Sex differences of lipoprotein(a) levels and associated risk of morbidity and mortality by age: The Copenhagen General Population Study

Simony, Sofie Bay; Mortensen, Martin Bødtker; Langsted, Anne; Afzal, Shoaib; Kamstrup, Pia R.; Nordestgaard, Børge G.

doi:10.1016/j.atherosclerosis.2022.06.1023

Cited by 58 publications

(31 citation statements)

References 28 publications

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“…When categorizing Lp(a) level into four age groups, as shown in Figure 3 , the magnitude of Lp(a) increased significantly after age 50 and was reported to be the highest in women above 60. In Figure 4 , we dichotomized the age into two groups based on a cut-off of 50 years [ 7 ], as reported before. ROC analysis was performed to see the predictive value for Lp(a) levels.…”

Section: Resultsmentioning

confidence: 99%

“…In the Women’s Health Study, Lp(a) at entry was slightly lower among 12,075 women who were active users of hormone replacement treatment (median 9.4 mg/dL) compared to 15,661 women who did not use hormone replacement therapy (11.6 mg/dL) [ 9 , 26 ]. The relationship between age in women and Lp(a) levels was well documented in The Copenhagen General Population Study [ 7 ]. Lipoprotein(a) levels were found to increase with age.…”

Section: Discussionmentioning

confidence: 99%

“…Despite the strong genetic influence on Lp(a) levels, some studies have found an increase in Lp(a) levels with age, particularly in women over 50. In contrast, others suggested that women’s Lp(a) levels rise during menopause [ 7 ]. The transition to menopause and the years preceding the final menstrual period (FMP) are marked by estrogen fluctuation and, eventually, estrogen deficiency, which has been linked to a proatherogenic lipid profile [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

“…It is unclear whether aging or hormonal changes cause this menopause-related increase in Lp(a). However, it should be noted that women on hormone replacement therapy (HRT) have lower Lp(a) levels than women who are not on HRT [ 7 ]. Fogacci et al systematically evaluated the effects of different anti-estrogen therapies on plasma Lp(a) levels in postmenopausal women from 10 clinical trials, including 1128 women in the active-treated arms and 921 women in the control arms.…”

Section: Introductionmentioning

confidence: 99%

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High-Risk Lipoprotein(a) Levels in Saudi Women and Its Relationship to Menopause and Adiposity

2023

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Lipoprotein(a) is an inherent CVD risk biomarker that varies by race, and the levels of Lp(a) in Saudi women are relatively unexplored. We aimed to examine the effect of age and menopause on Lp(a) and explore the correlation between adiposity and cardiometabolic risk factors with Lp(a) in Saudi women. The third aim was to determine the predictors of elevated Lp(a) in this population. In this cross-sectional study of 229 women, we compared Lp(a) serum levels, adiposity indices, and lipid and glycemic profiles between menopausal groups. We used immunoturbidimetry to measure serum Lp(a) and BIA to assess body composition. We evaluated the relationship between Lp(a) and our parameters using ANOVA and Spearman’s correlations. Regression was used to determine the predictors of high-risk Lp(a) levels. The mean of Lp(a) was 28.37 mg/dL, and the concentration increased significantly in postmenopausal (premenopausal 20.98 ± 12.30; perimenopausal 29.92 ± 9.53; postmenopausal 32.49 ± 9.83 mg/dL; p < 0.001. High-risk levels were 57.1% in postmenopausal and 19.1% in premenopausal. The magnitude of Lp(a) increased significantly after age 50. Lp(a) was significantly associated with age and cholesterol and negatively associated with % FFM. Lp(a) increased by 0.41 units for every year of age, indicating the strongest correlation.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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High-Risk Lipoprotein(a) Levels in Saudi Women and Its Relationship to Menopause and Adiposity

2023

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“…No significant sex differences were identified for the association of various lipid parameters, including total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and lipoprotein(a) with risk of different types of stroke. 19 , 32 , 34 …”

Section: Sex Differences In Associations Of Established Risk Factors ...mentioning

confidence: 99%

Assessment of Cardiovascular Risk in Women: Progress so Far and Progress to Come

Tschiderer¹,

Seekircher²,

Willeit³

et al. 2023

IJWH

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Cardiovascular disease is the leading cause of death in women worldwide. Nonetheless, there exist several uncertainties in the prediction, diagnosis, and treatment of cardiovascular disease in women. A cornerstone in the prediction of cardiovascular disease is the implementation of risk scores. A variety of pregnancy- and reproductive-factors have been associated with lower or higher risk of cardiovascular disease. Consequently, the question has been raised, whether these female-specific factors also provide added value to cardiovascular risk prediction. In this review, we provide an overview of the existing literature on sex differences in the association of established cardiovascular risk factors with cardiovascular disease and the relation between female-specific factors and cardiovascular risk. Furthermore, we systematically reviewed the literature for studies that assessed the added value of female-specific factors beyond already established cardiovascular risk factors. Adding female-specific factors to models containing established cardiovascular risk factors has led to little or no significant improvement in the prediction of cardiovascular events. However, analyses primarily relied on data from women aged ≥40 years. Future investigations are needed to quantify whether pregnancy-related factors improve cardiovascular risk prediction in young women in order to support adequate treatment of risk factors and enhance prevention of cardiovascular disease in women.

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Is There a Need for Sex‐Tailored Lipoprotein(a) Cut‐Off Values for Coronary Artery Disease Risk Stratification?

Yurtseven,

Ural,

Gursoy

et al. 2024

Clinical Cardiology

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BackgroundLipoprotein(a) [Lp(a)] plasma level is a well‐known risk factor for coronary artery disease (CAD). Existing data regarding the influence of sex on the Lp(a)‐CAD relationship are inconsistent.ObjectiveTo investigate the relationship between Lp(a) and CAD in men and women and to elucidate any sex‐specific differences that may exist.MethodsData of patients with Lp(a) measurements who were admitted to a tertiary university hospital, Koc University Hospital, were analyzed. The relationship between Lp(a) levels and CAD was explored in all patients and in subgroups created by sex. Two commonly accepted Lp(a) thresholds ≥ 30 and ≥ 50 mg/dL were analyzed.ResultsA total of 1858 patients (mean age 54 ± 17 years; 53.33% females) were included in the analysis. Lp(a) was an independent predictor of CAD according to the multivariate regression model for the entire cohort. In all cohort, both cut‐off values (≥ 30 and ≥ 50 mg/dL) were detected as independent predictors of CAD (p < 0.001). In sex‐specific analysis, an Lp(a) ≥ 30 mg/dL was an independent predictor of CAD only in women (p < 0.001), but Lp(a) ≥ 50 mg/dL was a CAD predictor both in men and women (men, p = 0.004; women, p = 0.047).ConclusionThe findings of this study may suggest that different thresholds of Lp(a) level can be employed for risk stratification in women compared to men.

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Sex differences of lipoprotein(a) levels and associated risk of morbidity and mortality by age: The Copenhagen General Population Study

Cited by 58 publications

References 28 publications

High-Risk Lipoprotein(a) Levels in Saudi Women and Its Relationship to Menopause and Adiposity

High-Risk Lipoprotein(a) Levels in Saudi Women and Its Relationship to Menopause and Adiposity

Assessment of Cardiovascular Risk in Women: Progress so Far and Progress to Come

Is There a Need for Sex‐Tailored Lipoprotein(a) Cut‐Off Values for Coronary Artery Disease Risk Stratification?

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