genotype. Conclusion: Overall, a weak significant association was observed between heterozygous alleles of LPA gene variant rs6415084 with increased serum Lp(a) level.

ANALYSIS AND CORELATION OF A PANEL OF SERUM BIOMARKERS WITH TREATMENT OUTCOME OF ISCHEMIC HEART DISEASE IN A TERTIARY CARE HOSPITAL OF WEST BENGAL

Background :In India Ischemic heart disease (IHD ) is the of most common causes of mortality and morbidity . Several studies have pointed out a strong association of serum Lipoprotein (a) , Homocysteine and highly sensitive – C reactive protein [hs-CRP],with IHD , but these markers have been studied in isolation . Aim: The aim of the study was to assess diagnostic potential of the above biomarkers as well as their ability to reect treatment outcome. Results : The results of statistical analysis showed that levels of serum Lp (a) and serum homocysteine were signicantly raised in patients in of IHD compared to their apparently age and sex matched controls whereas the level of serum hsCRP level did not showed any signicant difference in between cases and controls. We also found signicant lower value of serum level Lp (a), homocysteine and hsCRP in 3 months and 6 months post treated cases compared to untreated cases of IHD. But failed to show any signicant correlation in between serum levels of Lp(a) , hsCRP and Homocysteine level with disease severity( LVEF%) of IHD. Conclusion :So the serum Lp(a) , hsCRP and Homocysteine level is associated with increase risk factor of IHD and would be a better upcoming diagnostic and marker for diagnosis of IHD patients .

Study of Serum Lipoprotein (a) in Hypothyroidism

Hypothyroidism occurs when your body doesn’t produce enough thyroid hormones. The thyroid is a small, butterfly-shaped gland that sits at the front of your neck. It releases hormones to help your body regulate and use energy. To this study compare Serum lipoprotein levels in hypothyroid patients and in control group. To find the correlation of Lp(a) with thyroid hormones status in hypothyroid patients. To find the hypothyroid patients. Levels of serum Lp (a), FT3, FT4, TSH, TC and TG were all estimated from the samples of the study group. The results of this study provide ample evidence that the levels of Serum Lp(a) are increased in hypothyroid patients.

Lipoprotein(a) and Hyperinsulinemia in Healthy Normal-weight, Prepubertal Mexican Children

ABSTRACT Background. Given the numerous gaps in our knowledge about the biological interactions of lipoprotein(a) [Lp(a)], we determined whether Lp(a) was associated with hyperinsulinemia in healthy normal-weight, prepubertal children. Methods. A total of 131 healthy normal-weight Mexican children aged 6 to 9 years at Tanner stage 1 who were born appropriate for gestational age were enrolled in a case–control study. Children with hyperinsulinemia were allocated into the case group (n = 32), and children with normal insulin levels were allocated into the control group (n = 99). Birth weight, age, and body mass index were matching criteria. Multivariate logistic regression analysis was used to compute the odds ratio (OR) between Lp(a) and both hyperinsulinemia and insulin resistance. Furthermore, a multivariate linear regression analysis was performed to evaluate the association between Lp(a) and both insulin levels and HOMA-IR. Both models were adjusted by sex, age, birth weight, and body mass index. Results. The median (25–75 percentile) serum levels of Lp(a) [20.0 (13.7–29.6) versus 14.6 (10.6–26.7) mg/dL, p = .003] and insulin [24.5 (6.0–30) versus 7.9 (4.3–9.0) µU/L, p < .0005] were higher in the case group than in the control group. The logistic regression analysis showed that Lp(a) was associated with hyperinsulinemia (OR 5.86; 95%CI 2.5–13.6, p < .0005) and insulin resistance (OR 2.01; 95%CI 1.1–9.9, p = .004). In addition, the linear regression analysis showed a significant association between serum Lp(a) and insulin levels (β 11.1; 95%CI 1.8–10.9, p < .0001) and the HOMA-IR index (β 2.606; 95%CI 2.3–2.9, p < .0005). Conclusion. Lp(a) was associated with hyperinsulinemia and insulin resistance in healthy normal-weight, prepubertal children.

