Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland; Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland.
Novartis Finland Oy, Espoo, Finland.
Atherosclerosis. 2022 Sep;356:18-27. doi: 10.1016/j.atherosclerosis.2022.07.009. Epub 2022 Jul 16.
Lipoprotein (a) (Lp(a)) is a causal risk factor for cardiovascular diseases and its levels are under strict genetic control. Therefore, it is hypothesized that the concentration of Lp(a) remains stable throughout life. Finns have lower Lp(a) levels than central Europeans, but it is unknown whether there are differences within Finland, especially between the eastern and western parts of the country with known genetic duality and persistent differences in cardiovascular disease rates. We have examined the long-term stability of Lp(a) levels over 25 years in the Cardiovascular Risk in Young Finns Study (YFS), and the characteristics of individuals with different Lp(a) levels, including their geographical origin within Finland.
In YFS, the first large baseline examination was conducted in 1980 (baseline age, 3-18 years). Several follow-ups during the past 40 years have been conducted to investigate the determinants of cardiometabolic health. Lp(a) levels have been measured in study years 1986 (N = 2464, ages 9-24 years), 2001 (N = 2281, ages 24-39 years), 2007 (N = 2204, ages 35-45 years) and 2011 (N = 2044, ages 39-49 years). Tracking of Lp(a) was estimated by calculating Spearman's rank order correlations between the study years, and by cross-tabulating how many individuals diagnosed with either elevated or non-elevated Lp(a) levels in 1986, 2001 and 2007 remained in the same category in the latest follow-up in 2011.
Spearman's correlation coefficients varied between r = 0.84-0.96. Most individuals (87-94%) who had a high Lp(a) level (>30 mg/dl) in any of the previous study years had a high level also in 2011. On average, the median Lp(a) levels were consistently ∼20% higher in the individuals originating from eastern Finland compared to those from western Finland, but there were no differences in the distribution of known genetic determinants between eastern and western Finns that would have explained the observed difference.
These data confirm that Lp(a) levels remain very stable over the life-course. In line with the genetic duality between eastern and western parts of Finland, we observed about 20% higher Lp(a) levels in individuals originating from eastern Finland compared to those originating from western Finland.
脂蛋白(a)[Lp(a)]是心血管疾病的一个因果风险因素，其水平受到严格的遗传控制。因此，人们假设 Lp(a)的浓度在整个生命周期中保持稳定。芬兰人的 Lp(a)水平低于中欧人，但尚不清楚芬兰国内是否存在差异，特别是在该国东部和西部，那里存在已知的遗传双重性和心血管疾病发病率持续存在的差异。我们已经在心血管风险在年轻芬兰人研究(YFS)中检查了 Lp(a)水平在 25 年内的长期稳定性，以及不同 Lp(a)水平个体的特征，包括他们在芬兰国内的地理来源。
在 YFS 中，第一次大型基线检查于 1980 年进行(基线年龄为 3-18 岁)。在过去的 40 年中进行了几次随访，以研究心血管代谢健康的决定因素。Lp(a)水平在研究年份 1986 年(N=2464，年龄 9-24 岁)、2001 年(N=2281，年龄 24-39 岁)、2007 年(N=2204，年龄 35-45 岁)和 2011 年(N=2044，年龄 39-49 岁)进行了测量。通过计算研究年份之间的斯皮尔曼等级相关系数来估计 Lp(a)的跟踪情况，并通过交叉制表来确定在 1986 年、2001 年和 2007 年被诊断为 Lp(a)水平升高或非升高的个体中有多少人在 2011 年的最新随访中仍处于同一类别。
Spearman 相关系数在 r=0.84-0.96 之间变化。大多数在之前任何一年研究中 Lp(a)水平较高(>30mg/dl)的个体(87-94%)在 2011 年也有较高水平。平均而言，来自芬兰东部的个体的 Lp(a)中位数水平始终比来自芬兰西部的个体高约 20%，但在芬兰东部和西部的个体之间没有发现已知遗传决定因素的分布差异，这可以解释观察到的差异。
这些数据证实，Lp(a)水平在整个生命周期中非常稳定。与芬兰东部和西部之间的遗传双重性一致，我们观察到来自芬兰东部的个体的 Lp(a)水平比来自芬兰西部的个体高约 20%。
