Relationship between apolipoprotein(a) size plymorphism and coronary heart disease in overweight subjects

Enzo Emanuele, Emmanouil Peros, Piercarlo Minoretti, Colomba Falcone, Angela D'Angelo, Lorenza Montagna, Diego Geroldi

Research output: Contribution to journalArticlepeer-review


Background: Overweight is associated with an increased cardiovascular risk which is only partially explained by conventional risk factors. The objective of this study was to evaluate lipoprotein(a) [Lp(a)] plasma levels and apolipoprotein(a) [apo(a)] phenotypes in relation to coronary heart disease (CHD) in overweight subjects. Methods: A total of 275 overweight (BMI ≥ 27 kg/m2) subjects, of which 155 had experienced a CHD event, 337 normal weight subjects with prior CHD and 103 CHD-free normal weight subjects were enrolled in the study. Lp(a) levels were determined by an ELISA technique and apo(a) isoforms were detected by a high-resolution immunoblotting method. Results: Lp(a) levels were similar in the three study groups. Overweight subjects with CHD had Lp(a) concentrations significantly higher than those without [median (interquartile range): 20 (5-50.3) versus 12.6 (2.6-38.6) mg/dl, P <0.05]. Furthermore, overweight subjects with CHD showed a higher prevalence of low molecular weight apo(a) isoforms than those without (55.5% versus 40.8%, P <0.05) and with respect to the control group (55.5% versus 39.8%, P <0.05). Stepwise regression analysis showed that apo(a) phenotypes, but not Lp(a) levels, entered the model as significant independent predictors of CHD in overweight subjects. Conclusions: Our data indicate that small-sized apo(a) isoforms are associated with CHD in overweight subjects. The characterization of apo(a) phenotypes might serve as a reliable biomarker to better assess the overall CHD risk of each subject with elevated BMI, leading to more intensive treatment of modifiable cardiovascular risk factors.

Original languageEnglish
Article number12
JournalBMC Cardiovascular Disorders
Publication statusPublished - Dec 12 2003


  • Apolipoprotein(a) isoforms
  • Coronary heart disease
  • Genetic markers
  • Lipoprotein(a) concentration
  • Overweight

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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