Relationship between serum level of lipoprotein (a) and central macular thickness in diabetic patients

Background and aim Diabetic retinopathy and maculopathy are major tragedies in ophthalmology. Lipoprotein (Lp) (a) is a pro-atherogenic and a pro-thrombotic risk factor. It has an antifibrinolytic effect with increasing risk of clotting and blood vessel occlusion. Elevated Lp (a) concentrations can also damage the microcirculation by its oxidative effect. The aim of this study was to investigate the relationship between serum level of Lp (a) and the development of maculopathy in diabetic patients by measuring the central macular thickness (CMT) using optical coherence tomography.Patients and methods This case–control study included one case group of 40 eyes of 20 diabetic patients and one control group of 40 eyes of 20 nondiabetic age-matched and sex-matched patients. All participants were subjected to full ophthalmological examination, including best-corrected visual acuity testing, BMI calculation, glycosylated hemoglobin (HbA1c), serum Lp (a), and CMT measurement by three-dimensional optical coherence tomography.Results There was no significant difference between the two groups regarding age or sex. Cases group had significantly higher BMI, HbA1c, Lp (a), and CMT than the control group (P<0.001 for all). In addition, cases had significantly lower best-corrected visual acuity than the controls (P<0.001). A significant positive correlation was found between CMT (μm) and each of HbA1c, Lp (a), and BMI (P<0.001, P<0.001, and P=0.002, respectively). Lp (a) level of 11.34 ng/ml or more was found to have a 95% sensitivity, 95% specificity, and 95% overall accuracy in predicting central macular edema (CME). On univariate logistic regression analysis, both of the BMI and Lp (a) were independent significant predictors for CME (P<0.001 and P=0.05, respectively), with odds ratio of 1.569 and 14.482, respectively.Conclusion Lp (a) was significantly correlated with CMT. It had an excellent sensitivity and specificity in predicting CME and can be used as a potential marker for its detection.

Comparative Analysis of Serum Lipoprotein (a) in Hypothyroid and Healthy Subjects

This study is taken up to estimate and compare the level of serum Lp(a) in hypothyroid patients and in healthy controls. A total of 50 hypothyroid patients within aged group 20-60 years and total of 50 healthy controls within 20-60 years were enrolled in the study after taking written consent. Thyroid profile and Lp(a) were measured by CLIA and immune turbidemetric method respectively. Data collected was analysed using Stata version 14.1 software. Result shows an increased level of Lp(a) among hypothyroid patients when compared to healthy controls.

Is Lipoprotein (a) a Risk Factor for Coronary Artery Ectasia?

BackgroundThe pathophysiology of coronary artery ectasia (CAE) is under investigated and not well understood. Atherosclerosis is considered as the main etiologic factor for CAE in adults where more than 50% of CAE patients have atherosclerosis. Recently, lipoprotein (a) (Lp(a)) has emerged as a powerful risk factor for atherosclerosis and coronary artery disease (CAD). Serum levels of Lp(a) in patients with CAE have not been investigated. We assumed that Lp(a) may play a role in the pathogenesis of CAE. Principally, our study aims to identify whether Lp(a) is an independent risk factor for CAE.MethodsOur study is a prospective pilot study. Study population was collected prospectively from pool of patients referred for elective cardiac catheterization at Jordan University Hospital (JUH) in the period extending from February 17, 2018 to June 31, 2018. Patients were referred for elective coronary angiography after being interviewed and physically examined by a cardiologist (HA). Patients with known history of CAD or who are already on anti-lipidemic drugs either documented in the medical records or by interviewing patients for history of revascularization were excluded from the study.ResultsRegarding the primary outcome, there was no significant difference in Lp(a) concentrations between normal and ectasia groups in the general sample (median: 17.5mg/dL vs. 20.4 mg/dL, P value = 0.38).ConclusionsOur study concludes that there is no detected relationship between elevated Lp(a) levels and developing CAE. CAE was more common in patients with low high-density lipoprotein (HDL) level (compared with patients with normal coronaries), higher total cholesterol level (compared with patients with non-obstructive stenosis) and higher hemoglobin A1c (HbA1c).

Relationship between serum levels of osteoproteins, inflammatory cytokines and coronary heart disease and disease severity

