Question: What is a "normal" reading for a lipoprotein (a) test? Also, how easy is the test to administer, and is it expensive when compared to the standard lipid profile tests?
Dr. Hibberd's Answer:
Make life simple for yourself. Forget about lipoprotein (a) — Lp-(a). Concentrate on reducing LDL to less than 130 and ideally to 100, or even to 80, if possible. LP-(a) is more expensive, is done on a 12-14 hour fasting blood specimen, and isn't truly useful for most patients. Save your hard earned money!
If you must know, here is your answer:
Lp-(a) is composed of LDL particles that contain apolipoprotein-(a) (apo-a) linked to apo-(b). It is believed that apo-(a) increases the risk of forming clots, and it is evident that CHD (coronary heart disease) risk is increased as apo-(a) concentration increases.
It used to be felt that high Lp-(a) might increase risk of CHD (this is not proven except in the top 25 percent), and that this risk appeared not to be continuous (also unproven), but review revealed this increased only at high concentrations and then only when the LDL-C (LDL cholesterol calculated) was elevated. When adjusted for apo-(a) levels, no association with Lp-(a) levels and CHD were proven, though very high Lp-(a) levels above the 75th percentile are associated with increased angina risk.
Lp(a) concentrations vary from 0.1 to more than 180 nmol/L, and fourfold risks are seen at levels over 158 nMol/L. Normal levels vary by race and ethnicity, and levels become really important only when LDL is elevated.
So why bother with measuring your Lp-(a)? It has no clinical significance to most patients, and the LDL guide is simple and easy to follow.
Keep it simple! Complicated cholesterol-management regimens are unproven and a waste of your money. Conventional lipid panels are far less costly and possibly more useful than the esoteric, expensive, and complicated lipid tests some have promoted in the past.
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