Relationship of lipoprotein(a) to variables of coagulation and fibrinolysis in a healthy population

Abstract

In the Prospective Cardiovascular Münster (PROCAM) study, serum lipoprotein(a) [Lp(a)] and its relationship to pro- and anticoagulatory as well as fibrinolytic indices were determined in a large group of employees: 864 men (m) and 373 women (f), ages 16-65 years. Univariate statistical analysis showed Lp(a) concentration to be associated with fibrinogen concentrations in both sexes (m: r = 0.08, P less than 0.05; f: r = 0.20, P less than 0.001), but not with euglobulin fibrinolysis activity, tissue-type plasminogen activator, plasminogen activator inhibitor type 1 (PAI-1), or the split products of cross-linked fibrin (d-dimer). In women only, Lp(a) was significantly correlated with antithrombin III (r = 0.15, P less than 0.01) and Protein C (r = 0.17, P less than 0.01). Further sex-related differences were seen in the relationship between Lp(a) and age (m: r = 0.05; f: r = 0.23, P less than 0.001) and body mass index (m: r = 0.01; f: r = 0.19, P less than 0.001), primarily as a consequence of remarkable differences of Lp(a) concentrations between postmenopausal (mean = 79.4 mg/L) and premenopausal women (mean = 51.5 mg/L, P = 0.001). Multiple-regression analysis demonstrated a significant negative correlation of Lp(a) to PAI-1 (m: beta = -0.12, P less than 0.01; f: beta = -0.14, P less than 0.05) and a positive correlation to cholesterol (m: beta = 0.18, P less than 0.001; f: beta = 0.17, P less than 0.01) and systolic blood pressure (m: beta = 0.08, P less than 0.05; f: beta = 0.11, P less than 0.05).

Predictors of lipoprotein(a) levels in a European and South Asian population in the Newcastle Heart Project

“…A higher proportion of Pakistani women (40%) had Lp(a) levels greater than 300 mg L −1 , the threshold at which increased risk of CHD is believed to occur. Several studies have suggested an increase in Lp(a) levels after menopause [9,29]. However, in this study, age did not correlate with Lp(a) levels in South Asian women and therefore the differences cannot be explained by age-dependent hormonal changes.…”

“…A positive association between Lp(a) and fibrinogen is well established in Europeans [9,29] even though there is no obvious explanation for this relationship. We found a stronger association between Lp(a) and fibrinogen in women than men, which is in agreement with the data reported by Heinrich et al [29]. This relationship was also seen in South Asians (statistically significant in men).…”

Lipoprotein(a): resurrected by genetics

“…There are no major differences in Lp(a) levels between men and women. However, Lp(a) levels are higher in postmenopausal compared with premenopausal women [139]. In line with this, meta-analyses of women using hormone-replacement therapy with various agents demonstrated an average decrease in Lp(a) of about 25% with no major difference between oral and transdermal agents [140,141].…”

Effect of hypertriglyceridaemia on lipoprotein (a) serum concentrations

“…Multivariate regression analysis confirmed the negative correlation between the concentrations of Lp(a) and TG (r = -0.31; P < 0.001) as well as the positive correlation with HDL-cholesterol ( Table 2). These relationships were not observed in 1237 controls from the Prospective Cardiovascular Munster (PROCAM) Study [19,20].…”