To explore the relationship between serum levels of osteoprotein (OPG), soluble nuclear factor-κB receptor activator ligand (sRANKL), inflammatory factors and coronary heart disease (CHD) and its severity. The patients who underwent coronary angiography (CAG) due to chest pain admitted to department of cardiology of Tianjin Chest Hospital from April 2017 to December 2018 were enrolled, and they were divided into CHD group and non-CHD group according to the CAG results. The gender, age, history of hypertension, smoking history, diabetes, the levels of cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), apolipoprotein AI (apoAI), apolipoprotein B (apoB), lipoprotein (a) [Lp (a)], MB isoenzyme of creatine kinase (CK-MB) and other clinical data of patients were collected. The serum levels of OPG, sRANKL, matrix metalloproteinase-9 (MMP-9), monocyte chemotactic protein-1 (MCP-1), insulin-like growth factor-1 (IGF-1) and interleukin-6 (IL-6) were determined by enzyme-linked immunosorbent assay (ELISA). According to the results of CAG, the patients with CHD were divided into single-, double-, triple-branch coronary artery lesion groups, and the relationship between the levels of serum OPG, sRANKL, inflammatory factors and the degree of coronary artery lesions was observed. Multivariate Logistic regression was used to analyze the risk factors of CHD, and receiver operating characteristic (ROC) curve was plotted to analyze the predictive value of main risk factors for CHD. A total of 472 patients were enrolled in the final analysis during the study period, including 264 patients in the CHD group, 208 patients in the non-CHD group, 79 patients in the CHD group with single-branch disease, 75 patients with double-branch disease, and 110 patients with three-branch disease. (1) Compared with the non-CHD group, the CHD group had more older male patients, as well as higher proportion of hypertension and diabetes, the levels of serum Lp (a) and CK-MB were significantly increased, and the levels of serum HDL-C and apoAI were significantly lowered. There was no statistically significant difference in serum TC, LDL-C, or apoB between the two groups. The levels of serum OPG, MMP-9, MCP-1, IGF-1 and IL-6 in the CHD group were significantly higher than those in the non-CHD group [OPG (μg/L): 1.79±0.50 vs. 1.50±0.30, MMP-9 (μg/L): 57.91 (33.50, 130.46) vs. 38.33 (29.43, 109.78), MCP-1 (μg/L): 298.30 (207.96, 537.16) vs. 252.73 (165.22, 476.01), IGF-1 (μg/L): 734.03±486.11 vs. 217.75±126.45, IL-6 (ng/L): 64.76±40.25 vs. 48.60±15.80, all P < 0.05], and the levels of serum sRANKL was significantly lower than that in the non-CHD group (ng/L: 344.31±122.14 vs. 378.74±109.27, P < 0.05). (2) The serum OPG level showed a slight upward tendency with the increase in the number of coronary artery lesions, and the sRANKL level showed a slight downward tendency [OPG (μg/L) in the single-, double-, triple-branch coronary artery lesion groups was 1.74±0.49, 1.76±0.50, 1.85±0.52, and sRANKL (ng/L) was 354.96±116.64, 340.05±124.24, 339.57±125.03, respectively) without statistically significant differences (all P > 0.05). The levels of IGF-1 and IL-6 were increased with the number of coronary artery lesions [IGF-1 (μg/L) in the single-, double- and triple-branch coronary artery lesions groups was 372.13±258.42, 676.06±350.29, 1 033.47±468.06, and IL-6 (ng/L) was 48.87±16.72, 65.36±18.84, 75.76±22.72, respectively], and the differences among different lesion groups were statistically significant (all P < 0.01). Correlation analysis showed that IGF-1 level was significantly positively correlated with the number of coronary artery lesions (r = 0.612, P < 0.01), while IL-6 was not correlated with the number of coronary artery lesions (r = 0.185, P > 0.05). (3) Multivariate Logistic regression analysis showed that elevated serum OPG and IGF-1 levels were risk factors for CHD [OPG: odds ratio (OR) = 1.995, 95% confidence interval (95%CI) = 1.936-2.067, P = 0.012; IGF-1: OR = 1.009, 95%CI = 1.004-1.015, P = 0.001]. (4) ROC curve analysis showed that the area under ROC curve (AUC) of OPG and IGF-1 was 0.716 and 0.867, respectively. When the cut-off value of OPG was 1.13 μg/L, the sensitivity was 81.7%, the specificity was 58.1%; when the cut-off value of sRANKL was 401.20 μg/L, the sensitivity was 69.7%, the specificity was 95.7%. CHD was associated with increased in OPG, related inflammatory cytokines including MMP-9, MCP-1, IGF-1 and IL-6, and decreased in sRANKL. The level of IGF-1 was positively correlated with the severity of CHD. The serum levels of OPG and IGF-1 were risk factors for CHD, which had good predictive value for CHD.

Levels of Lipoprotein (a) in patients with coronary artery disease with and without inflammatory rheumatic disease: a cross-sectional study

ObjectivesPatients with various inflammatory rheumatic diseases (IRDs) have increased risk of atherothrombotic disease. Lipoprotein (a) (Lp(a)) is a risk factor for atherosclerosis but its role in IRD with accompanying coronary...

