Lipoprotein(a): Genotype-Phenotype relationship and impact on atherogenic risk

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Abstract

In 2010, more than 45 years after the initial discovery of lipoprotein(a) [Lp(a)] by Kare Berg, an European Atherosclerosis Society Consensus Panel recommended screening for elevated Lp(a) in people at moderate to high risk of atherosclerotic cardiovascular disease (CVD). This recommendation was based on extensive epidemiological findings demonstrating a significant association between elevated plasma Lp(a) levels and coronary heart disease, myocardial infarction, and stroke. In addition to those patients considered to be at moderate to high risk of heart disease, statin-treated patients with recurrent heart disease were also identified as targeted for screening of elevated Lp(a) levels. Taken together, recent findings have significantly strengthened the notion of Lp(a) as a causal risk factor for CVD. It is well established that Lp(a) levels are largely determined by the size of the apolipoprotein a [apo(a)] gene; however, recent studies have identified several other LPA gene polymorphisms that have significant associations with an elevated Lp(a) level and a reduced copy number of K4 repeats. In addition, the contribution of other genes in regulating Lp(a) levels has been described. Besides the strong genetic regulation, new evidence has emerged regarding the impact of inflammation as a modulator of Lp(a) risk factor properties. Thus, oxidized phospholipids that possess a strong proinflammatory potential are preferentially carried on Lp(a) particles. Collectively, these findings point to the importance of both phenotypic and genotypic factors in influencing apo(a) proatherogenic properties. Therefore, studies taking both of these factors into account determining the amount of Lp(a) associated with each individual apo(a) size allele are valuable tools when assessing a risk factor role of Lp(a).

Original languageEnglish (US)
Pages (from-to)411-418
Number of pages8
JournalMetabolic Syndrome and Related Disorders
Volume9
Issue number6
DOIs
StatePublished - Dec 1 2011

Fingerprint

Lipoprotein(a)
Genotype
Phenotype
Apolipoproteins
Heart Diseases
Cardiovascular Diseases
Genes
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Coronary Disease
Phospholipids
Stroke
Alleles
Myocardial Infarction

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Internal Medicine

Cite this

Lipoprotein(a) : Genotype-Phenotype relationship and impact on atherogenic risk. / Byambaa, Enkhmaa; Erdembileg, Anuurad; Zhang, Wei; Tran, Tina; Berglund, Lars.

In: Metabolic Syndrome and Related Disorders, Vol. 9, No. 6, 01.12.2011, p. 411-418.

Research output: Contribution to journalArticle

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