Lipoprotein(a) Modulates Carotid Atherosclerosis in Metabolic Syndrome

Abstract

Background and Aim: High lipoprotein(a) [Lp(a)] is a well-established cardiovascular (CV) risk factor, but the effect of mildly elevated Lp(a) on CV health is largely unknown. Our aim was to evaluate if Lp(a) is associated with the severity of carotid atherosclerosis (CA) in the specific subset of metabolic syndrome (MetS).Patients and Methods: Subjects with diagnosed MetS and ultrasound-assessed CA were enrolled. Those patients were categorized according to the severity of CA (moderate vs. severe), and the circulating levels of Lp(a) alongside with clinical, anthropometric, and biochemical data were collected.Results: Sixty-five patients were finally included: twenty-five with moderate and forty with severe CA (all with asymptomatic disease). Intergroup comparison showed Lp(a) as the only significantly different variable [6 (2–12) mg/dl vs. 11.5 (6–29.5) mg/dl; p = 0.018]. Circulating levels of Lp(a) were also confirmed as the only variable independently associated with severity of CA at logistic regression analysis [OR 2.9 (95% CI 1.1–7.8); p = 0.040]. ROC curve analysis for Lp(a) confirmed a serum level of 10 mg/dl as the best cut-off value [AUC 0.675 (95% CI 0.548–0.786)]. Although sensitivity and specificity were suboptimal (69.0 and 70.4%, respectively)—likely due to the small sample size—this result is in line with those previously reported in the literature.Conclusion: Lp(a) is independently associated with severity of CA in the subgroup of MetS patients.

Established and potential cardiovascular risk factors in metabolic syndrome: Effect of bariatric surgery

“…The Atherothrombosis Intervention in Metabolic Syndrome with Low HDL-C/High Triglycerides: Impact on Global Health Outcomes (AIM-HIGH) study has demonstrated an independent association of elevated Lp(a) with residual cardiovascular risk, atherosclerosis progression and the development of high-risk plaque features in patients with metabolic syndrome [59]. Although similar findings have been replicated subsequently [60], the association of Lp(a) with metabolic syndrome has been controversial. The Maracaibo City Metabolic Syndrome Prevalence Study showed a significant positive association of metabolic syndrome and Lp(a) concentration as well as a progressive increase in Lp(a) concentration as number of components of metabolic syndrome increased.…”