Correlation of lipoprotein(a) with clinical stability and severity of coronary artery lesions in patients with coronary artery disease

To analyze the correlation of lipoprotein(a) [Lp(a)] with the clinical stability and severity of coronary artery stenosis in patients with coronary artery disease (CAD). A total of 531 patients undergoing coronary angiography in Nanfang Hospital between January, 2013 and December, 2016 were enrolled in this study. At the cutoff Lp(a) concentration of 300 mg/L, the patients were divided into high Lp(a) group (n=191) and low Lp(a) group (n=340). In each group, the patients with an established diagnosis of CAD based on coronary angiography findings were further divided into stable angina pectoris (SAP) group and acute coronary syndrome (ACS) group. The correlation between the severity of coronary artery stenosis and Lp(a) was evaluated. The patients in high and low Lp(a) groups showed no significant differences in age, gender, body mass index, smoking status, hypertension, or diabetes (P&gt;0.05). Multivariate logistic regression analysis revealed that age, gender, and serum levels of low-density lipoprotein cholesterol (LDL-C) and Lp(a) were independent risk factors for CAD in these patients. A high Lp(a) level was associated with an increased risk of CAD (OR=2.443, 95%CI: 1.205-4.951, P=0.013). The patients with a high Lp(a) level were at a significantly higher risk of CAD than those with a low Lp(a) level irrespective of a low or high level of LDL-C (P=0.006 and 0.020). In the patients with CAD, the ACS group had a significantly higher Lp(a) level than the SAP group (P &lt; 0.001); the proportion of the patients with high Gensini scores was significantly greater in high Lp(a) group than in low Lp(a) group (17.3% vs 5.6%, P=0.026), and a linear relationship was found between Lp(a) level and Gensini score (R=0.130, P=0.006). Serum level of Lp(a) is an independent risk factor for CAD, and an increased Lp(a) is the residual risk for CAD. In patients with CAD, a high Lp(a) level is associated with the clinical instability and severity of coronary artery stenosis.

Advanced Nonalcoholic Steatohepatitis Is Associated with Low Serum Lipoprotein(a) Concentrations

Background: Nonalcoholic fatty liver disease (NAFLD), a complication frequently coexisting with diabetes, is at high risk of progression to nonalcoholic steatohepatitis (NASH), cirrhosis, liver failure, and hepatocellular carcinoma. Advanced NASH and advanced hepatitis C have poor prognoses, and therapeutic intervention is limited. In contrast, NAFLD may be related to serum lipoprotein(a) (Lp[a]) levels. However, the association between serum Lp(a) levels and progression of NAFLD to NASH remains unknown. We therefore investigated this issue among patients with biopsy-proven NAFLD. Methods: We enrolled 136 patients with biopsy-proven NAFLD (nonalcoholic fatty liver [NAFL], 20 patients; stage 1, 29 patients; stage 2, 32 patients; stage 3, 26 patients; stage 4, 29 patients), and classified them into the advanced NASH group (stages 3 and 4) and the non-advanced group (NAFL, and stages 1 and 2). Serum Lp(a) levels were measured using the turbidimetric latex agglutination method, and data were divided into tertiles. Results: In total, 76.5% and 47.2% of the patients were diabetic in the advanced NASH group and the non-advanced group, respectively. Serum Lp(a) levels in the advanced NASH group were significantly lower than those in the non-advanced group (P = 0.009). Multivariate analysis, adjusted for age, sex, body mass index, diabetes mellitus, dyslipidemia, and hypertension, showed that lower serum Lp(a) levels were significantly associated with a higher prevalence of advanced NASH; the adjusted odds ratios (95% confidence intervals) for advanced NASH in relation to serum Lp(a) levels of ≤6.1, 6.2-13, and ≥13.1 mg/dL were 1.00 (reference), 0.333 (0.14-0.791), and 0.341 (0.124-0.937), respectively (P for trend = 0.004). Conclusions: It was concluded that lower levels of serum Lp(a) could be a significant risk factor for advanced NASH and that serum Lp(a) levels may be a useful tool for distinguishing between NASH and NAFL. Disclosure K. Konishi: None. T. Miyake: None. H. Senba: None. S. Yamamoto: None. S. Furukawa: None. T. Watanabe: None. Y. Koizumi: None. O. Yoshida: None. M. Hirooka: None. T. Kumagi: None. M. Abe: None. B. Matsuura: None. Y. Hiasa: None.

