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Association between lipoprotein (a) and lipid profile and body composition in patients with high cardiovascular risk
Joanna Popiolek-Kalisz1, Pierre Sabouret2
1Department of Clinical Dietetics, Medical University of Lublin, Lublin, Poland; Department of Cardiology, Cardinal Wyszynski Hospital in Lublin, Lublin, Poland.
Insights
Lipoprotein(a) [Lp(a)] levels are not linked to body composition in high cardiovascular risk patients. However, body fat distribution still impacts HDL-C and triglycerides, suggesting body composition assessment is key for managing residual cardiovascular risk.
Area of Science:
- Cardiology
- Metabolic Health
- Biochemistry
Background:
- Dyslipidemia is a primary driver of atherosclerosis and cardiovascular events.
- Low-density lipoprotein cholesterol (LDL-C) lowering is the main therapeutic goal.
- Lipoprotein(a) [Lp(a)] is an independent, genetically determined cardiovascular risk factor often unresponsive to standard lipid-lowering therapies.
Purpose of the Study:
- To investigate the relationship between body composition parameters and lipid profiles, including Lp(a), in high cardiovascular risk patients.
- To determine if Lp(a) levels correlate with anthropometric measures and body composition.
- To assess the influence of body composition on lipid profiles despite lipid-lowering pharmacotherapy.
Main Methods:
- A cross-sectional study involving 207 clinically stable high cardiovascular risk patients undergoing lipid-lowering pharmacotherapy.
- Body composition assessed via bioelectrical impedance analysis, measuring body mass index (BMI), fat mass (FM%), and fat-free mass percentage (FFM%).
- Patients stratified into groups based on Lp(a) concentration (<75 nmol/L, 75-125 nmol/L, >125 nmol/L).
Main Results:
- Lp(a) levels showed no significant association with body composition, age, or sex.
- High-density lipoprotein cholesterol (HDL-C) was inversely correlated with BMI (R=-0.25, p<0.001) and triglycerides were positively correlated with FM% (R=0.17, p=0.02) and BMI (R=0.28, p<0.001).
- No significant differences in lipid profiles or body composition were observed across different Lp(a) concentration strata.
Conclusions:
- Lp(a) appears independent of body composition in high cardiovascular risk individuals, reinforcing its role as a non-modifiable, genetic risk factor.
- Despite pharmacotherapy, body fat distribution significantly influences HDL-C and triglyceride levels.
- Body composition assessment may offer clinical value in managing cardiovascular risk and addressing residual risk beyond LDL-C management.
Purpose:
Dyslipidemia remains a major contributor to atherosclerosis and cardiovascular events. While low-density lipoprotein cholesterol (LDL-C) lowering is the primary treatment target, lipoprotein(a) [Lp(a)] has emerged as an independent, genetically determined risk factor, often unaffected by standard treatment. This study aimed to analyze the relationship between body composition parameters and lipid profile, including Lp(a).
Materials And Methods:
Clinically stable high cardiovascular risk patients (n = 207) receiving lipid-lowering pharmacotherapy were enrolled in this cross-sectional study. Anthropometric data and body composition were assessed using bioelectrical impedance analysis, including body mass index (BMI), fat mass (FM%) and fat-free mass percentage (FFM%). Lp(a) and lipid profile were measured. Patients were stratified by Lp(a) concentration: <75 nmol/L, 75-125 nmol/L, and >125 nmol/L.
Results:
Lp(a) levels showed no significant association with body composition, age, and sex. In contrast, HDL-C was significantly inversely correlated with BMI (R = -0.25, p < 0.001) and this relationship was independent of sex (β = -0.68, p < 0.001), while triglycerides were positively correlated with FM% (R = 0.17, p = 0.02) and BMI (R = 0.28, p < 0.001) and negatively with FFM% (R = -0.17, p = 0.02). LDL-C was not associated with body composition. No significant differences in lipid profile or body composition were observed across Lp(a) strata.
Conclusions:
In high cardiovascular risk patients, Lp(a) appears unrelated to body composition, supporting its role as a non-modifiable, genetically driven risk factor. Conversely, despite pharmacotherapy, HDL-C and triglycerides demonstrated significant associations with body fat distribution. These findings suggest clinical role of body composition assessment in cardiovascular risk management, particularly in addressing residual risk beyond LDL-C.
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