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Updated: May 26, 2026
Isolation and Analysis of Plasma Lipoproteins by Ultracentrifugation
Published on: January 28, 2021
Testing for lipoprotein(a) concentration and apolipoprotein(a) phenotypes: method standardization and pediatric
Claus Langer1, Bertram Tambyrayah, Sabine Thedieck
1Department of Thrombosis and Hemostasis Research, Institute of Clinical Chemistry and Laboratory Medicine, Germany.
Insights
Elevated lipoprotein(a) (Lp[a]) is a risk factor for vascular disease in children. This study established age-dependent reference values for Lp[a] plasma concentrations in pediatric patients to aid in diagnosis and research.
Area of Science:
- Cardiovascular Research
- Pediatric Medicine
- Clinical Chemistry
Background:
- Elevated lipoprotein(a) (Lp[a]) is a recognized independent risk factor for atherosclerosis, heart disease, and stroke in adults.
- In children, high Lp[a] levels are also linked to an increased risk of symptomatic thromboembolism.
Purpose of the Study:
- To describe methods for evaluating Lp[a] phenotypes.
- To correlate Lp[a] phenotypes with plasma concentrations.
- To establish age-dependent reference values for Lp[a] in pediatric populations.
Main Methods:
- Enzyme-linked immunosorbent assay (ELISA) was used to measure Lp[a] plasma concentrations.
- Agarose gel electrophoresis and anti-apolipoprotein(a) immunoblotting were employed for phenotype analysis.
- Study included 184 pediatric patients with thromboembolic events and 150 healthy controls.
Main Results:
- Mean Lp[a] concentration was 3 mg/dL in infants (1-12 months) and 10 mg/dL in older children (1.2-18 years) in the control group.
- Established upper percentile cut-offs for Lp[a] concentrations across different pediatric age groups.
- Provided age-specific reference ranges for Lp[a] in children.
Conclusions:
- Age-dependent reference values for plasma Lp[a] concentrations in children have been established.
- These reference values will facilitate the harmonization of international pediatric studies.
- The findings will aid in further evaluating the role of elevated Lp[a] in childhood vascular diseases.
Abstract:
Increased levels of lipoprotein(a) (Lp[a])are known independent risk factor for atherosclerosis, heart disease, and stroke in adults. Even in children it could be shown that elevated levels of Lp(a) are an independent risk factor for symptomatic thromboembolism. The aim of this work was to describe the methods used for evaluating Lp(a) phenotypes, to link them to Lp(a) plasma concentrations, and to establish age-dependent reference values in children. Lp(a) plasma concentrations were measured with enzyme-linked immunosorbent assay technique in parallel to agarose gel electrophoresis and subsequent anti-apolipoprotein(a) immunoblotting. We included 184 pediatric patients with stroke or venous thromboembolism, and 150 healthy age-matched controls in this study. In the control children we could find a mean Lp(a) concentration of 3 mg/dL for children 1 to 12 months of age, and in subjects 1.2 to 18 years of age, the mean Lp(a) concentration was 10 mg/dL. Using percentile classification the upper percentile cut-offs were as follows: age 3 to 6 months: 14 mg/dL; 6.1 to 12 months: 15 mg/dL; 1.1 to 9 years: 22 mg/dL; and 9.1 to 18 years: 30 mg/dL, respectively. In the present study we have established age-dependent reference values of plasma Lp(a) concentrations. The latter will help to harmonize international pediatric studies and to further evaluate the role of elevated Lp(a) in childhood vascular disease.
