Tuchow Health Center, Medical Hospital Laboratory, Szpitalna St. 1, 33-170 Tuchow, Poland.
Department of Clinical Biochemistry, Pediatric Institute, College of Medicine, Jagiellonian University, Wielicka St. 265, 30-663 Cracow, Poland.
Cells. 2023 Oct 17;12(20):2472. doi: 10.3390/cells12202472.
Lipoprotein(a) (Lp(a)) molecule includes two protein components: apolipoprotein(a) and apoB100. The molecule is the main transporter of oxidized phospholipids (OxPL) in plasma. The concentration of this strongly atherogenic lipoprotein is predominantly regulated by the LPA gene expression. Lp(a) is regarded as a risk factor for several cardiovascular diseases. Numerous epidemiological, clinical and in vitro studies showed a strong association between increased Lp(a) and atherosclerotic cardiovascular disease (ASCVD), calcific aortic valve disease/aortic stenosis (CAVD/AS), stroke, heart failure or peripheral arterial disease (PAD). Although there are acknowledged contributions of Lp(a) to the mentioned diseases, clinicians struggle with many inconveniences such as a lack of well-established treatment lowering Lp(a), and common guidelines for diagnosing or assessing cardiovascular risk among both adult and pediatric patients. Lp(a) levels are different with regard to a particular race or ethnicity and might fluctuate during childhood. Furthermore, the lack of standardization of assays is an additional impediment. The review presents the recent knowledge on Lp(a) based on clinical and scientific research, but also highlights relevant aspects of future study directions that would approach more suitable and effective managing risk associated with increased Lp(a), as well as control the Lp(a) levels.
脂蛋白(a)(Lp(a))分子包括两种蛋白成分:载脂蛋白(a)和载脂蛋白 B100。该分子是血浆中氧化型磷脂(OxPL)的主要转运体。这种强致动脉粥样硬化脂蛋白的浓度主要受 LPA 基因表达调控。Lp(a)被认为是多种心血管疾病的危险因素。大量的流行病学、临床和体外研究表明,Lp(a)水平升高与动脉粥样硬化性心血管疾病(ASCVD)、钙化性主动脉瓣疾病/主动脉瓣狭窄(CAVD/AS)、中风、心力衰竭或外周动脉疾病(PAD)之间存在强烈关联。尽管 Lp(a)对上述疾病有公认的贡献,但临床医生在治疗降低 Lp(a)方面缺乏成熟的方法,以及在成人和儿科患者中诊断或评估心血管风险的常见指南,这给他们带来了许多不便。Lp(a)水平因特定种族或民族而异,并且在儿童期可能会波动。此外,检测方法缺乏标准化也是一个额外的障碍。本文综述了基于临床和科学研究的 Lp(a)的最新知识,但也强调了未来研究方向的相关方面,这些方面将探讨与升高的 Lp(a)相关的更合适和有效的风险管理,并控制 Lp(a)水平。
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