TY - JOUR
T1 - High lipoprotein(a) may explain one quarter of clinical familial hypercholesterolemia diagnoses in Danish lipid clinics
AU - Hedegaard, Berit Storgaard
AU - Nordestgaard, Børge Grønne
AU - Kanstrup, Helle Lynge
AU - Thomsen, Kristian Korsgaard
AU - Bech, Jan
AU - Bang, Lia Evi
AU - Henriksen, Finn Lund
AU - Andersen, Lars Juel
AU - Gohr, Thomas
AU - Larsen, Linnea Hornbech
AU - Soja, Anne Merete Boas
AU - Elpert, Frank-Peter
AU - Jakobsen, Tomas Joen
AU - Sjøl, Anette
AU - Joensen, Albert Marni
AU - Klausen, Ib Christian
AU - Schmidt, Erik Berg
AU - Bork, Christian Sørensen
N1 - © 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.
PY - 2024/3
Y1 - 2024/3
N2 - CONTEXT: 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).OBJECTIVE: We investigated plasma lipoprotein(a) in individuals referred to Danish lipid clinics and evaluated the effect of plasma lipoprotein(a) on a diagnosis of FH.METHODS: Individuals referred to 15 Danish lipid clinics who were suspected of having FH according to nationwide referral criteria were recruited between September 1, 2020 and November 30, 2021. All individuals were classified according to the Dutch Lipid Clinical 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: We included a total of 1166 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) greater than or equal to 50 mg/dL (105 nmol/L), while 2% had levels greater than or equal to 180 mg/dL (389 nmol/L). We found that in 27% (55/206) of those fulfilling a clinical diagnosis of FH, this was partly due to high lipoprotein(a).CONCLUSION: Elevated lipoprotein(a) was common in individuals referred to Danish lipid clinics and in one-quarter of individuals who fulfilled a clinical diagnosis of FH, this was 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.
AB - CONTEXT: 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).OBJECTIVE: We investigated plasma lipoprotein(a) in individuals referred to Danish lipid clinics and evaluated the effect of plasma lipoprotein(a) on a diagnosis of FH.METHODS: Individuals referred to 15 Danish lipid clinics who were suspected of having FH according to nationwide referral criteria were recruited between September 1, 2020 and November 30, 2021. All individuals were classified according to the Dutch Lipid Clinical 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: We included a total of 1166 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) greater than or equal to 50 mg/dL (105 nmol/L), while 2% had levels greater than or equal to 180 mg/dL (389 nmol/L). We found that in 27% (55/206) of those fulfilling a clinical diagnosis of FH, this was partly due to high lipoprotein(a).CONCLUSION: Elevated lipoprotein(a) was common in individuals referred to Danish lipid clinics and in one-quarter of individuals who fulfilled a clinical diagnosis of FH, this was 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.
KW - Cholesterol, LDL
KW - Denmark/epidemiology
KW - Heart Disease Risk Factors
KW - Humans
KW - Hyperlipoproteinemia Type II/diagnosis
KW - Lipoprotein(a)
KW - familial hypercholesterolemia
KW - lipid clinic
KW - Dutch Lipid Clinical Network score
KW - lipoprotein(a)
UR - http://www.scopus.com/inward/record.url?scp=85185614681&partnerID=8YFLogxK
U2 - 10.1210/clinem/dgad625
DO - 10.1210/clinem/dgad625
M3 - Journal article
C2 - 37862146
SN - 0021-972X
VL - 109
SP - 659
EP - 667
JO - The Journal of clinical endocrinology and metabolism
JF - The Journal of clinical endocrinology and metabolism
IS - 3
M1 - dgad625
ER -