Mariam Alaoui, Corinne Merle, Roselyne Garnotel, Damien Jolly, Vincent Durlach, Philippe Gillery
Study of Apo(a) Length Polymorphism and Lipoprotein(a) Concentrations in Subjects with Single or Double Apo(a) Isoforms
Cardiovascular risk is associated with high lipoprotein(
a) (Lp(a)) concentrations and low molecular
weight apolipoprotein(a) (apo(a)) isoforms. We studied
the relationship between these two biological parameters,
particularly in subjects expressing two
apo(a) isoforms. Plasma Lp(a) was measured by immunonephelometry
in 530 unrelated Caucasian patients
at high cardiovascular risk, and apo(a) size determined
by immunoblotting using a recombinant
standard. Two, one, or no apo(a) isoforms were detected
in 258, 270, and 2 subjects, respectively. Lp(a)
concentrations showed a non-Gaussian distribution,
being higher in the ‘double band’ than in the ‘single
band’ group (median 0.42 vs. 0.11 g/l, p < 0.0005).
Apo(a) size distribution was bimodal, with two frequency
peaks at 18 kringles (K) and 27 K. Small size
apo(a) isoforms were more frequently found in the
‘double band’ group, where major isoforms were of
lower size than minor isoforms (median 20 vs. 27 K).
Regression analysis showed that apo(a) gene length
accounted for 33% of Lp(a) variation, with a threshold
effect at 20 K, no correlation being found over this
value. The minor apo(a) isoform did not significantly
influence Lp(a) concentration. These data confirm the
relationship between apo(a) size and Lp(a) concentration
and suggest that the assessment of cardiovascular
risk should take into account the threshold effect at
20 K and the absence of influence of the minor apo(a)
isoform.
Clinical Chemical Laboratory Medicine, Walter de Gruyter
Print ISSN: 1434-6621
Volume: 41, 05/2003
Pages: 634 - 639
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