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Lipoprotein (a) in serum
Last reviewed: 18.10.2021
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Reference values (norm) of the content of lipoprotein (a) [LP (a)] in blood serum - 0-30 mg / dl.
Lipoprotein (a) consists of apo (a), which is inherently a glycoprotein and covalently linked to apo-B 100. Lipoprotein (a) has a significant structural similarity with plasminogen. LP (a) is larger than LDL, but has a higher density compared to them and has an electrophoretic mobility of pre-β-LP. The lipid composition of lipoprotein (a) does not differ from LDL, but the protein in LP (a) is greater. Lipoprotein (a) is synthesized in the liver. All modern immunochemical methods for determining lipoprotein (a) actually reveal a protein - apo (a).
Determination of lipoprotein (a) is an evaluation of the activity of the atherosclerotic process. Its content in the blood correlates with the area of atheromatous lesion of the aorta, the level of hyperglycemia, the time of blood clotting and markers of the excretory excretory function of the kidneys. Arterial hypertension in atherosclerosis is often combined with a rise in the blood lipoprotein (a) concentration.
The concentration of LP (a) in the blood is genetically determined, and currently there are no drugs that reduce it. In this regard, the only strategy for treating patients with elevated lipoprotein concentration (a) is to eliminate all other risk factors for IHD (smoking, overweight, hypertension, high LDL).
At present, there is a clear correlation between the concentration of total cholesterol in the blood and the mortality from cardiovascular diseases. When the cholesterol level in the blood is below 200 mg / dL (5.2 mmol / l), the risk of developing atherosclerosis is the least. If the LDL-C concentration in the blood is below 100 mg / dL (2.59 mmol / L), heart damage occurs very rarely. An increase in LDL-cholesterol above 100 mg / dl is noted when eating foods rich in animal fats and cholesterol. Malnutrition, smoking and hypertension are synergistic factors that increase the risk of coronary heart disease. The combination of one of these factors with any other for about 10 years accelerates the development of a critical degree of coronary atherosclerosis. Reducing the concentration of total cholesterol in the blood and increasing HDL-cholesterol reduces the rate of progression of atherosclerosis. Reducing the concentration of total cholesterol in the blood by 10% leads to a reduction in mortality from heart disease by 20%. An increase in HDL-CI concentration of 1 mg / dl (0.03 mmol / L) reduces the risk of coronary pathology by 2-3% in men and women. In addition, regardless of the content of total cholesterol in the blood (including more than 5.2 mmol / l), the inverse relationship between the content of HDL-C and the frequency of cardiac pathology remains. Concentrations of HDL-C (less than 1.3 mmol / l) and triglycerides in the blood are independent prognostic indicators of the probability of death from coronary heart disease. Therefore, the content of HDL-XC should be considered a more accurate prognostic indicator for mortality from coronary artery disease than the concentration of total cholesterol.
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