Elevated Lp(a) with a small apo(a) isoform in children: risk factor for the development of premature coronary artery disease.
BACKGROUND
levels of Lp(a) and low-molecular-weight apolipoprotein(a) isoform are strongly associated with the development of early cardiovascular disease. Certain types of apo(a) isoforms in combination with elevated levels of Lp(a) may be important in the determining of premature coronary artery disease. Therefore, we investigated the association of familial history of premature coronary artery disease and apo(a) size and Lp(a) levels in children and adolescents with hypercholesterolemia using a novel method determining apo(a) isoforms.


RESULTS
Isoforms were classified in six phenotype patterns: S1-S4, B, F and according to their K-IV repeats. Apo(a) isoforms were divided into two groups: low-molecular- and high-molecular apo(a) isoforms. In subjects with double-banded apo(a) isoforms containing a small- and a large-isoform Lp(a) each contribution was based on the intensity of staining of the two bands. The percentage of patients with elevated levels of Lp(a) and a small apo(a) isoform (i.e. elevated small-isoform Lp(a)) was 46% in the risk group and 20% in the control group, p < 0.05. The percentage number of children and adolescents with elevated Lp(a) levels was higher in the risk group, reaching statistical significance (p < 0.05).


CONCLUSIONS
Elevated levels of small-isoform Lp(a) might be a strong and independent risk factor for the development of premature coronary artery disease in children and adolescents with hypercholesterolemia.
Dirisamer
Albert
A
Department of Obesity and Lipid Disorder, University of Vienna, Austria.
Widhalm
Harald
H
Aldover-Macasaet
Elsie
E
Molzer
Sylvia
S
Widhalm
Kurt
K
D000293:Adolescent; D000367:Age Factors; D053241:Apoprotein(a) / Q000097:blood* / Q000235:genetics; D016022:Case-Control Studies; D002648:Child; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000097:blood* / Q000453:epidemiology* / Q000235:genetics; D005260:Female; D020022:Genetic Predisposition to Disease / Q000453:epidemiology*; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood / Q000453:epidemiology / Q000235:genetics; D008297:Male; D010641:Phenotype; D020033:Protein Isoforms / Q000097:blood / Q000235:genetics; D012307:Risk Factors; D012737:Sex Factors
D020033:Protein Isoforms; D053241:Apoprotein(a)