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Published on: October 12, 2017
Physiological within-day Variation in Lipoprotein(a): Is a Once-in-a-lifetime Measurement Sufficient for
Shuxin Song1, Satoshi Hirayama1,2, Haruka Inaba1
1Department of Clinical Laboratory Medicine, Juntendo University Graduate School of Medicine.
Aims:
Lipoprotein(a) (Lp(a)) is a strong risk factor for cardiovascular events, independent of low-density lipoprotein cholesterol (LDL-C). Because the Lp(a) concentration is largely determined by genetic factors, some dyslipidemia guidelines recommend a once-in-a-lifetime measurement of Lp(a). Furthermore, a non-fasting lipid profile assessment is allowed for initial screening of dyslipidemia. Although the LDL-C concentration decreases slightly throughout the day, the within-day variation of Lp(a) remains unknown. We aimed to investigate whether the Lp(a) concentration remains stable throughout the day.
Methods:
Lp(a) concentrations were measured at seven time points throughout the day in 34 patients using a latex turbidimetric immunoassay. The Lp(a) values are expressed in molar units, which are equivalent to those determined by a mass spectrometry-based reference measurement procedure.
Results:
We found that the Lp(a) concentrations decreased by 2.9±5.2 nmol/L at 14:00 (p＜0.05), 3.6±4.8 nmol/L at 20:00 (p＜0.001), and 2.9±5.1 nmol/L at 24:00 (p＜0.05). The mean percent Lp(a) decreased significantly at 17:30 (-6.2±0.1%) and 24:00 (-7.0±0.1%) from the fasting level.
Conclusion:
The Lp(a) concentration decreases slightly, but significantly, throughout the day. Considering physiological variations, it is preferable to re-evaluate the Lp(a) concentration in those with a borderline elevation.
