Lipoprotein(a) Elevation (Hyperlipoproteinemia): Causes

Pathogenesis (disease development)

The level of serum lipoprotein (a) is genetically determined (see below).The structure of lipoprotein (a) is similar to that of cholesterol. Because plasminogen (a nonactive proenzyme in the fibrinolysis factor group) also has this property, lipoprotein (a) is suspected to exert atherosclerotic effects via enhancement of the action of plasminogen.

Etiology (Causes)

Biographic Causes

  • Genetic burden from parents, grandparents
    • Genetic risk depending on gene polymorphisms:
      • Genes/SNPs (single nucleotide polymorphism):
        • Genes: LPA (LPA gene).
        • SNP: rs10455872 in the LPA (lipoprotein (a)) gene.
          • Allele constellation: AG (1.51-fold risk of coronary heart disease, CHD).
          • Allele constellation: GG (2.57-fold risk of coronary heart disease, CHD).
        • SNP: rs3798220 in the LPA (lipoprotein (a)) gene.
          • Allele constellation: CT (2-3-fold risk of coronary artery disease, CAD).
          • Allele constellation: GG (2-3-fold risk for coronary heart disease, CHD).
        • Approximately 18% of Europeans are carriers of one of the two risk variants mentioned above.
  • Hormonal factors – menopause (menopause in women).

Behavioral causes

  • High intake of trans fatty acids (10-20 g/day; e.g., baked goods, chips, fast foods, prepared foods, fried foods such as French fries, breakfast cereals with added fat, snacks, confectionery, dry soups).

Disease-related causes that increase lipoprotein (a).

  • Acromegaly – endocrinological disorder caused by overproduction of growth hormone (somatotropic hormone (STH), somatotropin), with marked enlargement of the body end limbs or protruding parts of the body (acras), such as the hands, feet, lower jaw, chin, nose, and eyebrow ridges.
  • Inflammation, such as pneumonia (pneumonia) or colitis (inflammation of the intestines).
  • Hypothyroidism (underactive thyroid gland)
  • Nephrotic syndrome – collective term for symptoms that occur in various diseases of the glomerulus (renal corpuscles); symptoms include: Proteinuria (increased excretion of protein in the urine) with a protein loss of more than 1 g/m²/body surface per day; Hypoproteinemia, peripheral edema due to hypalbuminemia of < 2.5 g/dl in serum, hyperlipoproteinemia (lipid metabolism disorder).
  • Renal insufficiency (kidney weakness).

Disease-related causes that lower lipoprotein (a).

Drugs that increase lipoprotein (a).

  • Growth hormones

Drugs that lower lipoprotein (a)

  • Neomycin
  • Niacin
  • Estrogens (female sex hormones)

Surgeries that increase lipoprotein (a).

  • Orchidectomy (testicular removal).