Highlights
- •Lp(a) distribution is evaluated for the first time in large-scale Chinese adults.
- •Lp(a)≥ 50 mg/dL is associated with carotid arteriopathy in a health check-up population.
- •The association between Lp(a) and arteriopathy is independent of LDL-C.
Abstract
Background and aims
The distribution of lipoprotein(a) [Lp(a)] has not been well-studied in a large population
in China. The relationship between Lp(a) and carotid atherosclerosis remains undefined.
In this study, we aimed to investigate the distribution of Lp(a) levels and to assess
their association with carotid arteriopathy in China.
Methods
In this cross-sectional study, 411,634 adults with Lp(a) measurements from 22 health
check-up centers were used to investigate Lp(a) distribution in China. Among participants
with Lp(a) data, carotid ultrasound was performed routinely at seven health check-up
centers covering 73,305 subjects. Carotid intima-media thickness (cIMT) and carotid
plaque were used as surrogate biomarkers of carotid arteriopathy. The multivariate
logistic regression model was applied to evaluate the association of increased Lp(a)
levels with carotid arteriopathy.
Results
The distribution of Lp(a) concentrations was right-skewed, with a median concentration
of 10.60 mg/dL. The proportions of Lp(a) levels ≥30 mg/dL and ≥50 mg/dL were 16.75%
and 7.10%, respectively. The median Lp(a) level was higher in females individuals
in northern China, and increased with age. Spearman's analysis revealed weak correlations
between the Lp(a) concentration as a continuous variable and other lipid profiles.
The multiple logistic regression analysis showed that participants with Lp(a) levels
≥50 mg/dL had an increased risk of cIMT ≥1.0 mm (OR = 1.138, 95% CI, 1.071–1.208)
and carotid plaque (OR = 1.296, 95% CI, 1.219–1.377) compared with those with Lp(a)
levels <50 mg/dL.
Conclusions
This is the first study of the Lp(a) distribution in a large population in China.
Our findings revealed a positive association between elevated Lp(a) levels (≥50 mg/dL)
and increased prevalence of carotid atherosclerosis, which implies an increased risk
of cardiovascular disease in the future.
Graphical abstract
Graphical Abstract
Keywords
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Article info
Publication history
Accepted:
March 7,
2023
Received in revised form:
February 19,
2023
Received:
May 6,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Published by Elsevier B.V.
