Carotid Intima-Media Thickness in Asymptomatic Subjects With Low Lipoprotein(a) Levels

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Background

Elevated and extreme circulating levels of lipoprotein(a) (Lp(a)) are considered to be an atherosclerotic risk factor, although additional studies on the low levels of Lp(a) are necessary to provide confirmation. The carotid intima-media thickness (CIMT) is known as a surrogate index of atherosclerosis. The aim of the present study was to investigate the correlation between the serum Lp(a) and CIMT in asymptomatic subjects with a relatively low Lp(a) level.

Methods

The study included 65 asymptomatic female Japanese subjects (mean age: 60 years) with a serum Lp(a) level < 30 mg/dL. Clinical data including the serum Lp(a) and CIMT were measured, and their correlations were examined.

Results

The median Lp(a) level was 18.6 mg/dL and the mean CIMT level was 0.8 mm. There was a significant and inverse correlation between the CIMT and Lp(a) (r = - 0.24, P ≤ 0.05), in addition to a significant and positive correlation between the CIMT and subject age and systolic blood pressure. A stepwise multiple linear regression analysis identified the Lp(a) to be correlated independently, significantly and inversely with the CIMT.

Conclusions

The Lp(a) levels were inversely correlated with the CIMT in this population, suggesting that subjects with a low Lp(a) level may have a predisposition to carotid atherosclerosis. This finding was preliminary and should be investigated further in larger studies and in additional settings.

Keywords

Lp(a); Carotid artery; IMT; Atherosclerosis

Related collections

Most cited references 32

Record: found
Abstract: found
Article: not found

Strong association between malnutrition, inflammation, and atherosclerosis in chronic renal failure.

P Stenvinkel, O Heimbürger, F Paultre … (1999)

Atherosclerotic cardiovascular disease and malnutrition are widely recognized as leading causes of the increased morbidity and mortality observed in uremic patients. C-reactive protein (CRP), an acute-phase protein, is a predictor of cardiovascular mortality in nonrenal patient populations. In chronic renal failure (CRF), the prevalence of an acute-phase response has been associated with an increased mortality. One hundred and nine predialysis patients (age 52 +/- 1 years) with terminal CRF (glomerular filtration rate 7 +/- 1 ml/min) were studied. By using noninvasive B-mode ultrasonography, the cross-sectional carotid intima-media area was calculated, and the presence or absence of carotid plaques was determined. Nutritional status was assessed by subjective global assessment (SGA), dual-energy x-ray absorptiometry (DXA), serum albumin, serum creatinine, serum urea, and 24-hour urine urea excretion. The presence of an inflammatory reaction was assessed by CRP, fibrinogen (N = 46), and tumor necrosis factor-alpha (TNF-alpha; N = 87). Lipid parameters, including Lp(a) and apo(a)-isoforms, as well as markers of oxidative stress (autoantibodies against oxidized low-density lipoprotein and vitamin E), were also determined. Compared with healthy controls, CRF patients had an increased mean carotid intima-media area (18.3 +/- 0.6 vs. 13.2 +/- 0.7 mm2, P or = 10 mg/liter). Malnourished patients had higher CRP levels (23 +/- 3 vs. 13 +/- 2 mg/liter, P < 0.01), elevated calculated intima-media area (20.2 +/- 0.8 vs. 16.9 +/- 0.7 mm2, P < 0.01) and a higher prevalence of carotid plaques (90 vs. 60%, P < 0.0001) compared with well-nourished patients. During stepwise multivariate analysis adjusting for age and gender, vitamin E (P < 0.05) and CRP (P < 0.05) remained associated with an increased intima-media area. The presence of carotid plaques was significantly associated with age (P < 0.001), log oxidized low-density lipoprotein (oxLDL; P < 0.01), and small apo(a) isoform size (P < 0.05) in a multivariate logistic regression model. These results indicate that the rapidly developing atherosclerosis in advanced CRF appears to be caused by a synergism of different mechanisms, such as malnutrition, inflammation, oxidative stress, and genetic components. Apart from classic risk factors, low vitamin E levels and elevated CRP levels are associated with an increased intima-media area, whereas small molecular weight apo(a) isoforms and increased levels of oxLDL are associated with the presence of carotid plaques.

0 comments Cited 353 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Apolipoprotein(a) gene accounts for greater than 90% of the variation in plasma lipoprotein(a) concentrations.

