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Variability of lipoprotein(a) and its correlation with lipid profile fluctuations
Session:
Sessão de Posters 07 - Lípidos para além do LDL: a nova fronteira do risco
Speaker:
Marta Catarina Almeida
Congress:
CPC 2026
Topic:
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Theme:
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Subtheme:
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Session Type:
Posters Eletrónicos
FP Number:
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Authors:
Carolina Marques Neves; Marta Catarina Almeida; André Lobo; Eduardo Vilela; Ricardo Fontes-Carvalho
Abstract
<p style="margin-left:47px; text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong>Background: </strong>Plasma lipoproteina(a) [Lp(a)] concentrations are considered to be largely unaffected by traditional lipid parameters, including LDL cholesterol, HDL cholesterol, or triglycerides. Despite limited known correlation with conventional lipid profile, Lp(a) variability has been recently enhanced and evidence in factors related to that variability is still scarce.</span></span></p> <p style="margin-left:47px; text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong>Purpose: </strong>The aim of this study was to analyze Lp(a) levels variability and lipid profile changes.</span></span></p> <p style="margin-left:47px; text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong>Methods: </strong>A retrospective single center analysis of patients with more than one measurement of Lp(a) levels was conducted. Anti-dyslipidemia treatment was registered and patients receiving PCSK9 inhibitor therapy at the time of either Lp(a) measurement were excluded. Context of measurement, time intervals and Lp(a) levels and lipid profile were collected. Statistical analysis was done using Chi-square, Spearman and Mann-Whitney tests.</span></span></p> <p style="margin-left:47px; text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong>Results:</strong> This study included 221 participants. At first analysis, most of the patients were under anti-dyslipidemia treatment: 67.0% (n = 148) with statins, 17.6% (n = 39) on ezetimibe and 5.0% (n = 11) with fibrates. Lipid profile showed median HDL levels of 44 [19] mg/dL, total cholesterol of 145 [56] mg/dL, triglycerides of 102 [59] mg/dL, and LDL levels of 77 [50] mg/dL. Lp(a) had a median of 52.10 [141.50] nmol/L in the first analysis. The time interval between measurements was 107 [286] days. Anti-dyslipidemia treatment was changed between the two analyses in 68 (30.8%) patients. HDL showed an absolute variation of 5 [8] mg/dL, total cholesterol of 22 [26] mg/dL, triglycerides of 25 [39] mg/dL and LDL levels of 18 [27] mg/dL. The absolute variation in Lp(a) was 11.40 [36.95] nmol/L. Statistically significant correlations were observed between absolute Lp(a) variation and changes in HDL (p < 0.001) and total cholesterol (p = 0.013). No significant correlations were found with triglycerides (p = 0.151) or LDL variation (p = 0.062). Variation in total cholesterol (p < 0.001), LDL (p < 0.001) and triglycerides (p = 0.004) was higher in patients who changed anti-dyslipidemia treatment, as expected. A trend for higher Lp(a) variation in patients who change anti-dyslipidemia treatment was verified (16.80 [47] <em>versus</em> 9.35 [30] in patient who did not change), as exposed on Graph 1, but not statistically significant (p = 0.052), nor was variation in HDL (p = 0.512).</span></span></p> <p style="margin-left:47px; text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong>Conclusion: </strong>Lp(a) levels demonstrated measurable intra-individual variability over time, yet this variation showed only correlations with changes in HDL and total cholesterol and a non-significant trend toward higher Lp(a) variation with modifications in anti-dyslipidemia therapy. These findings challenge the traditional view of Lp(a) as a largely static and lipid-independent biomarker, suggesting that its variability may parallel specific lipid metabolism or treatment changes that deserve further research.</span></span></p>
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