High lipoprotein(a) may explain one quarter of clinical familial hypercholesterolemia diagnoses in Danish lipid clinics.

Dutch Lipid Clinical Network Score Familial hypercholesterolemia Lipid Clinic Lipoprotein(a)

Journal

The Journal of clinical endocrinology and metabolism
ISSN: 1945-7197
Titre abrégé: J Clin Endocrinol Metab
Pays: United States
ID NLM: 0375362

Informations de publication

Date de publication:
20 Oct 2023
Historique:
received: 09 06 2023
revised: 13 10 2023
accepted: 17 10 2023
medline: 20 10 2023
pubmed: 20 10 2023
entrez: 20 10 2023
Statut: aheadofprint

Résumé

Cholesterol carried in lipoprotein(a) adds to measured low-density lipoprotein cholesterol (LDL-C) and may therefore drive some diagnoses of clinical familial hypercholesterolemia (FH). We investigated plasma lipoprotein(a) in subjects referred to Danish lipid clinics and evaluated the impact of plasma lipoprotein(a) for a diagnosis of FH. Individuals referred to 15 Danish lipid clinics suspected of FH according to nationwide referral criteria were recruited between September 1st 2020 and November 30th 2021. All individuals were classified according to the Dutch Lipid Network criteria for FH before and after LDL-C was adjusted for 30% cholesterol content in lipoprotein(a). We calculated the fraction of individuals fulfilling a clinical diagnosis of FH partly due to elevated lipoprotein(a). We included a total of 1,166 individuals for analysis, of whom 206 fulfilled a clinical diagnosis of FH. Median lipoprotein(a) was 15 mg/dL (29 nmol/L) in those referred and 28% had lipoprotein(a) ≥50 mg/dL (105 nmol/L), while 2% had levels ≥180 mg/dL (389 nmol/L). We found that 27% (55/206) of those fulfilling a clinical diagnosis of FH was partly due to high lipoprotein(a). Elevated lipoprotein(a) was common in individuals referred to Danish lipid clinics and one quarter of individuals who fulfilled a clinical diagnosis of FH were partly due to elevated lipoprotein(a). These findings support the notion that the LPA gene should be considered an important causative gene in patients with clinical FH and further support the importance of measuring lipoprotein(a) when diagnosing FH as well as for stratification of cardiovascular risk.

Sections du résumé

BACKGROUND BACKGROUND
Cholesterol carried in lipoprotein(a) adds to measured low-density lipoprotein cholesterol (LDL-C) and may therefore drive some diagnoses of clinical familial hypercholesterolemia (FH). We investigated plasma lipoprotein(a) in subjects referred to Danish lipid clinics and evaluated the impact of plasma lipoprotein(a) for a diagnosis of FH.
METHODS METHODS
Individuals referred to 15 Danish lipid clinics suspected of FH according to nationwide referral criteria were recruited between September 1st 2020 and November 30th 2021. All individuals were classified according to the Dutch Lipid Network criteria for FH before and after LDL-C was adjusted for 30% cholesterol content in lipoprotein(a). We calculated the fraction of individuals fulfilling a clinical diagnosis of FH partly due to elevated lipoprotein(a).
RESULTS RESULTS
We included a total of 1,166 individuals for analysis, of whom 206 fulfilled a clinical diagnosis of FH. Median lipoprotein(a) was 15 mg/dL (29 nmol/L) in those referred and 28% had lipoprotein(a) ≥50 mg/dL (105 nmol/L), while 2% had levels ≥180 mg/dL (389 nmol/L). We found that 27% (55/206) of those fulfilling a clinical diagnosis of FH was partly due to high lipoprotein(a).
CONCLUSIONS CONCLUSIONS
Elevated lipoprotein(a) was common in individuals referred to Danish lipid clinics and one quarter of individuals who fulfilled a clinical diagnosis of FH were partly due to elevated lipoprotein(a). These findings support the notion that the LPA gene should be considered an important causative gene in patients with clinical FH and further support the importance of measuring lipoprotein(a) when diagnosing FH as well as for stratification of cardiovascular risk.

Identifiants

pubmed: 37862146
pii: 7325785
doi: 10.1210/clinem/dgad625
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© The Author(s) 2023. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Auteurs

Berit Storgaard Hedegaard (BS)

The Danish FH Study Group.
Department of Cardiology, Regional Hospital Central Jutland, Viborg, Denmark.
Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
Department of Clinical Biochemistry, Copenhagen University Hospital, Herlev-Gentofte, Copenhagen, Denmark.

Børge Grønne Nordestgaard (BG)

The Danish FH Study Group.
Department of Clinical Biochemistry, Copenhagen University Hospital, Herlev-Gentofte, Copenhagen, Denmark.
Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
The Copenhagen General Population Study, Copenhagen University Hospital, Herlev-Gentofte, Copenhagen, Denmark.

Helle Lynge Kanstrup (HL)

The Danish FH Study Group.
Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.

Kristian Korsgaard Thomsen (KK)

The Danish FH Study Group.
Department of Cardiology, Hospital South West Jutland, University Hospital of Southern Denmark, Esbjerg, Denmark.

Jan Bech (J)

The Danish FH Study Group.
Department of Cardiology, Bispebjerg-Frederiksberg University Hospital, Copenhagen Denmark.

Lia Evi Bang (LE)

The Danish FH Study Group.
The Heart Center, Department of Cardiology, Copenhagen University Hospital Rigshospitalet Copenhagen, Denmark.

Finn Lund Henriksen (FL)

The Danish FH Study Group.
Department of Cardiology, Odense University Hospital, Odense, Denmark.

Lars Juel Andersen (LJ)

The Danish FH Study Group.
Department of Cardiology, Zealand University Hospital, Roskilde, Denmark.

Thomas Gohr (T)

The Danish FH Study Group.
Department of Cardiology, Lillebælt Hospital, Kolding, Denmark.

Linnea Hornbech Larsen (LH)

The Danish FH Study Group.
Department of Cardiology, Copenhagen University Hospital, Herlev-Gentofte, Copenhagen, Denmark.

Anne Merete Boas Soja (AMB)

The Danish FH Study Group.
Department of Internal Medicine, Section of Cardiology, Holbæk Hospital, Holbæk, Denmark.

Frank-Peter Elpert (FP)

The Danish FH Study Group.
Department of Cardiology, Hospital of Southern Jutland, Aabenraa, Denmark.

Tomas Joen Jakobsen (TJ)

The Danish FH Study Group.
Department of Cardiology, North Zealand Hospital, Frederikssund, Denmark.

Anette Sjøl (A)

The Danish FH Study Group.
Department of Cardiology, Amager-Hvidovre Hospital, Denmark.

Albert Marni Joensen (AM)

The Danish FH Study Group.
Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
Department of Cardiology, North Denmark Regional Hospital, Hjørring, Denmark.

Ib Christian Klausen (IC)

The Danish FH Study Group.
Department of Cardiology, Regional Hospital Central Jutland, Viborg, Denmark.

Erik Berg Schmidt (EB)

The Danish FH Study Group.
Department of Cardiology, Regional Hospital Central Jutland, Viborg, Denmark.
Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.

Christian Sørensen Bork (CS)

The Danish FH Study Group.
Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark.

Classifications MeSH