Relationship of Lipoprotein (A) with Other Measures of Atherogenic Cholesterol

Purpose: Lipoprotein (a) [LP(a)] represents a class of lipoproteins with structural similarity to low density lipoprotein (LDL). Lp(a) consists of a cholesterol-laden LDL–like particle bound to a plasminogen-like glycoprotein [apolipoprotein(a)], making it capable of contributing to both atherosclerosis and thrombosis. Indeed Lp (a) has been shown to be an independent risk factor in the development of CVD and causative of CVD-related events. Nonetheless, questions remain about screening and treatment of individual with elevated levels, especially youth ( Methods This is a retrospective chart review of youth (age) referred to the Cardiovascular Health and Risk Reduction Program at Cook Children’s Medical Center between Jan 2012 and Feb 2015. Records were reviewed and de-identified data collected of those routinely tested for risk factors associated with premature CVD, including total and LDL-C, HDL-C, TG and Lp(a). Non HDL-C was calculated as: Total cholesterol – HDL-C. Since fasting has little effect on levels of HDL-C, LDL-C, and non HDL-C, blood samples were collected with and without fasting. Pearson’s correlations and non-parametric Spearman’s rho (Ρ) were calculated between Lipoprotein (a) and each individual risk factor. Results The two sets of correlations produced similar results. Lp(a) was positively and significantly, though modestly, correlated with total cholesterol, non HDL-C and LDL-C. However, Lp(a) was not significantly correlated with HDL-C or TG. Conclusions Lp (a) is associated with increased risk for premature cardiovascular disease, such as myocardial infarction and stroke. While moderate correlations to Lp (a) were observed between non HDL-C and LDL-C, Lp (a) seemingly remains an independent risk factor.