ORIGINAL ARTICLE

Lipoprotein (a) does not participate in the early acute phase response to training or extreme physical activity and is unlikely to enhance any associated immediate cardiovascular risk

D J Byrne¹, I A Jagroop¹, H E Montgomery², M Thomas¹, D P Mikhailidis¹, N G Milton¹, A F Winder¹

¹ Department of Molecular Pathology and Clinical Biochemistry, Royal Free and University College Medical School, University College London, Royal Free Campus, Rowland Hill Street, London NW3 2PF, UK
² The Hatter Institute for Cardiovascular Studies, Department of Academic and Clinical Cardiology, University College London Medical School, London WC1 6DB, UK

Correspondence to:
Correspondence to:
Dr D J Byrne, Department of Molecular Pathology and Clinical Biochemistry, Royal Free and University College Medical School, University College London, Royal Free Campus, Rowland Hill Street, London NW3 2PF, UK;
d.byrne{at}rfc.ucl.ac.uk

Aims: To investigate the proposal that lipoprotein (a) (Lp(a)) contributes to the acute phase response and thus possibly to the acute cardiac risks associated with major physical effort.

Methods/Results: Fit, healthy, British army recruits were reviewed at the beginning and the end of a 10 week programme of basic training concluding with an intense 48 hour military exercise. Final recruit assessment was staggered over the last week of training, giving rise to six recruit groups, with determination of Lp(a), C reactive protein (CRP), fibrinogen, albumin, and total creatine kinase values from 12 hours to five days after the final exercise. A clear acute phase response was seen following the final exercise, marked by a significant increase in circulating concentrations of fibrinogen and a reduction of albumin, and a trend with non-significant increases in CRP.

Conclusion: Lp(a) did not behave as an early marker of the acute response. Previous reports may have been confounded by concurrent disease in older subjects and by late sampling. Lp(a) determination for cardiovascular risk profiling is not confounded by associated physical effort. It is also unlikely that the acute risks of major physical effort are enhanced by any process involving Lp(a).

Keywords: lipoprotein(a); acute phase response; cardiovascular disease

Abbreviations: apo(a), apolipoprotein (a); APR, acute phase response; BMI, body mass index; CK, creatine kinase; CRP, C reactive protein; Lp(a), lipoprotein (a); ME, military exercise; NS, not significant; SDS, standard deviation

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