title: Lipoprotein(a): fasting and nonfasting levels, inflammation, and cardiovascular risk.
abstract: OBJECTIVE
  There are no recommendations in guidelines on measuring lipoprotein(a) in the fasting or nonfasting state, or on the influence of inflammation. We tested the hypotheses that lipoprotein(a) levels change only minimally in response to normal food intake, and to inflammation. Also, we tested whether normal food intake or inflammation influenced lipoprotein(a)'s ability to predict ischemic heart disease.
  
  
  METHODS
  We studied 34 829 individuals from the Danish general population using the Copenhagen General Population Study and the Copenhagen City Heart Study.
  
  
  RESULTS
  Lipoprotein(a) levels did not change in response to normal food intake: median fasting levels were 17.3 mg/dL, while median levels at 3-4 h since last meal were 19.4 mg/dL(p = 0.38). Lipoprotein(a) levels increased minimally with increasing levels of C-reactive protein(CRP): median lipoprotein(a) levels at CRP <1 mg/L were 18.0 mg/dL, while median levels at CRP >10 mg/L were 21.1 mg/dL(p < 0.001). Furthermore, highest versus lowest tertile of lipoprotein(a) at <3 h and ≥3 h since last meal was associated with a 1.4(95%CI:1.2-1.6) and 1.4(1.2-1.6) fold increased risk of ischemic heart disease(p = 0.82), and a 1.8(1.5-2.2) and 1.4(1.1-1.7) fold increased risk of myocardial infarction(p = 0.05). The corresponding odds ratios at CRP levels of <2 mg/L and ≥2 mg/L were 1.3(1.2-1.5) and 1.4(1.2-1.6)(p = 0.80) for ischemic heart disease, and 1.5(1.2-1.8) and 1.7(1.4-2.0)(p = 0.38) for myocardial infarction.
  
  
  CONCLUSIONS
  Lipoprotein(a) levels did not change in response to normal food intake, but were minimally increased at increased levels of CRP. The ability of elevated lipoprotein(a) levels to predict ischemic heart disease and myocardial infarction in the general population was not affected by normal food intake or inflammation.
authors.affiliation: Department of Clinical Biochemistry and the Copenhagen General Population Study, Herlev Hospital, Copenhagen University Hospital, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.
authors.forename: Anne
authors.initials: A
authors.lastname: Langsted
authors.affiliation: Department of Clinical Biochemistry and the Copenhagen General Population Study, Herlev Hospital, Copenhagen University Hospital, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.
authors.forename: Pia R
authors.initials: PR
authors.lastname: Kamstrup
authors.affiliation: Department of Clinical Biochemistry and the Copenhagen General Population Study, Herlev Hospital, Copenhagen University Hospital, Denmark; The Copenhagen City Heart Study, Frederiksberg Hospital, Copenhagen University Hospital, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Denmark. Electronic address: Boerge.Nordestgaard@regionh.dk.
authors.forename: Børge G
authors.initials: BG
authors.lastname: Nordestgaard
mesh_terms: D000368:Aged; D002097:C-Reactive Protein / Q000032:analysis*; D002318:Cardiovascular Diseases / Q000097:blood* / Q000453:epidemiology*; D005215:Fasting / Q000097:blood*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood; D017270:Lipoprotein(a) / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000453:epidemiology; D017202:Myocardial Ischemia / Q000097:blood / Q000453:epidemiology; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D017270:Lipoprotein(a); D002097:C-Reactive Protein
keywords: Inflammation; Ischemic heart disease; Lipoprotein(a); Myocardial infarction; Nonfasting