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Lipoprotein(a): an emerging cardiovascular risk factor
Giuseppe Lippi1, Giancesare Guidi
1Istituto di Chimica e Microscopia Clinica, Dipartimento di Scienze Morfologiche e Biomediche, Università degli Studi di Verona, Verona, Italy.
Critical Reviews in Clinical Laboratory Sciences
|March 12, 2003
Summary
Raised lipoprotein(a) levels are a key inherited risk factor for atherosclerosis. While its role in vascular disease is complex, lipoprotein(a) may also have protective effects, influencing longevity.
Area of Science:
- Biochemistry
- Cardiovascular Medicine
- Genetics
Background:
- Lipoprotein(a) [Lp(a)] is a cholesterol-rich particle with a unique apolipoprotein(a) linked to apolipoprotein B100.
- Plasma Lp(a) levels are primarily genetically determined, but influenced by acquired factors affecting its metabolism.
- Elevated Lp(a) is a significant inherited risk factor for atherosclerosis and cardiovascular disease.
Purpose of the Study:
- To explore the dual role of Lipoprotein(a) in cardiovascular health and disease.
- To understand the mechanisms underlying Lp(a)'s athero-thrombotic potential.
- To investigate potential counterbalancing effects of Lp(a) on cardiovascular risk.
Main Methods:
- Structural comparison of Lp(a) with plasminogen and LDL.
- Analysis of clinical data correlating Lp(a) levels with atherosclerosis and cardiovascular risk.
- Review of existing literature on Lp(a) metabolism and function.
Main Results:
- Lp(a) shares structural similarities with plasminogen and LDL, suggesting roles in both thrombosis and lipid metabolism.
- High Lp(a) concentrations are strongly linked to premature and advanced atherosclerosis.
- Paradoxically, elevated Lp(a) has been observed in individuals with longevity, suggesting potential protective or regenerative properties.
Conclusions:
- Lipoprotein(a) plays a complex role in vascular occlusive disorders, bridging atherosclerosis and thrombosis.
- The athero-thrombotic mechanisms of Lp(a) require further elucidation.
- Lp(a)'s potential regenerative and antineoplastic properties may counterbalance its atherogenicity in certain contexts, impacting longevity.