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Elevated Lp(a) with a small apo(a) isoform in children: risk factor for the development of premature coronary artery

Albert Dirisamer1, Harald Widhalm, Elsie Aldover-Macasaet

  • 1Department of Obesity and Lipid Disorder, University of Vienna, Austria.

Acta Paediatrica (Oslo, Norway : 1992)
|August 8, 2008
PubMed

Insights

Elevated small-isoform Lipoprotein(a) (Lp(a)) is a significant risk factor for early cardiovascular disease in children with hypercholesterolemia. This finding highlights the importance of assessing apo(a) size and Lp(a) levels in pediatric cardiovascular risk assessment.

Area of Science:

  • Cardiovascular Science
  • Genetics
  • Pediatric Endocrinology

Background:

  • Lipoprotein(a) (Lp(a)) and apolipoprotein(a) (apo(a)) isoforms are linked to cardiovascular disease.
  • Specific apo(a) isoforms combined with high Lp(a) may predict premature coronary artery disease.

Purpose of the Study:

  • Investigate the association between familial history of premature coronary artery disease, apo(a) size, and Lp(a) levels in hypercholesterolemic children and adolescents.
  • Utilize a novel method for determining apo(a) isoforms.

Main Methods:

  • Classified apo(a) isoforms into six phenotype patterns (S1-S4, B, F) based on K-IV repeats.
  • Grouped apo(a) isoforms into low-molecular-weight and high-molecular-weight categories.
  • Quantified Lp(a) contribution in double-banded isoforms based on band intensity.

Main Results:

  • 46% of the risk group had elevated Lp(a) with a small apo(a) isoform, compared to 20% in the control group (p < 0.05).
  • Children and adolescents in the risk group showed a statistically significant higher prevalence of elevated Lp(a) levels (p < 0.05).

Conclusions:

  • Elevated levels of small-isoform Lp(a) may serve as a strong, independent risk factor for premature coronary artery disease.
  • This is particularly relevant in pediatric populations with hypercholesterolemia.
Abstract

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