Lipoprotein(a) as a potent risk indicator for early cardiovascular disease

Aim: Elevated levels of lipoprotein (a) [Lp(a)] are associated with increased cardiovascular risk in adults. It is not known whether Lp(a) elevation can be regarded as an additional risk factor even in children and adolescents. Therefore the purpose of this study was to compare the serum concentrations, distribution and frequency of Lp(a) and lipids of children and adolescents with premature parental and/or grandparental cardiovascular disease (CVD) with controls. Methods: 103 children and adolescents, aged 6–18 y, from families with premature CVD in a parent and/or grandparent, i.e. before the age of 55 y, and 103 controls were estimated for lipids and Lp(a). Results: Mean levels of total cholesterol (TC), low‐density lipoprotein cholesterol (LDL‐C) and Lp(a) were significantly higher in the risk than in the control group. Median Lp(a) levels were 20 (10–61.5) mg dl‐1 in the risk subjects, and 15 (6–26.5) mg dl‐1 in the control subjects (p= 0.005). Mean TC and LDL‐C concentrations of the risk group compared with the control group were 211 mg dl‐1 (5.5 mmol l‐1) versus 165 mg dl‐1 (4.3 mmol l‐1) (p > 0.0001), and 140 mg dl‐1 (3.6 mmol l‐1) versus 101 mg dl‐1 (2.6 mmol l‐1) (p > 0.0001), respectively. Conclusion: It may be important to estimate plasma Lp(a) levels in progeny with a familial history of premature CVD, because it seems possible to identify those subjects who are at greater risk for later CVD either with or without elevated LDL‐C levels.