Elsevier

Atherosclerosis

Volume 108, Issue 2, August 1994, Pages 111-126
Atherosclerosis

Review article and viewpoint
Lp(a) lipoprotein in cardiovascular disease

https://doi.org/10.1016/0021-9150(94)90106-6Get rights and content

Abstract

The article summarizes the increased knowledge about the enigmatic Lp(a) lipoprotein and its clinical importance over the past 20 years. The mode of inheritance, the unique features of Lp(a) composition and structure and the unusual distribution of the mainly genetically determined plasma Lp(a) levels are discussed. The main factors that can significantly change the inherited Lp(a) levels are endocrine disorders and hormone treatment. It seems possible that sex hormones protect females to a large extent from the potentially deleterious effects of inherited high Lp(a) levels until menopause. The exceptionally strong independent association found in most studies between Lp(a) lipoprotein levels and atherosclerotic disorders indicates that Lp(a) is a factor of outstanding importance in the pathogenesis of atherosclerosis. Probable pathogenetic mechanisms are reviewed. The associations found between Lp(a) and insulin release, rheumatoid arthritis and renal diseases suggerst that Lp(a) may be invovled in immunological mechanisms. In a new hypothesis it is suggested that an autoimmune process might especially occur in individuals with inherited high Lp(a) levels and certain HLA class II genotypes, triggered by a concurrent infection.

References (128)

  • A. Gurakar et al.

    Levels of lipoprotein Lp(a) decline with neomycin and niacin treatment

    Atherosclerosis

    (1985)
  • R. Zechner et al.

    Fluctuations of plasma lipoprotein-A concentrations during pregnancy and post parturn

    Metabolism

    (1986)
  • J.J. Albers et al.

    Reduction of lecithin-cholesterol acyltransferase, apolipoprotein D and the Lp(a) lipoprotein with the anabolic steroid stanazolol

    Biochim. Biophys. Acta

    (1984)
  • S. Maeda et al.

    Transient changes of serum lipoprotein (a) as an acute phase protein

    Atherosclerosis

    (1989)
  • G. Hellsten et al.

    Lipids and endurance physical activity

    Atherosclerosis

    (1989)
  • M.B.A. Oldstone

    Molecular mimicry and autoimmune disease

    Cell

    (1987)
  • G.H. Dahlen et al.

    Electrophoresis of lipoproteins on cellulose acetate membrane

    Acta Med. Scand.

    (1972)
  • G.H. Dahlen et al.

    Angina of effort and an extra pre-beta lipoprotein fraction

    Acta Med. Scand.

    (1972)
  • G.H. Dahlen et al.

    Myocardial infarction and an extra pre-beta lipoprotein fraction

    Acta Med. Scand.

    (1972)
  • G.H. Dahlen et al.

    Familial occurrence of an extra prebeta lipoprotein fraction

    Acta Med. Scand.

    (1972)
  • R.D. Ellefson et al.

    Pre-beta (or alpha-2) lipoprotein of high density in human blood

  • H. Garoff et al.

    Demonstration by disc electrophoresis of the lipoprotein carrying the Lp(a) antigen in human sera

    Acta Pathol. Microbiol. Scand.

    (1970)
  • G. Utermann et al.

    Disk-elektrophoretischer Nachweis des Lp(a)-Proteins in Lipoproteinfraktionen

    Humangenetik

    (1979)
  • W. Renninger et al.

    Beitrag zur Problematik des Lp-systems

    Humangenetik

    (1965)
  • K. Berg

    The Lp system

    Series Hematol.

    (1968)
  • N.R. Harvie et al.

    Studies of Lp-lipoprotein as a quantitative genetic trait

  • J.J. Albers et al.

    Immunochemical quantification of human plasma Lp(a) lipoprotein

    Lipids

    (1974)
  • J.J. Albers et al.

