Lipoprotein (a) concentrations as risk factors for atherosclerosis
Atherosclerosis is a thickening and hardening of the blood vessels caused by accumulation of lipids (fats) and other substances. A family history of coronary heart disease (CHD), which affects the major blood vessels supplying the heart, or cerebrovascular disease (CVD), which affects the circulation of the brain, may increase the risk of atherosclerosis. Research indicates that increased levels of lipoproteins, which are complexes of lipids and proteins, and elevated levels of low-density lipoprotein (LDL) cholesterol contribute to the development of atherosclerosis. Elevated blood lipoprotein levels have been associated with a family history of early heart attack. A specific lipoprotein called lipoprotein (a) may combine with the compound glycosaminoglycan, and these complexes may be involved in the formation of lesions in the arteries. The blood levels of lipoproteins were measured in 102 children without a family history of CHD or CVD (the control group), as well as 42 children of parents with CHD and 50 children of parents with CVD. The blood levels of the apolipoproteins A I and B and of high-density lipoprotein (HDL) cholesterol differed between the control group and the children of parents with heart disease. The blood levels of total cholesterol, apolipoprotein A II, and lipoprotein (a) differed between the control group and children with a family history of CHD. The differences in lipoprotein (a) levels between children with a family history of CHD and control children were only apparent after age 10 years, as a result of an increase in lipoprotein (a) between age two and 13 years. Children of parents with CVD had similar lipoprotein (a) levels as those of the control group. The blood levels of glycosaminoglycan varied with age and were higher in children with a family history of heart disease than in control children. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Archives of Disease in Childhood
Lipoprotein(a) and atherosclerosis
Cholesterol and related substances in the blood have been shown to be important in the genesis of heart disease. One of these newly-recognized related molecules is lipoprotein(a), or Lp(a). Research shows that people with levels of Lp(a) in the top quarter of the population have a two-to-five times greater risk for developing heart disease that those in the lower three quarters. The more atherogenic form of Lp(a) (the form most likely to form plaques on the walls of coronary arteries) is inherited in a dominant fashion, with no prevalence in either sex. Those individuals who develop premature heart disease should have their levels of Lp(a) measured. Unfortunately, none of the current cholesterol-lowering drugs has been found to be of much use in lowering levels of Lp(a), with the exception of nicotinic acid, which must be given in high doses that are often toxic. Nevertheless, patients with high levels of Lp(a) should be identified so they may be encouraged to try to reduce their risk for heart disease in other ways, such as not smoking and controlling high blood pressure. Further research into the mechanism by which Lp(a) contributes to heart disease and what drugs might lower the risk of heart disease is warranted. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Annals of Internal Medicine
Hyperlipidemia and pancreatitis during pregnancy in two sisters with a mutation in the lipoprotein lipase gene
Pregnant women with an inherited genetic mutation may be at greater risk for an inflammatory disorder of the pancreas called pancreatitis. Researchers presented the medical histories of two French Canadian sisters with pancreatitis, one pregnant and one three weeks after delivery. Both sisters had a genetic mutation on a gene that codes for an enzyme important to fat metabolism, lipoprotein lipase. Both had elevated triglyceride and cholesterol levels during the pancreatitis episodes. One patient had a tear in her small intestine, went into respiratory failure, had a burst artery to the spleen, and had blood poisoning associated with the pancreatitis episode. The women lost between 9 and 10 kilograms of weight and their triglyceride and cholesterol levels dropped significantly after one year on a diet limited to 25 grams of fat per day. Both of their babies are healthy.
Publication Name: Annals of Internal Medicine
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