Lipoprotein (a) as an Acute Phase Reactant in Patients on Chronic Hemodialysis

Topçiu-Shufta, Valdete; Begolli, Luljeta; Kryeziu, Emrush

doi:10.17305/bjbms.2010.2728

Cited by 11 publications

(6 citation statements)

References 31 publications

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“… 55 Several studies have suggested a strong association between increased Lp(a) and cardiovascular disease, including stroke, and aortic stenosis. 56 Also, Lp(a) was shown to be positively correlated with interleukin (IL)‐6 and CRP after acute myocardial infarcts, 57 , 58 indicating its involvement in immune and pro‐inflammatory responses. Similar to sdLDL‐C, in the present study, we also found that TA patients had a higher Lp(a) level than the healthy participants and that Group I had higher Lp(a) levels than Groups II and III, indicating that serum Lp(a) levels are associated with TA severity.…”

Section: Discussionmentioning

confidence: 99%

Serum concentrations of small dense low‐density lipoprotein cholesterol and lipoprotein(a) are related to coronary arteriostenosis in Takayasu arteritis

Chen

Luan

et al. 2021

Clinical Laboratory Analysis

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Background: Serum small dense low-density lipoprotein cholesterol (sdLDL-C) and lipoprotein(a) [Lp(a)] levels are related to coronary disease, but their specific associations with coronary arteriostenosis in Takayasu arteritis (TA) have not been ascertained. This study explored the correlations between serum sdLDL-C and Lp(a) levels and coronary arteriostenosis in TA patients as well as the degree of artery stenosis.Methods: This retrospective study included 190 TA patients and 154 healthy subjects. TA patients were divided into three categories based on the degree of coronary stenosis: Group I, stenosis >50%; Group II, stenosis 1%-50%; and Group III, stenosis 0%. Independent risk factors for coronary arteriostenosis in TA were identified by logistic regression, followed by receiver operating characteristic curve analysis to determine the specificity and sensitivity of risk factors and Youden's Index score calculation to determine the cutoff points.Results: Takayasu arteritis patients had significantly higher serum levels of sdLDL-C and Lp(a) than healthy controls (p < 0.0001). The total cholesterol, triglyceride, LDL-C, sdLDL-C, and Lp(a) levels and the sdLDL-C/LDL-C ratio in Group I were significantly higher than those in Groups II and III (p < 0.05). An elevated serum sdLDL-C level elevated the risk of coronary arteriostenosis by 5-fold (cutoff value, 0.605 mmol/l).An increased serum Lp(a) level increased the risk of coronary arteriostenosis by 3.9fold (cutoff value, 0.045 g/l). An elevated sdLDL-C/LDL-C ratio increased the risk of coronary arteriostenosis by 2.1-fold (cutoff value, 0.258). Conclusions: Serum sdLDL-C and Lp(a) levels and sdLDL-C/LDL-C ratio may be used as diagnostic factors for coronary arteriostenosis in TA patients. K E Y W O R D S coronary arteriostenosis, lipoprotein(a), small dense low-density lipoprotein cholesterol, Takayasu arteritis How to cite this article: Chen S, Luan H, He J, et al. Serum concentrations of small dense low-density lipoprotein cholesterol and lipoprotein(a) are related to coronary arteriostenosis in Takayasu arteritis.

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Section: Discussionmentioning

confidence: 99%

Serum concentrations of small dense low‐density lipoprotein cholesterol and lipoprotein(a) are related to coronary arteriostenosis in Takayasu arteritis

Chen

Luan

et al. 2021

Clinical Laboratory Analysis

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“…In RA patients Lp(a) was associated with elevated CRP-level and erythrocyte sedimentation rate (ESR) and therefore playing an important role in the acute phase cascade reaction process [23] Lp(a) is claimed to react as acute phase protein in other diseases as well esp. ischemic stroke [43] vestibular neuronitis [44], in patients on chronic haemodialysis [45, 46] and polymyalgia rheumatica [47]. …”

Section: Discussionmentioning

confidence: 99%

A Systematic Literature Review of the Association of Lipoprotein(a) and Autoimmune Diseases and Atherosclerosis

