title: [Effect of biliary obstruction on lipoprotein(a) concentration].
abstract: OBJECTIVE
  This study was appointed to determine the correlation between the concentration of lipoprotein(a) [Lp(a)], apolipoproteins and lipids with biochemical parameters of liver function in a group of patients with reversible cholestasis. We have also determined the concentration of these parameters once solved the biliary obstruction process.
  
  
  METHODS
  Eighteen adults over 17 years with extrahepatic cholestasis were included in the study on a prospective basis, and we determined in them biochemical liver function parameters and lipoprotein metabolism parameters, particularly Lp(a) before and after unblocking.
  
  
  RESULTS
  The concentration of Lp(a) prior to desobstruction was inverse and statistically significantly correlated with the concentration of gamma glutamyl transpeptidase (correlation coefficient [r] = -0.757, P = .018). The concentration of Lp(a) (median = 2.66 mg/dL, interquartile range = 5,62) showed a statistically significant increase (median = 9.72 mg/dL, interquartile range = 28.76, P < .001), once the unblocking was performed. Concentrations of total cholesterol and triglycerides had a statistically significant decrease, and HDL cholesterol and apolipoprotein A-1 showed a statistically significant increase once the unblocking was carried out.
  
  
  CONCLUSIONS
  The concentration of Lp(a) is decreased during cholestasis, although there is a significant simultaneous hypercholesterolemia. Cholestasis has a causal role in lowering Lp(a), because the unblocking of bile duct recovers Lp(a) concentration. Our study supports the concept that bile acids exert a controlling effect on the synthesis of Lp(a) and open a mechanism for the treatment of hyper Lp(a).
authors.affiliation: Servicio de Bioquímica Clínica, Hospital Universitario Miguel Servet, Zaragoza, España. Electronic address: mpcalmarza@salud.aragon.es.
authors.forename: Pilar
authors.initials: P
authors.lastname: Calmarza
authors.affiliation: Servicio de Digestivo, Hospital Universitario Miguel Servet, Zaragoza, España.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Bajador
authors.affiliation: Servicio de Medicina Preventiva, Hospital Universitario Miguel Servet, Zaragoza, España.
authors.forename: Carlos
authors.initials: C
authors.lastname: Lapresta
authors.affiliation: Servicio de Análisis Clínicos, Hospital San Jorge, Huesca, España.
authors.forename: Sandra
authors.initials: S
authors.lastname: García Castañón
authors.affiliation: Unidad de Lípidos y Laboratorio de Investigación Molecular, Hospital Universitario Miguel Servet, Zaragoza, España.
authors.forename: Isabel
authors.initials: I
authors.lastname: de Castro
authors.affiliation: Unidad de Lípidos y Laboratorio de Investigación Molecular, Hospital Universitario Miguel Servet, Zaragoza, España.
authors.forename: Fernando
authors.initials: F
authors.lastname: Civeira
mesh_terms: D000328:Adult; D001053:Apolipoproteins / Q000378:metabolism; D001651:Cholestasis, Extrahepatic / Q000503:physiopathology* / Q000628:therapy; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D006801:Humans; D006937:Hypercholesterolemia / Q000453:epidemiology* / Q000209:etiology; D008055:Lipids / Q000097:blood; D017270:Lipoprotein(a) / Q000378:metabolism*; D008111:Liver Function Tests; D011446:Prospective Studies; D014280:Triglycerides / Q000097:blood; D005723:gamma-Glutamyltransferase / Q000378:metabolism*
chemical_list: D001053:Apolipoproteins; D008076:Cholesterol, HDL; D008055:Lipids; D017270:Lipoprotein(a); D014280:Triglycerides; D002784:Cholesterol; D005723:gamma-Glutamyltransferase
keywords: Apolipoproteins; Apolipoproteínas; Bile acids; Biliary obstruction; Cholestasis; Colestasis; Farnesoid receptor; Lipoprotein(a); Lipoproteína(a); Obstrucción biliar; Receptor farnesoide; Ácidos biliares