Lp (a) - Lipoprotein(a)

Clinical definition of the Lp (a) the test
Lp (a) or Lipoprotein (a) are molecules made of proteins and fat. They carry cholesterol and similar substances through the blood. They are made in the liver and are genetic variation of LDL (bad) cholesterol. They are very similar to LDL, or “bad” cholesterol, except that the LDL cholesterol molecule has an apolipoprotein (A) molecule attached to it. Lp (a) may interact with substances found in the artery walls and contribute to the buildup of fatty deposits. It has been identified through some research studies, as a risk factor for atherosclerotic diseases such as coronary heart disease (CHD), cerebrovascular disease (CVD), thrombosis, and stroke. However, the complete function of lipoprotein (a) is not fully known although it has been found that it is is genetically linked.

Why is the Lp (a) test done?
An Lp(a) test is done to measure the amount of lipoprotein-a in the blood. Since high levels of lipoproteins can increase the risk of heart disease, it is usually done to check the risk of atherosclerosis, stroke, and heart attack of the person. Currently, there is no medicine or drugs that to effectively lower the Lp (a). Large doses of vitamin C, L-lysine, and L-proline have been found to have a positive effect in reducing the amount of Lp(a) in the blood and help to keep the blood vessels healthy and plaque free over periods of time.

What are the common signs/symptoms when the Lp (a) test is done?

  • Hypertension 
  • Shortness of breath
  • Headaches
  • Pain, fullness, and/or squeezing sensation of the chest
  • Jaw pain, toothache, headache
  • Nausea, vomiting, and/or general epigastric (upper middle abdomen) discomfort
  • Sweating
  • Heartburn and/or indigestion
  • Arm pain (more commonly the left arm, but may be either arm)
  • Upper back pain
  • General malaise (vague feeling of illness)

Who should do the Lp (a) test? (Target population)?
It may be ordered more frequently for those who have may have risk factors for heart disease such as:

  • People who may have a heart disease but the lipid profile shows normal or only mildly elevated levels of cholesterol and/or LDL
  • Age (men 45 years or older or women 55 years or older)
  • Overweight or obese people
  • Smokers
  • Heavy drinkers
  • People with a family history of heart disease or health problems such as diabetes, high blood pressure (hypertension),
  • People who consume excess of saturated fats - found mostly in animal products and trans-fatty acids -found in fast foods and commercially processed food products.
  • Pre-existing heart disease or those who have already had a heart attack

What should I do before the Lp (a) test?

Specimen type

Specimen collection procedure

Preparatory instructions during specimen collection*

Serum

(Blood Sample)

Venipuncture

(Collection of blood from a vein, usually from the arm)

Fasting Required.

Fasting samples have to be collected after a minimum 12-14 hour overnight fasting status.

Clear fluids like water is allowed during this period. Refrain from consumption of early morning beverages like tea, coffee and milk until specimen collection is completed.

In case of diabetics on oral or injectable hypoglycemic agents, consult your physician about continuing with these medications prior to specimen collection.

*Subjects suffering from any illness or on oral or injectable medications are advised to consult their physician prior to requesting any tests or procedures.

How do I interpret my Lp (a) test results?

Reference

Interval

< 14 mg/dL

Desirable

14 - 30 mg/dL

Borderline risk

31 - 50 mg/dL

High risk:

> 50 mg/dL

Very high risk

Inference: Higher than normal values of Lp (a) are associated with a high risk for atherosclerosis, stroke, and heart attack.
‘*A Reference range is a set of values which helps the healthcare professional to interpret a medical test. It may vary with age, gender, and other factors. Reference ranges may also vary between labs, in value & units depending on instruments used and method of establishment of reference ranges’

Diseases/conditions related to the Lp (a) test

  • Atherosclerotic heart disease
  • Familial hyperlipoproteinemia
  • Malabsorption
  • Malnutrition
  • Familial combined hyperlipidemia
  • Familial dysbetalipoproteinemia
  • Familial hypertriglyceridemia

Other tests related to the Lp (a) test

  • Lipid Profile
  • Homocysteine
  • hs-CRP
  • Apolipoprotein A-1
  • Apolipoprotein B

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Lipoprotein(a) Lp(a)

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