Lipoprotein a LPa in various Clinical Conditions

Abstract

The mean plasma Lp(a) for the Indian ethnic group was found to be 23.2 + 17.3 mg/dl. Among Indians, the age, sex, food habits and living conditions do not alter the Lp(a) levels. The plasma Lp(a) levels in the Indian population is highly skewed (skewness +1.468). There is an inverse relationship between the plasma Lp(a) levels and the apo(a) size. The percentage of unexpressed alleles i.e., the null alleles was found to be 22.3 %, which is higher than what was reported in the literature for the other ethnic groups. Twenty five percent of the normal population had high Lp(a) gt30 mg/dl and this may be one of the reasons why Indians have a higher risk for CHD. The C/T, PNR and apo E polymorphisms have no influence on plasma Lp(a). In the CHD patients the mean plasma Lp(a) level as well as the percentage of individuals with elevated Lp(a) gt30 mg/dl was higher than their age and sex matched controls. In CHD patients the plasma Lp(a) levels increased with the degree of vessel disease although it was not statistically significant. Smoking, diabetes mellitus and hypertension had no apparent influence on plasma Lp(a) levels towards atherogenecity. In the Indian population the CHD risk is not phenotype dependent, but depend on the absolute Lp(a) value. Plasma Lp(a) levels are highly elevated in ESRD patients. After transplantation the levels are markedly decreased, reaching a minimum by the third month. The percentage of individuals that were assumed to have a high Lp(a) gt30 mg/dl before the onset of renal failure was very similar to that observed for the normal population. In the Indian NIDDM patients Lp(a) is not significantly elevated, even in those with poor glycemic control. Only in those NIDDM patients with secondary complications namely CHD and proteinuria Lp(a) levels are elevated. In hypothyroid patients the plasma Lp(a) levels are markedly elevated. About 53 % of the hypothyroid patients were with elevated Lp(a) gt30 mg/dl, which is the highest percentage observed in the present study. newline