title: Relationship between apolipoprotein(a) size polymorphism and coronary heart disease in overweight subjects.
abstract: BACKGROUND
  Overweight is associated with an increased cardiovascular risk which is only partially explained by conventional risk factors. The objective of this study was to evaluate lipoprotein(a) [Lp(a)] plasma levels and apolipoprotein(a) [apo(a)] phenotypes in relation to coronary heart disease (CHD) in overweight subjects.
  
  
  METHODS
  A total of 275 overweight (BMI > or = 27 kg/m2) subjects, of which 155 had experienced a CHD event, 337 normal weight subjects with prior CHD and 103 CHD-free normal weight subjects were enrolled in the study. Lp(a) levels were determined by an ELISA technique and apo(a) isoforms were detected by a high-resolution immunoblotting method.
  
  
  RESULTS
  Lp(a) levels were similar in the three study groups. Overweight subjects with CHD had Lp(a) concentrations significantly higher than those without [median (interquartile range): 20 (5-50.3) versus 12.6 (2.6-38.6) mg/dl, P < 0.05]. Furthermore, overweight subjects with CHD showed a higher prevalence of low molecular weight apo(a) isoforms than those without (55.5% versus 40.8%, P < 0.05) and with respect to the control group (55.5% versus 39.8%, P < 0.05). Stepwise regression analysis showed that apo(a) phenotypes, but not Lp(a) levels, entered the model as significant independent predictors of CHD in overweight subjects.
  
  
  CONCLUSIONS
  Our data indicate that small-sized apo(a) isoforms are associated with CHD in overweight subjects. The characterization of apo(a) phenotypes might serve as a reliable biomarker to better assess the overall CHD risk of each subject with elevated BMI, leading to more intensive treatment of modifiable cardiovascular risk factors.
authors.affiliation: Molecular Medicine Laboratory, IRCCS San Matteo Hospital, University of Pavia, Italy. enzo.em@libero.it
authors.forename: Enzo
authors.initials: E
authors.lastname: Emanuele
authors.forename: Emmanouil
authors.initials: E
authors.lastname: Peros
authors.forename: Piercarlo
authors.initials: P
authors.lastname: Minoretti
authors.forename: Colomba
authors.initials: C
authors.lastname: Falcone
authors.forename: Angela
authors.initials: A
authors.lastname: D'Angelo
authors.forename: Lorenza
authors.initials: L
authors.lastname: Montagna
authors.forename: Diego
authors.initials: D
authors.lastname: Geroldi
mesh_terms: D001054:Apolipoproteins A / Q000097:blood* / Q000737:chemistry; D015415:Biomarkers / Q000097:blood / Q000737:chemistry; D016022:Case-Control Studies; D003327:Coronary Disease / Q000097:blood* / Q000209:etiology; D005260:Female; D006801:Humans; D017270:Lipoprotein(a) / Q000097:blood* / Q000737:chemistry; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood* / Q000150:complications; D010641:Phenotype; D011110:Polymorphism, Genetic; D013223:Statistics as Topic
chemical_list: D001054:Apolipoproteins A; D015415:Biomarkers; D017270:Lipoprotein(a)