Cruz-Bautista Ivette, Flores-Jurado Yuscely, Roa-Álvarez Guillermo, Salas-Aldana Mariana, Elías-Lopez Daniel Benjamin, Hernández-Franco Ricardo Federico, Rosales-Uvera Sandra, Vargas-Vázquez Arsenio, Valdez-Echeverría Raymundo, Luna Del Villar Velasco Sonia, Muñoz-Hernández Liliana, Mehta Roopa, Morales-Esponda Mario, Aguilar-Panduro Misael, Chan-Puga Guillermo, Mota Adrián Soto, Aguilar-Salinas Carlos Alberto
Unidad de Investigación en Enfermedades Metabólicas, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México City, Mexico.
Departamento de Endocrinología y Metabolismo, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México City, Mexico.
Lipids Health Dis. 2025 May 26;24(1):192. doi: 10.1186/s12944-025-02610-w.
Approximately 20% of the global population has a Lp(a) concentrations above 50 mg/dL (> 125nmol/L), yet many remain unaware of the associated cardiovascular risks. In Mexico, routine measurement of Lp(a) is uncommon. This study aimed to investigate the frequency of Lp(a) testing, and the clinical actions taken by physicians upon detecting elevated Lp(a) concentrations in patients at a tertiary medical institution.
Using an algorithm-based screening system, we reviewed the clinical and biochemical data of patients with Lp(a) measurements from 2019 to 2024. Data were retrieved from the laboratory information system and electronic health records. Complementary assessment data were obtained from the radiology and cardiology departments.
Of the 150,083 individuals evaluated at the institution, only 830 (0.5%) underwent Lp(a) testing, with testing rates increasing from 0.037% in 2019 to 0.24% in 2023. Elevated Lp(a) concentrations (> 50 mg/dL) were found in 21% of patients, and 2.2% had concentrations > 180 mg/dL. Patients with elevated Lp(a) had significantly higher rates of atherosclerotic cardiovascular disease (ASCVD) (p < 0.001) and familial hypercholesterolemia (p < 0.004) than those with lower Lp(a) levels. Interestingly, diabetes prevalence was higher in those with Lp(a) < 4 mg/dL (51.5% vs. 33.4%, p < 0.001). Despite the cardiovascular risk, only 26% of patients with elevated Lp(a) levels received interventions to modify risk factors.
Lp(a) testing was infrequent in a tertiary medical setting. Clinical interventions to modify cardiovascular risk factors were insufficient among patients with elevated Lp(a). These findings highlight the need for greater awareness among healthcare providers and the development of comprehensive screening and management algorithms to mitigate Lp(a) -related cardiovascular risk.
全球约20%的人口脂蛋白(a)[Lp(a)]浓度高于50mg/dL（>125nmol/L），但许多人仍未意识到相关的心血管风险。在墨西哥，Lp(a)的常规检测并不常见。本研究旨在调查一家三级医疗机构中Lp(a)检测的频率，以及医生在检测到患者Lp(a)浓度升高后采取的临床措施。
我们使用基于算法的筛查系统，回顾了2019年至2024年进行Lp(a)检测的患者的临床和生化数据。数据从实验室信息系统和电子健康记录中获取。补充评估数据从放射科和心内科获取。
在该机构评估的150,083名个体中，只有830人（0.5%）进行了Lp(a)检测，检测率从2019年的0.037%升至2023年的0.24%。21%的患者Lp(a)浓度升高（>50mg/dL），2.2%的患者浓度>180mg/dL。Lp(a)升高的患者患动脉粥样硬化性心血管疾病（ASCVD）（p<0.001）和家族性高胆固醇血症（p<0.004）的比例显著高于Lp(a)水平较低的患者。有趣的是，Lp(a)<4mg/dL的患者糖尿病患病率更高（51.5%对33.4%，p<0.001）。尽管存在心血管风险，但Lp(a)水平升高的患者中只有26%接受了干预以改变危险因素。
在三级医疗环境中，Lp(a)检测并不常见。Lp(a)升高的患者中，针对心血管危险因素的临床干预不足。这些发现凸显了医疗服务提供者提高认识的必要性，以及制定全面的筛查和管理算法以降低与Lp(a)相关的心血管风险的必要性。
