High Lipoprotein(a) Concentrations Are Associated with Impaired Endothelial Function in Children
Jouni Lapinleimu, Olli T. Raitakari, Helena Lapinleimu,Katja Pahkala
DOI:
http://dx.doi.org/10.1016/j.jpeds.2014.12.051 Abstract
Objective
To examine the association between familial high lipoprotein(a), or Lp(a), concentrations and endothelial function in children participating in the Special Turku Coronary Risk Factor Intervention Project study.
Study design
Seven-month-old children (n=1062) with their families were randomized to a risk intervention group or to a control group. The intervention group received individualized dietary counseling to reduce the total cholesterol concentration. Children's Lp(a) and lipid values were measured repeatedly. At age 11years, children were recruited to an ultrasound study of the flow-mediated dilation (FMD) of the brachial artery. The association between relative peak FMD and Lp(a) concentration was examined in 198 control and 193 intervention group children by linear regression yses adjusted for sex, total cholesterol concentration, and basal artery diameter. The yses were made in both the control and intervention groups and in the familial risk children who had a parent with Lp(a) concentration greater than 250mg/l.
Results
Lp(a) concentrations were similar at age 11years in the intervention and control groups. In all control children, FMD (%) associated inversely with Lp(a) concentration: (β [%/1000mg/L]=−3.74, 95% CI [−6.43, −1.45];P=.007) and in 68 familial risk children (β=−4.92, 95% CI [−8.18, −1.66];P=.0037). In the intervention group the associations were lacking (P>.5), and FMD in the children with high Lp(a) concentrations (>500mg/L, n=12) had no attenuation (P=.027).
Conclusions
Familial high Lp(a) concentration is associated with attenuated endothelial function. This association may be mitigated by an early lifestyle intervention.
