Cardiology, Geneva University Hospitals, Geneva, Switzerland.
Department of Nephrology and Hypertension, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Eur J Clin Invest. 2022 Feb;52(2):e13699. doi: 10.1111/eci.13699. Epub 2021 Nov 8.
Lipoprotein(a) [Lp(a)] is an LDL-like molecule that is likely causal for cardiovascular events and Lp(a) variability has been shown to be mostly of genetic origin. Exogenous hormones (hormone replacement therapy) seem to influence Lp(a) levels, but the impact of endogenous hormone levels on Lp(a) is still unknown. The aim of the study was to assess the effect of endogenous steroid hormone metabolites on Lp(a).
Lipoprotein(a) levels were measured in 1,021 participants from the Swiss Kidney Project on Genes in Hypertension, a family-based, multicentre, population-based prospective cohort study. Endogenous levels of 28 steroid hormone precursors were measured in 24-h urine collections from 883 individuals. Of the participants with Lp(a) data, 1,011 participants had also genotypes available.
The participants had an average age of 51 years and 53% were female. Median Lp(a) levels were 62 mg/L, and the 90 percentile was 616 mg/L. The prevalence of a Lp(a) elevation ≥700 mg/L was 3.2%. Forty-three per cent of Lp(a) variability was explained respectively by: age (2%, p < .001), LDL-C (1%, p = .001), and two SNPs (39%, p value<2⋅10 ). Of the 28 endogenous steroid hormones assessed, androstenetriol, androsterone, 16α-OH-DHEA and estriol were nominatively associated with serum Lp(a) levels in univariable analyses and explained 0.4%-1% of Lp(a) variability, but none of them reached significance in multivariable models.
In this contemporary population-based study, the prevalence of a Lp(a) elevation ≥700 mg/L was 3.2%. The effect of endogenous steroid hormone levels of Lp(a) variability was small at best, suggesting a negligible impact on the wide range of Lp(a) variability.
脂蛋白(a) [Lp(a)] 是一种类似 LDL 的分子，可能与心血管事件有关，并且已经证明 Lp(a) 的变异性主要是遗传起源。外源性激素（激素替代疗法）似乎会影响 Lp(a) 水平，但内源性激素水平对 Lp(a) 的影响尚不清楚。本研究旨在评估内源性甾体激素代谢物对 Lp(a) 的影响。
在瑞士肾脏项目中，对来自高血压基因的 1021 名参与者进行了脂蛋白(a) 水平测量，这是一项基于家庭的、多中心的、基于人群的前瞻性队列研究。在 883 名个体的 24 小时尿液采集物中测量了 28 种甾体激素前体的内源性水平。在有 Lp(a) 数据的参与者中，有 1011 名参与者也有基因型可供使用。
参与者的平均年龄为 51 岁，53%为女性。中位数 Lp(a) 水平为 62mg/L，第 90 个百分位数为 616mg/L。Lp(a)升高≥700mg/L 的患病率为 3.2%。Lp(a) 变异的 43%分别由以下因素解释：年龄（2%，p<0.001）、LDL-C（1%，p=0.001）和两个 SNP（39%，p 值<2 ⋅ 10）。在评估的 28 种内源性甾体激素中，雄烯三醇、雄酮、16α-OH-DHEA 和雌三醇在单变量分析中与血清 Lp(a)水平有命名关联，并且解释了 Lp(a)变异性的 0.4%-1%，但在多变量模型中均无统计学意义。
在这项现代人群研究中，Lp(a)升高≥700mg/L 的患病率为 3.2%。内源性甾体激素水平对 Lp(a)变异性的影响很小，表明其对 Lp(a)变异性的广泛范围影响可以忽略不计。