    Radioimmunoassay of human plasma Lp(a) lipoprotein

    J. Lipid Research

    (1977)
  • G.H. Dahlen et al.

    Lp(a) lipoprotein and pre-beta-l-lipoprotein in young adults

    Acta Med. Scand.

    (1974)
  • K. Berg et al.

    Lp(a) lipoprotein and pre-beta-l-lipoprotein in patients with coronary heart disease

    Clin. Genet.

    (1974)
  • G.H. Dahlen et al.

    Lp(a) lipoprotein/pre-beta-I-lipoprotein in Swedish middleaged males and in patients with coronary heart disease

    Clin. Genet.

    (1975)
  • M.H. Frick et al.

    Serum pre-beta-l-lipoprotein fraction in coronary atherosclerosis

    Acta Med. Scand.

    (1974)
  • G.H. Dahlen

    The pre-beta-l-lipoprotein phenomenon in relation to serum cholesterol and triglyceride levels, the Lp(a) lipoprotein and coronary heart disease

    Acta Med. Scand.

    (1975)
  • G.H. Dahlen et al.

    A comparison between lipoprotein patterns in agarose gel and on cellulose acetate membranes in the 12-h fasting state and postprandial

    Opuscula Med.

    (1975)
  • J.D. Morrisett et al.

    Lipoprotein (a): purification problems and structural properties

  • G.H. Dahlen

    Clinical significance of Lp(a) lipoprotein, Plenary lecture

  • G.H. Dahlen et al.

    Insulin response to an oral glucose load in relation to Lp(a)/pre-beta-(-lipoprotein levels in nondiabetic patients with peripheral vascular disease and in controls

    Acta Chir. Scand.

    (1979)
  • G.H. Dahlen et al.

    Association of lipoprotein Lp(a), plasma lipids and other lipoproteins with coronary artery disease documented by angiography

    Circulation

    (1986)
  • G.G. Rhoads et al.

    Lp(a) lipoprotein as a risk factor for myocardial infarction

    J. Am. Med. Assoc.

    (1986)
  • Ö Norrgård et al.

    High concentrations of Lp(a) lipoprotein in serum are common among patients with abdominal aortic aneurysms

    Int. Angiol.

    (1988)
  • K. Asplund et al.

    Lp(a) lipoprotein in patients with acute stroke

    Cerebrovasc. Dis.

    (1991)
  • S. Rantapää-Dahlgvist et al.

    Lipoprotein (a), lipids, and lipoproteins in patients with rheumatoid arthritis

    Ann. Rheum. Dis.

    (1991)
  • H.A. Isomäki et al.

    Death rate and cause of death in patients with rheumatoid arthritis

    Scand. J. Rheumatol.

    (1975)
  • G.H. Dahlen

    Potential significance of Lp(a) lipoprotein. Clinical and methodological aspects

  • G.H. Dahlen

    Lipoprotein (a) in relation to atherosclerotic disease. Recent aspects on diagnosis and treatment of lipoprotein disorders. Impact on prevention of atherosclerotic diseases

  • G.H. Dahlen

    Lipoprotein (a) as a risk factor for atherosclerotic diseases

    Arctic Med. Res.

    (1988)
  • A. Rosengren et al.

    Lipoprotein (a) and coronary heart disease: a prospective case-control study in a general population sample of middle-aged men

    Br. Med. J.

    (1990)
  • H.F. Hoff et al.

    Serum Lp(a) level as a predictor of vein graft stenosis after coronary artery bypass surgery in patients

    Circulation

    (1988)
  • G.L. Cushing et al.

    Quantitation and localization of apolipoproteins (a) and B in coronary artery bypass vein grafts resected at reoperation

    Arteriosclerosis

    (1989)
  • S.R. Johansson et al.

    Lack of correlation between the serum level of lipoprotein (a) and restenosis after coronary angioplasty

    Coronary Artery Dis.

    (1992)
  • Cited by (0)

    View full text