title: Lipoprotein (a), metabolic syndrome and coronary calcium score in a large occupational cohort.
abstract: OBJECTIVE
  Whether lipoprotein (a) [Lp(a)] concentration is associated with metabolic syndrome (MetS) and pre-clinical atherosclerosis in different ethnic groups is uncertain. The association between Lp(a), MetS and a measure of pre-clinical atherosclerosis was studied in a large Asian cohort.
  
  
  RESULTS
  Data were analyzed from a South Korean occupational cohort who underwent a cardiac computed tomography (CT) estimation of CAC score and measurements of cardiovascular risk factors (n = 14,583 people). The key exposure was an Lp(a) concentration in the top quartile (>38.64 mg/dL)) with a CAC score >0 as the outcome variable and measure of pre-clinical atherosclerosis. Logistic regression was used to describe the associations. 1462 participants had a CAC score >0. In the lowest Lp(a) quartile (<11.29 mg/dL), 25.8% had MetS, compared with 16.1% in the highest Lp(a) quartile (>38.64 mg/dL (p < 0.001). MetS, and component features, were inversely related to Lp(a) concentration (all p < 0.0001). In the highest Lp(a) quartile group, there was an association between Lp(a) and CAC score >0 in men (OR 1.21[1.05, 1.40], p = 0.008), and women (OR 1.62[1.03, 2.55], p = 0.038), after adjustment for age, sex, lipid lowering therapy, and multiple cardiovascular risk factors. There was no evidence of an interaction between highest quartile Lp(a) and either high LDLc (>147 mg/dL) (p = 0.99), or MetS (p = 0.84) on the association with CAC score >0.
  
  
  CONCLUSIONS
  Lp(a) levels are inversely related to MetS and its components. There was a robust association between Lp(a) concentration >38.6 mg/dL and marker of early atherosclerosis in both men and women, regardless of LDLc, level MetS or other cardiovascular risk factors.
authors.affiliation: Division of Cardiology, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, #108, Pyung Dong, Jongro-Ku, 110-746 Seoul, Republic of Korea. Electronic address: kcmd.sung@samsung.com.
authors.forename: K-C
authors.initials: KC
authors.lastname: Sung
authors.forename: S H
authors.initials: SH
authors.lastname: Wild
authors.forename: C D
authors.initials: CD
authors.lastname: Byrne
mesh_terms: D000328:Adult; D050197:Atherosclerosis / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D002118:Calcium / Q000378:metabolism*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D017270:Lipoprotein(a) / Q000097:blood*; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood*; D008875:Middle Aged; D056910:Republic of Korea; D012307:Risk Factors; D014057:Tomography, X-Ray Computed
chemical_list: D015415:Biomarkers; D017270:Lipoprotein(a); D002118:Calcium
keywords: Atherosclerosis; BMI; CAC; CVD; Cardio-metabolic risk factors; Cardiovascular disease (CVD); Coronary artery calcium (CAC) score; DBP; FRS; Framingham Risk Score; HDLc; Lp(a); MetS; Metabolic syndrome (MetS); SBP; TG; body mass index; cardiovascular disease; coronary artery calcium score; diastolic blood pressure; high density lipoprotein cholesterol; metabolic syndrome; systolic blood pressure; triglyceride