Effect of Lipoprotein(a) on the Diagnosis of Familial Hypercholesterolemia: Does it Make a Difference in the Clinic?

A new interesting article has been published in Clin Chem. 2019 Jul 15. pii: clinchem.2019.306738. doi: 10.1373/clinchem.2019.306738. and titled:

Effect of Lipoprotein(a) on the Diagnosis of Familial Hypercholesterolemia: Does it Make a Difference in the Clinic?

Authors of this article are:

Chan DC, Pang J, Hooper AJ, Bell DA, Burnett JR, Watts GF.

A summary of the article is shown below:

BACKGROUND: Diagnostic tools for familial hypercholesterolemia (FH) rely on estimation of LDL cholesterol concentration. However, routine measurement or calculation of LDL cholesterol concentration using the Friedewald equation contains a cholesterol contribution from lipoprotein(a) [Lp(a)]. We investigated whether Lp(a) influences the phenotypic diagnosis of FH by commonly used clinical criteria.METHODS: A cohort of 907 adult index patients attending a clinic were studied. The Dutch Lipid Clinic Network (DLCN) and Simon Broome (SB) diagnostic criteria were estimated before and after adjusting LDL cholesterol concentration for the cholesterol content (30%) of Lp(a). Diagnostic reclassification rates and area under the ROC (AUROC) curves in predicting an FH mutation were also compared.RESULTS: Seventy-four patients defined by DLCN criteria (8.2%) and 207 patients defined by SB criteria (22.8%) were reclassified to “unlikely” FH after adjusting LDL cholesterol for Lp(a) cholesterol. The proportion of FH patients defined by DLCN (probable/definite) and SB (possible/definite) criteria decreased significantly in patients with increased Lp(a) (>0.5 g/L; n = 330) after Lp(a) cholesterol adjustment (P < 0.01). The overall reclassification rate was significantly higher in patients with Lp(a) concentration >1.0g/L (P < 0.001). The AUROC curve for LDL cholesterol concentration ≥191 mg/dL (≥5.0mmo/L), DLCN criteria, and SB criteria in predicting an FH mutation increased significantly after adjustment (P < 0.001). There was no significant difference in AUROC curve before and after Lp(a) cholesterol adjustment at an LDL cholesterol concentration ≥251 mg/dL (≥6.5 mmol/L).CONCLUSIONS: Adjusting LDL cholesterol concentration for Lp(a) cholesterol improves the diagnostic accuracy of DLCN and SB criteria, especially with Lp(a) >1.0g/L and LDL cholesterol <251 mg/dL (<6.5mmol/L). Lp(a) should be measured in all patients suspected of having FH.© 2019 American Association for Clinical Chemistry.
Check out the article’s website on Pubmed for more information:

This article is a good source of information and a good way to become familiar with topics such as: n/a.

New Chemicals from MOLECULAR DEPOT

New Proteins from MOLECULAR DEPOT

New Antibodies from MOLECULAR DEPOT

New Research Kits from MOLECULAR DEPOT

Molecular Depot

Your specialty peptide, proteins, antibodies and chemical compounds store.