Missala

Kassner

Steinhagen‐Thiessen

2012

International Journal of Rheumatology

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Objective. To investigate the association of lipoprotein(a) and atherosclerosis-related autoimmune diseases, to provide information on possible pathophysiologic mechanisms, and to give recommendations for Lp(a) determination and therapeutic options. Methods. We performed a systematic review of English language citations referring to the keywords “Lp(a)” AND “autoimmune disease” AND “atherosclerosis,” “Lp(a)” AND “immune system” OR “antiphospholipid (Hughes) syndrome (APS)” OR “rheumatoid arthritis” OR “Sjögren's syndrome” OR “systemic lupus erythematosus” OR “systemic sclerosis” OR “systemic vasculitis” published between 1991 and 2011 using Medline database. Results. 22 out of 65 found articles were identified as relevant. Lp(a) association was highest in rheumatoid arthritis (RA), followed by systemic lupus erythematosus (SLE), moderate in APS and lowest in systemic sclerosis (SSc). There was no association found between Lp(a) and systemic vasculitis or Sjögren's syndrome. Conclusion. Immune reactions are highly relevant in the pathophysiology of atherosclerosis, and patients with specific autoimmune diseases are at high risk for CVD. Elevated Lp(a) is an important risk factor for premature atherosclerosis and high Lp(a) levels are also associated with autoimmune diseases. Anti-Lp(a)-antibodies might be a possible explanation. Therapeutic approaches thus far include niacin, Lp(a)-apheresis, farnesoid x-receptor-agonists, and CETP-inhibitors being currently under investigation.

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“…Approximately, 20–30% of the world’s population have an elevated Lp(a), defined as > 50 mg/dL or > 125 nmol/L [ 17 ]. There are exceptions to generally stable levels, including a stressful environment such as sepsis, in which Lp(a) levels are acutely elevated [ 18 , 19 ]. Normal lifestyle activities such as diet, exercise, and weight loss have limited effect on Lp(a), and lipid medications, such as statins, may modestly raise Lp(a) levels [ 20 , 21 ].…”

Section: Lp(a) and Antifibrinolytic Effectsmentioning

confidence: 99%

Lipoprotein(a) and Its Potential Association with Thrombosis and Inflammation in COVID-19: a Testable Hypothesis

Moriarty

Gorby

Stroes

et al. 2020

Curr Atheroscler Rep

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Purpose of Review The COVID-19 pandemic has infected over > 11 million as of today people worldwide and is associated with significant cardiovascular manifestations, particularly in subjects with preexisting comorbidities and cardiovascular risk factors. Recently, a predisposition for arterial and venous thromboses has been reported in COVID-19 infection. We hypothesize that besides conventional risk factors, subjects with elevated lipoprotein(a) (Lp(a)) may have a particularly high risk of developing cardiovascular complications. Recent Findings The Lp(a) molecule has the propensity for inhibiting endogenous fibrinolysis through its apolipoprotein(a) component and for enhancing proinflammatory effects such as through its content of oxidized phospholipids. The LPA gene contains an interleukin-6 (IL-6) response element that may induce an acute phase-type increase in Lp(a) levels following a cytokine storm from COVID-19. Summary Thus, subjects with either baseline elevated Lp(a) or those who have an increase following COVID-19 infection, or both, may be at very high risk of developing thromboses. Elevated Lp(a) may also lead to acute destabilization of preexisting but quiescent atherosclerotic plaques, which might induce acute myocardial infarction and stroke. Ongoing studies with IL-6 antagonists may be informative in understanding this relationship, and registries are being initiated to measure Lp(a) in subjects infected with COVID-19. If indeed an association is suggestive of being causal, consideration can be given to systematic testing of Lp(a) and prophylactic systemic anticoagulation in infected inpatients. Therapeutic lipid apheresis and pharmacotherapy for the reduction of Lp(a) levels may minimize thrombogenic potential and proinflammatory effects. We propose studies to test the hypothesis that Lp(a) may contribute to cardiovascular complications of COVID-19.

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Lipoprotein (a) as an Acute Phase Reactant in Patients on Chronic Hemodialysis

Cited by 11 publications

References 31 publications

Serum concentrations of small dense low‐density lipoprotein cholesterol and lipoprotein(a) are related to coronary arteriostenosis in Takayasu arteritis

Serum concentrations of small dense low‐density lipoprotein cholesterol and lipoprotein(a) are related to coronary arteriostenosis in Takayasu arteritis

A Systematic Literature Review of the Association of Lipoprotein(a) and Autoimmune Diseases and Atherosclerosis

Lipoprotein(a) and Its Potential Association with Thrombosis and Inflammation in COVID-19: a Testable Hypothesis

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