Genetics
Lp(a) was discovered in 1963 and its size heterogeneity explained decades later by Gerd Utermann, a historical appraisal (J Lipid Res 2017)
Original title: Lipoprotein (a): a historical appraisal
This historical review by Kostner and Kostner traces Lp(a) research from its detection in 1963 by Kare Berg, when Lp(a)-positive individuals were found more often among coronary heart disease patients than controls, through the discovery that Lp(a) is actually present in all individuals at greatly variable levels. Gerd Utermann later found that apo(a) is expressed by multiple alleles, explaining Lp(a) unique size heterogeneity and, along with numerous mutations, its wide variability in plasma concentration. The authors recall proposing a myocardial infarction risk cut-off of 30-50 mg/dL, still used in many epidemiological studies, and note renewed research interest in Lp(a) driven by new Lp(a)-lowering therapies, despite persistent gaps in understanding its function and metabolism.
Original abstract
Initially, lipoprotein (a) [Lp(a)] was believed to be a genetic variant of lipoprotein (Lp)-B. Because its lipid moiety is almost identical to LDL, Lp(a) has been deliberately considered to be highly atherogenic. Lp(a) was detected in 1963 by Kare Berg, and individuals who were positive for this factor were called Lpa+ Lpa+ individuals were found more frequently in patients with coronary heart disease than in controls. After the introduction of quantitative methods for monitoring of Lp(a), it became apparent that Lp(a), in fact, is present in all individuals, yet to a greatly variable extent. The genetics of Lp(a) had been a mystery for a long time until Gerd Utermann discovered that apo(a) is expressed by a variety of alleles, giving rise to a unique size heterogeneity. This size heterogeneity, as well as countless mutations, is responsible for the great variability in plasma Lp(a) concentrations. Initially, we proposed to evaluate the risk of myocardial infarction at a cut-off for Lp(a) of 30-50 mg/dl, a value that still is adopted in numerous epidemiological studies. Due to new therapies that lower Lp(a) levels, there is renewed interest and still rising research activity in Lp(a). Despite all these activities, numerous gaps exist in our knowledge, especially as far as the function and metabolism of this fascinating Lp are concerned.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.