Long-term effects of lipoprotein(a) on carotid atherosclerosis in elderly Japanese.
BACKGROUND
Serum level of lipoprotein(a) [Lp(a)] is hereditarily constant throughout life within an individual, but the relationship between Lp(a) and atherosclerosis in elderly people is still controversial.


METHODS
Serum Lp(a) levels were studied in 208 elderly Japanese participants aged 80 years with a variety of diseases, using carotid ultrasonography (US), brain computerized tomography (CT), electrocardiography (ECG), and ankle brachial pressure index (ABPI). Carotid plaque lesions were divided into 3 types based on the US echogenicity assessed by a computer-assisted system: L type (hypoechoic plaque), H type (hyperechoic plaque), and M type (heterogeneous plaque).


RESULTS
The frequency of the L type and occlusion was significantly higher in the high Lp(a) group (n = 38) than in the normal Lp(a) group (n = 170). The mean height of the plaque was also greater in the high Lp(a) group than in the normal Lp(a) group. There was no difference in CT findings between the two groups. Myocardial ischemia on ECG and low ABPI (<0.9) were both frequently, but not significantly, seen in the high Lp(a) group. Among factors influencing US findings, multiple regression analysis showed that high Lp(a) correlated markedly to L type and cigarette smoking correlated to M type.


CONCLUSIONS
These findings indicate that, in Japanese elderly patients aged 80, serum Lp(a) strongly correlates with hypoechoic carotid lesions, which correspond histologically to lipid-rich, unstable atherosclerosis. This suggested that Lp(a) could promote the formation of atherosclerosis throughout life, and play a role as an independent risk factor for circulatory disturbance of the organ later in life.
Iwamoto
Toshihiko
T
Department of Geriatric Medicine, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan. i-wam@ma.kcom.ne.jp
Fukuda
Sara
S
Shimizu
Souichirou
S
Takasaki
Masaru
M
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002340:Carotid Artery Diseases / Q000097:blood* / Q000175:diagnosis; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007564:Japan; D017270:Lipoprotein(a) / Q000097:blood* / Q000502:physiology*; D008297:Male; D012307:Risk Factors; D013997:Time Factors
D017270:Lipoprotein(a)