Lipoprotein ( a) - Causes, symptoms and treatment.MF .

August 12, 2017 17:52 | Laboratory

Lipoprotein (a) - a substance consisting of protein and lipid parts and is the main form of transport of lipids in the body.It is synthesized in the liver and lipid composition does not differ from the low-density lipoprotein, however, it contains more protein.

Indicators Norma (mg / div)
figures from 0 to 90 years
& lt; 30
figures from 0 to 90years
& lt; 30

pregnancy from 1 to 40 weeks
& lt; 30

Preparing to study :

material for the study of blood serum.Blood is collected from a vein into a vacuum tube immediately after taking to deliver to the lab.

Patient Preparation - fasting 12 hours to eliminate the hormones, niacin, phenytoin.Reference

content value of lipoprotein (a) [Lp (a)] in blood serum - 0-30 mg / dl.

Lp (a) consists of apo (a) which is inherently glikopro-Thein and covalently bound to apo B100.Lp (a) has a significant structural similarity to plasminogen.Lp (a) is larger LDL, but has compared them with higher density and elec

trophoretic mobility has pre-ß-LP.By PL lipid composition (a) is different from LDL, but protein Lp (a) is greater.Lp (a) is synthesized in the liver.All modern immunochemical methods for the determination of Lp (a) actually detect protein - apo (a).

increased concentration of Lp (a) levels - a risk factor for CHD.According to the literature, the average content of apo (a) in blood of patients with coronary heart disease is 12 mg / dL.In 2/3 patients atherosclerosis depends on the presence of high blood concentrations of LP (a).The close correlation between the concentration of Lp (a) in serum and coronary artery disease development.Epidemiological studies have shown that people with normal cholesterol concentrations, but higher OV content (a) (above 30 mg / dl) on the risk of CHD less 2 times higher.The risk increases by 8 times, if simultaneously elevated LDL and Lp (a).Myocardial infarction developed in 4 times more common in young people, to which the content of apo (a) greater than 48 mg / dL.In patients with atherosclerosis obliterans content of apo (a) is also increased.

LP concentration (a) in the blood increases after surgery, patients with cancer, diabetes mellitus, acute phase of rheumatic fever.

similarity of the structure of apo (a) and acute phase proteins allows us to consider it as a specific protein of the acute phase in destructive athero-sclerotic processes in the vascular wall.Determination of Lp (a) - activity evaluation test atherosclerotic process.His blood levels correlated with the area of ​​atheromatous lesions of the aorta, the level of hyperglycemia, blood clotting time, and markers of renal excretory function failure.Hypertension atherosclerosis is often combined with an increase in blood levels of Lp (a).

LP concentration (a) in the blood is genetically determined, and currently there are no drugs that reduce it.In this regard, the only treatment strategy for patients with high concentrations of Lp (a) - the elimination of all other cardiovascular risk factors (smoking, overweight, hypertension, high LDL concentration).

Currently installed is a clear correlation between blood concentrations of total cholesterol and mortality from cardiovascular disease.When the content of cholesterol in the blood is below 200 mg / dl (5.2 mmol / l), the lowest risk of atherosclerosis.If the concentration of LDL-cholesterol in the blood is below 100 mg / dL (2.59 mmol / l), heart disorders are very rare.Increased LDL-cholesterol levels above 100 mg / dL mark in the use of write rich in animal fats and cholesterol.An unhealthy diet, smoking and hypertension - the synergistic effect of the factors that increase the risk of CHD.The combination of these factors with any other approximately 10 years accelerates the development of coronary atherosclerosis critical degree.Decrease in total cholesterol concentration in blood and increasing HDL-cholesterol reduces the rate of progression of atherosclerosis.Lowering blood concentration of total cholesterol by 10% results in a reduction in mortality from heart disease by 20%.Increasing the concentration of HDL cholesterol at 1 mg / dL (0.03 mmol / l) reduces the risk of coronary disease by 2-3% in men and women.Furthermore, regardless of the total cholesterol content in blood (including exceeding 5.2 mmol / l) is stored inverse relationship between the content of HDL-cholesterol and the incidence of heart disease.Concentrations of HDL-cholesterol (less than 1.3 mmol / L) and triglycerides in the blood - an independent prognostic indicator of the likelihood of death from coronary heart disease.Therefore, the HDL-cholesterol content should be considered a more accurate predictor for mortality from coronary heart disease than the total cholesterol concentration.

Laboratory test - to identify pathology
TG + XC -50%
TG + LDL + HDL-cholesterol - 57%
TG + LDL + HDL-cholesterol + apo-A - 72%
TG + LDL + HDL-cholesterol + apo-A + apo-B - 92%
TG + LDL + HDL-cholesterol + apo-a, apo +, B + LP (a) - Up to 100%

following aspects should be considered in clinical practice.

  • Lowering LDL-cholesterol concentrations and increase the concentration of HDL-cholesterol helps reduce the frequency of atherosclerosis.
  • ratio "total cholesterol / HDL-cholesterol 'normally is 3.4 to 75-89 years it rises to 4.7;find the best ratio of 3.5, and at values ​​of 5 or more CHD risk increases significantly.
  • lipid profile is directly related to the dominance of testosterone in men and estrogen in women.
  • PL concentration (a) in serum reflects the activity of atherosclerosis.
  • Excessive nutrition, obesity, smoking and physical inactivity have an adverse effect on the lipid profile.
  • Correction of lipid disorders should include not just a reduction in the concentration of cholesterol, but also normalization of adverse lipid profiles.
  • Weight loss and exercise, the concentration of HDL in the blood increases, and LDL-cholesterol and triglycerides - reducing.
  • development of atherosclerosis begins even at a young age, so its appearance in the later stages of life can be prevented by leading a healthy lifestyle from a young age.

optimal cholesterol-lipoprotein profile provides the next level of performance in the serum.

  • Total cholesterol - less than 200 mg / dl (5.2 mmol / L).
  • HDL-cholesterol - more than 50 mg / dL (1.3 mmol / l).
  • LDL-cholesterol levels - less than 130 mg / dL (3.4 mmol / l).
  • triglycerides - at least 250 mg / dl (2.3 mmol / L).

Elevated levels of lipoprotein (a) in the blood is associated with a high risk of coronary heart disease, as it contributes to the progression of atherosclerosis, the formation of plaques in the coronary vessels.In addition, always there is a high level of lipoprotein (a) in patients with atherosclerosis obliterans of lower limb arteries, atherosclerosis of brain vessels.Among other conditions in which the content of this indicator is increased, it should be noted diabetes mellitus, some cancers, as well as the first few days after surgery (in this case, lipoprotein (a) reacts like an acute phase inflammatory protein).

Reducing the amount of lipoprotein (a) usually observed in hyperthyroidism (increased synthesis of thyroid hormones), severe liver disease with evidence of hepatic failure, prolonged starvation and cachexia (wasting), malabsorption syndrome (malabsorption in the intestines due to various reasons).