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Lipoprotein(a) at birth, in blacks and whites
1Department of Laboratory Medicine, Children's National Medical Center, Washington, D.C. 20010.
Insights
Newborns show no significant differences in lipoprotein(a) (Lp(a)) levels by race or gender. Lp(a) concentrations gradually increase from birth to adult levels by age two, indicating an immature system at birth.
Area of Science:
- Cardiovascular Science
- Pediatric Health
- Biochemistry
Background:
- Lipoprotein(a) (Lp(a)) is a known risk factor for cardiovascular diseases, including coronary heart disease, vein graft restenosis, and cerebrovascular disease.
- Previous studies indicate higher Lp(a) concentrations in Black individuals compared to White individuals, and minor differences between males and females.
Purpose of the Study:
- To investigate whether racial and gender disparities in Lp(a) concentrations are present at birth.
- To understand the developmental trajectory of Lp(a) levels from infancy to adulthood.
Main Methods:
- Analysis of Lp(a) concentrations in cord blood samples from 109 Black and 123 White newborns.
- Inclusion of maternal age, gestational age, fetal maturity, weight, height, and head circumference as covariates.
- Cross-sectional examination of serum Lp(a) in 221 infants, children, and adults.
Main Results:
- Mean cord blood Lp(a) concentration was 4.0 mg/dl, approximately five-fold lower than adult levels.
- No statistically significant differences in Lp(a) concentrations were observed between racial groups (Black vs. White) or gender groups (male vs. female) at birth.
- Serum Lp(a) concentrations showed a gradual increase from birth, reaching adult values by the second year of life.
Conclusions:
- Racial and gender differences in Lp(a) concentrations are not established at birth.
- The regulatory system for Lp(a) appears immature or unchallenged in newborns.
- Lp(a) levels undergo significant development during early childhood.
Abstract:
It has been shown that blacks have considerably higher concentrations than whites of lipoprotein(a) (Lp(a)), which has been identified as an independent risk factor for coronary heart disease, vein graft restenosis, and cerebrovascular disease. Smaller differences in Lp(a) concentrations have been noted between males and females. To examine whether gender and race differences are already detectable at birth, we examined Lp(a) concentrations in cord blood samples of 109 black (49 male and 60 female) and 123 white (67 male and 56 female) newborns. Maternal age, gestational age, fetal maturity indicators, weight, height and head circumference were analyzed as covariates. For race and sex combined, the mean Lp(a) concentration was 4.0 mg/dl (S.D. of 3.94 mg/dl), approximately 5-fold lower than that observed in adults. No statistically significant differences were found between race or gender groups. The cross-sectional examination of serum Lp(a) concentrations of 221 infants, children and adults showed a gradual increase in Lp(a) concentrations from birth to adult values by the second year of life. We conclude that the system responsible for the production and control of Lp(a) concentration is not yet mature--or has not yet been challenged--at birth.