E Boerwinkle, Chin Lin, C C Leffert … (1992)

Plasma lipoprotein(a) [Lp(a)], a low density lipoprotein particle with an attached apolipoprotein(a) [apo(a)], varies widely in concentration between individuals. These concentration differences are heritable and inversely related to the number of kringle 4 repeats in the apo(a) gene. To define the genetic determinants of plasma Lp(a) levels, plasma Lp(a) concentrations and apo(a) genotypes were examined in 48 nuclear Caucasian families. Apo(a) genotypes were determined using a newly developed pulsed-field gel electrophoresis method which distinguished 19 different genotypes at the apo(a) locus. The apo(a) gene itself was found to account for virtually all the genetic variability in plasma Lp(a) levels. This conclusion was reached by analyzing plasma Lp(a) levels in siblings who shared zero, one, or two apo(a) genes that were identical by descent (ibd). Siblings with both apo(a) alleles ibd (n = 72) have strikingly similar plasma Lp(a) levels (r = 0.95), whereas those who shared no apo(a) alleles (n = 52), had dissimilar concentrations (r = -0.23). The apo(a) gene was estimated to be responsible for 91% of the variance of plasma Lp(a) concentration. The number of kringle 4 repeats in the apo(a) gene accounted for 69% of the variation, and yet to be defined cis-acting sequences at the apo(a) locus accounted for the remaining 22% of the inter-individual variation in plasma Lp(a) levels. During the course of these studies we observed the de novo generation of a new apo(a) allele, an event that occurred once in 376 meioses.

0 comments Cited 99 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Oxidized phospholipids predict the presence and progression of carotid and femoral atherosclerosis and symptomatic cardiovascular disease: five-year prospective results from the Bruneck study.

Manuel Mayr, Siegfried Weger, Sotirios Tsimikas … (2006)

The purpose of this work was to determine the predictive value of oxidized phospholipids (OxPLs) present on apolipoprotein B-100 particles (apoB) in carotid and femoral atherosclerosis. The OxPLs are pro-inflammatory and pro-atherogenic and may be detected using the antibody E06 (OxPL/apoB). The Bruneck study is a prospective population-based survey of 40- to 79-year-old men and women initiated in 1990. Plasma levels of OxPL/apoB and lipoprotein (a) [Lp(a)] were measured in 765 of 826 (92.6%) and 671 of 684 (98.1%) subjects alive in 1995 and 2000, respectively, and correlated with ultrasound measures of carotid and femoral atherosclerosis. The distribution of the OxPL/apoB levels was skewed to lower levels and nearly identical to Lp(a) levels. The OxPL/apoB and Lp(a) levels were highly correlated (r = 0.87, p < 0.001), and displayed long-term stability and lacked correlations with most cardiovascular risk factors and lifestyle variables. The number of apolipoprotein (a) kringle IV-2 repeats was inversely related to Lp(a) mass (r = -0.48, p < 0.001) and OxPL/apoB levels (r = -0.46, p < 0.001). In multivariable analysis, OxPL/apoB levels were strongly and significantly associated with the presence, extent, and development (1995 to 2000) of carotid and femoral atherosclerosis and predicted the presence of symptomatic cardiovascular disease. Both OxPL/apoB and Lp(a) levels showed similar associations with atherosclerosis severity and progression, suggesting a common biological influence on atherogenesis. This study suggests that pro-inflammatory oxidized phospholipids, present primarily on Lp(a), are significant predictors of the presence and extent of carotid and femoral atherosclerosis, development of new lesions, and increased risk of cardiovascular events. The OxPL biomarkers may provide valuable insights into diagnosing and monitoring cardiovascular disease.

0 comments Cited 38 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Journal

Journal ID (nlm-ta): J Clin Med Res

Journal ID (iso-abbrev): J Clin Med Res

Journal ID (publisher-id): Elmer Press

Title: Journal of Clinical Medicine Research

Publisher: Elmer Press

ISSN (Print): 1918-3003

ISSN (Electronic): 1918-3011

Publication date (Print): April 2012

Publication date (Electronic): 23 March 2012

Volume: 4

Issue: 2

Pages: 130-134

Affiliations

[a ]Division of Preventive Medicine, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Kyoto, Japan

[b ]Department of Clinical Laboratory Medicine, Jichi Medical University, Tochigi, Japan

Author notes

[c ]Corresponding author: Kazuhiko Kotani, Organization Kyoto Medical Center, 1-1 Fukakusa mukaihata, Fushimi-ku, Kyoto 612-8555, Japan. Email: kazukotani@ 123456jichi.ac.jp

Article

DOI: 10.4021/jocmr849w

PMC ID: 3320123

PubMed ID: 22505987

SO-VID: d8ea3906-d4f0-459c-a11e-a0d3e46b4ed0

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Carotid Intima-Media Thickness in Asymptomatic Subjects With Low Lipoprotein(a) Levels

Read this article at

Abstract

Background

Methods

Results

Conclusions

Keywords

Related collections

Wits Journal of Clinical Medicine

Most cited references 32

Strong association between malnutrition, inflammation, and atherosclerosis in chronic renal failure.

Apolipoprotein(a) gene accounts for greater than 90% of the variation in plasma lipoprotein(a) concentrations.

Oxidized phospholipids predict the presence and progression of carotid and femoral atherosclerosis and symptomatic cardiovascular disease: five-year prospective results from the Bruneck study.

Author and article information

Journal

Affiliations

Author notes

Article

History

Categories

Comments

Comment on this article

Similar content 531

Cited by 5

Most referenced authors 656