Increased serum lipoprotein(a) concentrations and low molecular weight phenotypes of apolipoprotein(a) are associated with symptomatic peripheral arterial disease.
BACKGROUND
Increased concentrations of lipoprotein(a) [Lp(a)] have been considered a genetically determined risk factor for coronary artery and cerebrovascular disease. Only 2 small and conflicting studies have investigated the possibility of an association of peripheral arterial disease (PAD) with high serum Lp(a) concentrations and low molecular weight (LMW) phenotypes of apolipoprotein(a) [apo(a)].


METHODS
We measured serum concentrations of Lp(a) and apo(a) phenotypes in 213 patients with symptomatic PAD and 213 controls matched for sex, age (within 2 years), and presence of diabetes.


RESULTS
Patients with PAD showed significantly higher median serum concentrations of Lp(a) (76 vs 47 mg/L; P = 0.003) and a higher frequency of LMW apo(a) phenotypes (41% vs 26%; P = 0.002) than controls. After adjustment for several potential confounders, increased Lp(a) concentrations (>195 mg/L, i.e., 75th percentile of the entire study sample) and LMW apo(a) phenotypes were significant predictors of PAD, with odds ratios of 3.73 (95% CI 2.08-6.67; P <0.001) and 2.21 (95% CI 1.33-3.67; P = 0.002), respectively.


CONCLUSIONS
In this study sample, both increased serum concentrations of Lp(a) and the presence of LMW apo(a) phenotypes were associated with the presence of symptomatic PAD independent of traditional and nontraditional cardiovascular risk factors. Because PAD is considered an indicator of systemic atherosclerotic disease, our results suggest a possible role of Lp(a) as a genetically determined marker for systemic atherosclerosis.
Dieplinger
Benjamin
B
Department of Laboratory Medicine, Konventhospital Barmherzige Brueder Linz, Linz, Austria.
Lingenhel
Arno
A
Baumgartner
Nadja
N
Poelz
Werner
W
Dieplinger
Hans
H
Haltmayer
Meinhard
M
Kronenberg
Florian
F
Mueller
Thomas
T
D000368:Aged; D053241:Apoprotein(a) / Q000097:blood* / Q000737:chemistry; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D017270:Lipoprotein(a) / Q000097:blood*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D008970:Molecular Weight; D016491:Peripheral Vascular Diseases / Q000097:blood / Q000175:diagnosis*; D010641:Phenotype; D044967:Serum
D015415:Biomarkers; D017270:Lipoprotein(a); D053241:Apoprotein(a)