Summary

Lipoprotein(a), abbreviated as Lp(a), is a type of lipoprotein found in the blood. Elevated Lp(a) levels are associated with an increased risk of cardiovascular diseases, such as heart attacks and strokes. Lp(a) levels are predominantly determined by genetics and, unlike other lipoproteins, are not significantly influenced by lifestyle or diet. 

‍

Overview

Lipoproteins carry cholesterol and other fats through your bloodstream to your cells. The two main groups of lipoproteins are called HDL (high-density lipoprotein) or "good" cholesterol and LDL (low-density lipoprotein) or "bad" cholesterol.

Lp(a) is composed of a cholesterol-rich LDL particle bound to a protein called Apolipoprotein(a), abbreviated ApoA . Elevated Lp(a) levels can lead to the buildup of cholesterol in the arterial walls, causing atherosclerosis - a condition where the arteries become narrowed and hardened due to plaque accumulation.^[1] Lipoprotein(a) particles are stickier than other types of LDL particles, so they may be more likely to cause blockages and blood clots in your arteries.

‍

What should you know about this biomarker?

Each laboratory uses different machines and protocols, so the results might vary in terms of the reference ranges or used units of measurement. In Macromo blood tests, we use nmol/l (nanomoles per liter), but you can also find the values in mg/dl (milligrams per deciliter).

It is not a routine screening test and is generally performed if you are already believed to be at greater risk of cardiovascular problems. Routine cholesterol tests may show that your LDL cholesterol level is "healthy," but if a large percentage of your LDL cholesterol is carried by lipoprotein (a) particles, your risk for heart disease and stroke could still be high.

Optimal levels are individual, but in general a level below 75 nmol/l is desirable. Elevated Lp(a) can be genetically determined and may signify cardiovascular risks, while lower values are often linked to healthier arteries.

Your blood test could indicate one of several potential outcomes.

• Your Lp(a) levels fall within the reference range. It is generally considered beneficial for heart health. No specific intervention is required, but it is beneficial to maintain a healthy lifestyle.
• Your Lp(a) levels are above the reference range, indicating a higher risk of heart disease, even if your cholesterol levels are normal and you are healthy. Consult with your healthcare provider for guidance. 

‍

Genetics

Lp(a) levels are mainly determined by genetics. Certain genetic variations in the LPA gene, which encodes the apolipoprotein(a) protein, can lead to higher levels of Lp(a). A family history of high Lp(a) or early heart disease could indicate genetically elevated Lp(a) levels.^[1]

A recent study found that 80-90% of Lp(a) levels are influenced by genetics, and this study also highlighted the significant differences in levels between individual people (up to 1000-fold).^[1,2] 

Another study focused on the association of single nucleotide polymorphisms (SNPs) of the LPA and IL1F9 genes with coronary artery calcification, an important predictor of coronary artery disease. A significant association between Lp(a) levels and coronary artery calcification was also observed.^[3] 

‍

Recommendations

Monitoring Lp(a) levels can be an important aspect of assessing cardiovascular risk, especially in individuals with a family history of cardiovascular diseases:

• If you have a family history of heart disease or if your Lp(a) levels are elevated, it is advisable to consult a healthcare professional.
• While Lp(a) levels are primarily determined by genetics and are not significantly influenced by lifestyle, maintaining a healthy lifestyle is still important for overall heart and vascular health in your body.

‍

The information and tests provided on our website are for educational purposes only and are not a substitute for professional medical advice. Always consult with your healthcare provider before making health decisions. Our tests do not diagnose or treat diseases. Individual results may vary and should be discussed with a healthcare provider.