The study of characteristic of serum Lp(a) level in in patients with chronic kidney disease

Objective To investigate the characteristic of lipoprotein(a)[Lp(a)] in different phases of chronic kidney disease(CKD), to provide the basis for clinical prevention and treatment of CKD. Methods 200 patients with CKD in the Republic Hospital of Shifang were collected as study group, including 5 phases (every phase had 40 cases), and 100 healthy people were selected as control group.Measured the serum Lp(a) of both study and control group, analyzed the correlations between Lp(a) and different phase of CKD.All data were analyzed by SPSS version 17.0.The significant level was established at 0.05. Results CKD1 [(146.0±95.5)mg/L] and all CKD group [(231.5±133.2)mg/L] had higher level of serum Lp(a) than the control group [(115.5±70.2)mg/L] (Z=-2.800, P<0.05 and Z=-7.922, P<0.05). CKD3 had higher Lp(a) level than CKD2(Z=-2.069, P<0.05), while there were no significant differences between each of the other two groups.CKD4-5 [(325.0±194.7)mg/L] also had higher Lp(a) level than CKD1-3 [(182.0±110.5)mg/L](Z=-4.439, P<0.05). Conclusion Patients with CKD always have high level of serum Lp(a), which have been slowly increased since CKD1, meanwhile the level of Lp(a) may have a certain correlation with the stage of CKD development, since Lp(a) is an important promoting factor in the progress of CKD. Key words: Nephrosis; Lipoprotein(a)

Correlation between serum levels of proprotein convertase subtilisin/kexin type 9 (PCSK9) and atherogenic lipoproteins in patients with coronary artery disease.

BackgroundProprotein convertase subtilisin/kexin type 9 (PCSK9) is a key regulator of serum low-density lipoprotein (LDL) cholesterol levels. Recently, PCSK9 has additionally been related to metabolic risk factors such as the levels of triglycerides, apolipoprotein B (apoB), insulin, and glucose, as well as body mass index. The purpose of this study was to investigate correlations between serum levels of PCSK9 and apoB-containing atherogenic lipoproteins in patients with coronary artery disease (CAD).MethodsSerum levels of PCSK9 and lipoprotein(a) [Lp(a)]; small, dense LDL; and oxidized LDL were measured in 101 patients with CAD who were not receiving lipid-lowering therapy.ResultsSerum hetero-dimer PCSK9 levels were positively correlated with serum levels of Lp(a) (r = 0.195, p = 0.05); small, dense LDL (r = 0.336, p = 0.0006); and oxidized LDL (r = 0.268, p = 0.008). Multivariate regression analyses showed that serum hetero-dimer PCSK9 was a significant predictor of serum levels of Lp(a) (β = 0.235, p = 0.01); small, dense LDL (β = 0.143, p = 0.03); and oxidized LDL (β = 0.268, p = 0.008).ConclusionsSerum PCSK9 levels were positively correlated with serum levels of Lp(a); small, dense LDL; and oxidized LDL in patients with CAD. This suggests that the interaction between serum PCSK9 and apoB-containing lipoproteins plays a role in establishing the atherosclerotic status of patients.Trial registrationUMIN Clinical Trials Registry, UMIN ID: C000000311.

Serum levels of Lp(a) are related to waist circumference in NAFLD patients with low prevalence of co-morbidities

Background: Novel evidence suggests a relationship between circulating Lp(a) levels and the presence of cardiovascular events independently from the cardio-metabolic profile.Methods and results: The purpose of this study was to investigate serum Lp(a) concentrations in relation to carotid intima-media thickness (IMT), anthropometric measures, lipid profile, assessment of insulin resistance, and other parameters conventionally used to predict CVD risk, in obese patients suffering from hepatic steatosis (HS), the well-known nonalcoholic fatty liver disease (NAFLD). Evidencing the key-points of this research, firstly, serum Lp(a) concentrations were not associated with carotid IMT in this selected population or, consequently, with early atherosclerosis, at least as evaluated by IMT. Secondly, carotid IMT was not predicted by HS severity, as evaluated by ultrasound. Finally, in the adjusted model, Lp(a) was positively predicted by waist circumference (WC) (β = 0.25, t = 2.3, p = 0.02) and negatively by central adiposity, assessed as visceral adipose tissue at US (β = −0.33, t = −3.0, p = 0.003).Conclusion: Serum Lp(a) values may not play a direct role in increasing IMT, albeit associated with WC.