Lipoprotein(a) [Lp(a)] is a genetically determined cardiovascular risk factor. Additionally, Lp(a) levels are affected by dietary saturated fat (SFA) reduction. We previously reported an Lp(a) increas Show more
Lipoprotein(a) [Lp(a)] is a genetically determined cardiovascular risk factor. Additionally, Lp(a) levels are affected by dietary saturated fat (SFA) reduction. We previously reported an Lp(a) increase in response to SFA reduction in both white and black cohorts. However, less is known whether diets impact Lp(a)'s oxidized phospholipids (OxPL) and lipid components. We assessed responses of Lp(a)-OxPL concentration, Lp(a)-OxPL subspecies abundance, and the Lp(a)-lipidome to SFA reduction [from 16% energy with the average American diet (AAD) to 6% energy with a DASH-type diet] in 166 African-Americans. Responses by variability in Lp(a) levels and apolipoprotein(a) [apo(a)] sizes were tested. Mean age was 35 years; 70% were women; mean BMI was 28 kg/m Show less
Lipoprotein(a) (Lp[a]) was discovered more than six decades ago. Since then, it has evolved from a subject of curious experiments performed by a few scientists to an extensively explored therapeutic t Show more
Lipoprotein(a) (Lp[a]) was discovered more than six decades ago. Since then, it has evolved from a subject of curious experiments performed by a few scientists to an extensively explored therapeutic target for prevention and management of cardiovascular disease (CVD). This has prompted an intense search for therapies and agents with potent Lp(a)-specific lowering effects on the horizon. Some of these agents are already in clinical trials to clarify whether lowering high Lp(a) levels would result in reductions in CVD events. The road to this point has been filled with many challenges, where landmark genetic discoveries opened new avenues and set the stage for interventions. Although there is no doubt that genetics play a key role in determining Lp(a) level, accumulating evidence also supports a role for some clinical conditions in influencing Lp(a) levels. CKD is a prevalent condition associated with elevated Lp(a) levels. Most available data show that elevated Lp(a) levels predict CVD risk in patients with CKD. Given the growing evidence for a relationship between Lp(a), CVD, and CKD as well as ongoing cardiovascular outcomes trials of Lp(a)-specific agents, we provide an overview of recent evidence on this topic. We focus on recent studies in patients with CKD on treatment modalities affecting Lp(a) level as well as on existing gaps in knowledge and future research directions related to clinical care and CVD risk reduction in patients with CKD. Show less