May 26, 2018

I have high LP(a) and you may too

What Is Lp(a)?

Lipoproteins are the particles that transport cholesterol and triglycerides in the blood stream.

Lipoproteins are composed of proteins (apolipoproteins), phospholipids, triglycerides and cholesterol.

The lipoproteins vary in the major lipoprotein present and the relative contents of the different lipid components.

Lp(a) is a lipoprotein rich in cholesterol. It differs from LDL?as it contains an additional protein, apolipoprotein (a). Similar to LDL, a Lp(a) particle also contains one molecule of apolipoprotein B.

What Is the Normal Range For Blood?Levels of Lp(a)?

It as assumed that Lp(a) is produced by liver cells. However, the pathways for the clearance of this substance are not clearly understood.

Plasma levels of Lp(a) rise shortly after birth and the levels appear to become consistent within a few months.

In adults, plasma levels of Lp(a) vary widely, ranging from 0.2 ? 250 mg/dL. The levels are similar in men and women.

Studies indicate?that about one in five individuals have plasma levels above 50 mg/dL (80th percentile), and about one in four have plasma levels above 32 mg/dL (75th percentile). Lp(a) levels less than 30 mg/dL are considered normal.

Here?s how Lp(a) lelevls are looked at in terms of risk:

Desirable: < 14 mg/dL (< 35 nmol/l)
Borderline risk: 14 ? 30 mg/dL (35 ? 75 nmol/l)
High risk: 31 ? 50 mg/dL (75 ? 125 nmol/l)
Very high risk: > 50 mg/dL (> 125 nmol/l)

My Lp(a) is 192 nmol/liter!!

About 20% or?one in five people have high levels of Lp(a) greater than 50mg/dL?from birth based on genetic factors they inherited from their parents, and most don?t know they have it. As high levels of Lp(a) travel through the bloodstream, it collects in the arteries, leading to gradual narrowing of the artery that can limit blood supply to the heart, brain, and kidneys as well as the legs. It can increase the risk of blood clots, heart attack or stroke.

What’s my risk?

Uncontrollable Risks

Family History of Premature Heart Disease/Heart Attack; Men <40 years of age, Women <50 years of age.??No

Family History of High Blood Pressure, Diabetes, Stroke or Kidney Disease.?No

Lipoprotein(a) [Lp(a)] >30 mg/dL or 75 nmols/L??Yes – 192 nmol/l (very high risk)

Age???50 males;???60 female?Yes

?Controllable Risks

High Blood Pressure >130/90 mm Hg?No

Total Cholesterol >200 mg/dL?Yes – 269 (high risk)

LDL-C (Low Density Lipoprotein Cholesterol) > 100 mg/dL?Yes – 165 (high risk)

Cholesterol/HDL-C ratio? > 3.5? No – 3.3 (optimum)

HDL-C (High Density Lipoprotein Cholesterol) <40 (male)/50 (female)?mg/dL??No-81 (optimum)

TG (Triglycerides) > 150 mg/dL??No – 111 (optimum)

NON-HDL-C >130 mg/dL?Yes – 188 (moderate risk)

LDL-P >1000 nmols/L?Yes – 1343 (moderate risk)

Apolipoprotein B >80mg/dL?Yes – 111 (moderate risk)

Fasting Blood Glucose >100 mg/dL??No (guessing)

Smoking (including secondhand)??No

BMI (Body Mass Index) >28 Kg/m2?No

Waist Circumference >35″ Women; 40″ Men?No

Less than 30 Minutes Physical Activity Daily?No

Who has high Lp (a)?

This guy. The one who just backpacked 10 miles into the Grand Canyon with his daughter to make some memories.

The guy who carried a 50 pound pack on his back and didn’t have a heart attack. But he seems to be at risk.

Better to know than not I guess. Stay tuned.

What’s my plan?

I am going to get more information to understand my risk better. Specifically,

  • I am going to test for inflammation since this what drives all the bad things to happen. If you have inflammation, then you’re more likely to have arterial wall damage and sites for the plaque buildup to initiate.
  • I am going to get a coronary calcium scan. This is a direct measurement of the amount of plaque in my coronary arteries and then I’ll know how worried I should be.
  • Reduce total cholesterol and LDL-C. Need a plan for this. This will be tweaks to my diet primarily.
  • I am going to start some dietary interventions like adding niacin supplementation and perhaps L-carnitine and a few others I have read might be beneficial. This will be a continuous learning process.
  • I will test my lipid panel quarterly and report results.

About the author 

Mark Fickler

Mark aka The Old Spartan and Over-50 Fitness Savior is a 64 year old coffee guzzling father of five wandering the outdoors around Albuquerque, New Mexico. Mark helps Active Boomers get lean, healthy and strong so they live rewarding, fun lives using his signature 2 Rule Easy Fat Loss training program.

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