Lipoprotein(a)

Lipids marker

Lp(a)

Lipoprotein(a)

Category: Lipids
Unit: nmol/L

Genetically determined lipoprotein particle. Elevated levels are an independent risk factor for cardiovascular disease, aortic stenosis, and stroke. Levels are ~90% determined by genetics and largely unaffected by lifestyle.

PED Notes

Lp(a) is almost entirely genetic -- AAS, diet, and exercise have minimal effect on levels. However, it is a critical cardiovascular risk marker that every PED user should know once. If elevated (>75 nmol/L or >30 mg/dL), it compounds the already elevated cardiovascular risk from AAS-worsened lipids. Test once -- if normal, no need to retest as levels are stable throughout life.

Limited options (genetically determined):

  • Niacin -- 1-2g/day may reduce levels by 20-30% (limited clinical evidence)
  • PCSK9 inhibitors -- show promise but prescription-only

Key strategy: Focus on aggressively managing modifiable risk factors (LDL, ApoB, HDL, blood pressure) if Lp(a) is elevated

References:

  • AIM-HIGH Investigators, Boden, W. E., Probstfield, J. L., et al. (2011). Niacin in patients with low HDL cholesterol levels receiving intensive statin therapy. New England Journal of Medicine, 365(24), 2255-2267. DOI: 10.1056/NEJMoa1107579
  • Baggish, A. L., Weiner, R. B., Kanayama, G., et al. (2017). Cardiovascular toxicity of illicit anabolic-androgenic steroid use. Circulation, 135(21), 1991-2002. DOI: 10.1161/CIRCULATIONAHA.116.026945

History Chart

Reading History

Frequently Asked Questions

Reference Ranges

Standard Range

0 - 75 nmol/L

Statistics