High familial Lp(a) impairs blood vessel function in children, an effect blunted by early dietary intervention, the Finnish STRIP study at age 11 (J Pediatr 2015)

Original title: High lipoprotein(a) concentrations are associated with impaired endothelial function in children

J Pediatr · 4 February 2015 · 7

Lapinleimu J, Raitakari OT, Lapinleimu H, Pahkala K, Rönnemaa T, Simell OG, Viikari JS

This study examined the association between familial high Lp(a) and endothelial function in children from the Special Turku Coronary Risk Factor Intervention Project (STRIP), which randomised 1062 seven-month-old infants and their families to dietary counselling or a control group. At age 11, flow-mediated dilation (FMD) of the brachial artery was assessed in 198 control and 193 intervention children. In control children, FMD was inversely associated with Lp(a) (beta -3.74 per 1000 mg/L, 95% CI -6.43 to -1.45, P=.007), an association stronger in 68 children with familial risk, defined as a parent with Lp(a) above 250 mg/L (beta -4.92, 95% CI -8.18 to -1.66, P=.0037). In the intervention group, this association was absent (P>.5), including in the 12 children with Lp(a) above 500 mg/L. The findings show familial high Lp(a) is associated with impaired endothelial function in children, an effect that may be mitigated by early dietary lifestyle intervention.

Original abstract

Objective: To examine the association between familial high lipoprotein(a), or Lp(a), concentrations and endothelial function in children participating in the Special Turku Coronary Risk Factor Intervention Project study.

Study Design: Seven-month-old children (n = 1062) with their families were randomized to a risk intervention group or to a control group. The intervention group received individualized dietary counseling to reduce the total cholesterol concentration. Children's Lp(a) and lipid values were measured repeatedly. At age 11 years, children were recruited to an ultrasound study of the flow-mediated dilation (FMD) of the brachial artery. The association between relative peak FMD and Lp(a) concentration was examined in 198 control and 193 intervention group children by linear regression analyses adjusted for sex, total cholesterol concentration, and basal artery diameter. The analyses were made in both the control and intervention groups and in the familial risk children who had a parent with Lp(a) concentration greater than 250 mg/l.

Results: Lp(a) concentrations were similar at age 11 years in the intervention and control groups. In all control children, FMD (%) associated inversely with Lp(a) concentration: (β [%/1000 mg/L] = -3.74, 95% CI [-6.43, -1.45]; P = .007) and in 68 familial risk children (β = -4.92, 95% CI [-8.18, -1.66]; P = .0037). In the intervention group the associations were lacking (P > .5), and FMD in the children with high Lp(a) concentrations (>500 mg/L, n = 12) had no attenuation (P = .027).

Conclusions: Familial high Lp(a) concentration is associated with attenuated endothelial function. This association may be mitigated by an early lifestyle intervention.

Trial Registration: ClinicalTrials.gov: NCT00223600.

Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.