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Lipoprotein (a)

LIPOPROTEIN (A) [FS-LIPO(A)]

Lipoprotein(a) or Lp(a) is a type of lipoprotein that carries cholesterol in the blood. It is structurally similar to LDL cholesterol – it consists of one apolipoprotein-B, cholesterol, and other lipids, such as one apolipoprotein (a) molecule.


High Lp(a) levels are a significant risk factor for cardiac diseases, coronary artery calcification, cardiac arrest, stroke, peripheral arterial disease, and venous thrombosis. Lp(a) may promote the utilization of LDL cholesterol in the walls of blood vessels associated with inflammation and endothelial damage, i.e., it may encourage the build-up of atherosclerotic plaque. Due to the structure of apo(a) (a part of Lp(a)) that may prevent the function of clot-dissolving enzymes, Lp(a) may promote the build-up of atherosclerotic plaque in the arteries.


The levels of Lp(a) present are primarily determined by genetics. Conventional lifestyle factors have no significant impact on them. Inflammation appears to further intensify the plaque-forming tendency of Lipo(a), suggesting that reducing inflammation naturally by consuming an anti-inflammatory diet may reduce cardiovascular disease risk elevated by Lp(a). Elevated Lp(a) levels commonly occur with hypothyroidism. This means that treating hypothyroidism properly may also reduce Lp(a) levels. Niacin (vitamin B3) has also been found to lower Lp(a). Studies recommend the use of long-acting, extended-release niacin products.


Finnish reference range and recommended values (fS-Lipo(a)):

  • Optimal: Less than 35 nmol/L
  • Borderline normal: 35–75 nmol/L
  • Normal reference range: less than 75 nmol/L
  • Elevated risk: 75–125 nmol/L
  • High risk: more than 125 nmol/L

Individuals with a value higher than 125 nmol/L have 2–3 times the risk of coronary thrombosis compared to normal levels.

SUMMARY:

Saturated fat does not block arteries. Coronary artery disease is a chronic inflammatory disease, the risk of which can be reduced significantly with lifestyle factors (see above). In terms of cholesterol values, the two main factors predicting cardiac diseases are:

  • The ratio of total cholesterol to HDL – the higher the ratio, the higher the risk
  • The ratio of triglycerides to HDL cholesterol predicts insulin resistance and cardiac mortality – the higher the ratio, the higher the likelihood of type 2 diabetes, coronary artery disease, coronary thrombosis, and mortality associated with these.

In addition to conventional cholesterol values, it is a good idea to test the number of LDL particles; high levels correlate directly with cardiovascular disease. Lipoprotein(a) is an independent risk factor marker for cardiovascular diseases.