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Elevated levels of lipoprotein (a) in association with cerebrovascular saccular aneurysmal disease
C Bolger1, J Phillips, S Gilligan
1Department of Neurosurgery, Walton Centre for Neurology and Neurosurgery, Liverpool, England.
Insights
Elevated lipoprotein (a) [Lp(a)] levels are linked to cerebrovascular aneurysmal disease, particularly in women. This suggests Lp(a) may be a risk factor for vascular conditions beyond atherosclerosis.
Area of Science:
- Vascular Biology
- Cardiovascular Medicine
- Biochemistry
Background:
- The connection between cerebrovascular aneurysmal disease and atherosclerosis is not well understood.
- Lipoprotein (a) [Lp(a)] is an established independent risk factor for atherosclerosis.
- Investigating Lp(a) in patients with aneurysmal disease may elucidate shared risk factors or novel pathogenic mechanisms.
Purpose of the Study:
- To compare serum Lp(a) levels in patients with saccular cerebrovascular aneurysmal disease and healthy controls.
- To determine if Lp(a) is associated with aneurysmal disease independently of atherosclerosis.
- To explore potential sex-specific differences in Lp(a) levels related to aneurysmal disease.
Main Methods:
- Serum Lp(a) levels were measured in 50 patients with angiographically confirmed saccular aneurysmal disease and no significant clinical atherosclerosis.
- A control group of 42 healthy individuals was included for comparison.
- Statistical analyses, including t-tests and chi-squared tests, were used to compare Lp(a) levels between groups, with subgroup analysis by sex and age.
Main Results:
- Patients with aneurysmal disease exhibited significantly higher median serum Lp(a) levels (20.1 mg/dl) compared to controls (10.8 mg/dl; P < 0.01).
- This difference was most pronounced in females, with significantly elevated Lp(a) in female patients (22.2 mg/dl) versus female controls (9.5 mg/dl; P < 0.005), especially those under 50.
- No significant difference in Lp(a) levels was observed between male patients and male controls.
Conclusions:
- Elevated serum Lp(a) levels are associated with cerebrovascular aneurysmal disease, even in the absence of significant atherosclerosis.
- Lipoprotein (a) may represent a risk factor for cerebrovascular aneurysmal disease, potentially through mechanisms distinct from atheroma formation.
- Further research is warranted to clarify the role of Lp(a) in the pathogenesis of cerebrovascular aneurysms and other vasculopathies.
Abstract:
The relationship between cerebrovascular aneurysmal disease and atherosclerosis remains unclear. Elevated serum levels of lipoprotein (a) (Lp[a]), are an independent risk factor for atherosclerosis. We measured serum Lp(a) levels in 50 patients who had angiographically proven saccular aneurysmal disease and who were free of clinically significant atheromatous disease (as judged by their medical histories and the results of physical examination, electrocardiography, and carotid angiography). The Lp(a) serum levels in these patients were compared with the Lp(a) serum levels in a group of 42 normal healthy controls. Serum Lp(a) levels in the patients was 20.1 +/- 0.42 mg/dl (median +/- standard error); however, median serum Lp(a) in the control subjects was 10.8 +/- 0.47 mg/dl (P < 0.01). Among females, the difference in serum Lp(a) levels was significant; the levels were 22.2 +/- 0.6 for female patients (n = 29) and 9.5 +/- 0.53 in female control subjects (n = 26) (P < 0.005). The most significant difference (P < 0.002) was seen in females < 50 years old (14 patients, 10 control subjects). No significant differences were seen in the Lp(a) serum levels between 21 male patients and 16 male control subjects. Lp(a) levels above the threshold level (30 mg/dl) were found in 20 patients and 7 control subjects (chi 2 = 5.99, P < 0.02); 12 female patients and 3 female control subjects (chi 2 = 6.16, P < 0.02; 8 male patients and 4 male control subjects (this difference was not significant). These results indicate either that cerebrovascular aneurysmal disease and subclinical atherosclerosis are related or that Lp(a) is a risk factor for vasculopathies other than atheroma.