Lipoprotein(a) mass: A massively misunderstood metric

Joseph P. McConnell, Philip A. Guadagno, Thomas D. Dayspring, Daniel M. Hoefner, Dawn L. Thiselton, G. Russell Warnick, William S. Harris

Research output: Contribution to journalReview article

27 Scopus citations

Abstract

The importance of lipoprotein (a) - Lp(a) - as a cardiovascular (CV) risk marker has been underscored by recent findings that CV risk is directly related to baseline Lp(a) levels, even in well-treated patients. Although there is currently little that can be done pharmacologically to lower Lp(a) levels, knowledge of its serum concentration is important in overall risk assessment. This review focuses on 1 aspect of Lp(a) that is rarely discussed directly: how to express its levels in serum. There is considerable confusion on this point, and a fuller understanding of what the concentration units mean will help improve study-to-study comparisons and thereby advance our understanding of the pathobiology of this lipoprotein particle. As discussed here, the term Lp(a) mass refers to the entire mass of the particle: lipids, proteins, and carbohydrates combined. At present, there are no commercially available assays that are completely insensitive to the variability in particle mass, which arises not only from differences in apo(a) isoform mass but also from variations in lipid mass. Because lipoprotein "particle number" (molar concentration) has been found to be superior to component-based metrics (ie, low-density lipoprotein particle vs cholesterol concentrations) for CV disease risk prediction, the development of a mass-insensitive Lp(a) assay should be a high priority.

Original languageEnglish (US)
Pages (from-to)550-553
Number of pages4
JournalJournal of clinical lipidology
Volume8
Issue number6
DOIs
StatePublished - Jan 1 2014

Keywords

  • Apolipoprotein(a)
  • Laboratory methods
  • Lipoprotein(a)
  • Lipoproteins
  • Particle number

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Nutrition and Dietetics
  • Cardiology and Cardiovascular Medicine

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  • Cite this

    McConnell, J. P., Guadagno, P. A., Dayspring, T. D., Hoefner, D. M., Thiselton, D. L., Warnick, G. R., & Harris, W. S. (2014). Lipoprotein(a) mass: A massively misunderstood metric. Journal of clinical lipidology, 8(6), 550-553. https://doi.org/10.1016/j.jacl.2014.08.003