Lp(a) ranges from under 0.1 to over 100 mg/mL between individuals, and is higher in women, a review of its evolutionary origins and genetic determinants (Curr Med Chem 2017)

Original title: Lipoprotein (a) Evolution: Possible Benefits and Harm. Genetic and Non-Genetic Factors Influencing its Plasma Levels

Curr Med Chem · 1 January 2017 · 6

Kostakou PM, Hatzigeorgiou G, Kolovou V, Mavrogeni S, Kolovou GD

This review by Kostakou, Hatzigeorgiou, Kolovou, Mavrogeni and Kolovou examines the possible evolutionary origins and physiological role of Lp(a), a lipoprotein found only in humans, Old World primates, and the European hedgehog. Plasma Lp(a) varies widely between individuals, from under 0.1 to over 100 mg/mL, and is highly genetically determined, primarily by the LPA gene, with substantial variation by race. Lp(a) appears protective after injury, binding macrophage and platelet receptors to promote fibrin activation and wound healing, but is also implicated in atheromatous plaque formation, cerebrovascular events and aortic valve stenosis. Women tend to have higher Lp(a) than men, while type 2 diabetes tends to lower it, and nutrition, hormones and various drugs can also influence circulating Lp(a) levels.

Original abstract

The limited distribution of lipoprotein (a) (Lp(a)) to humans, Old World primates and to the European hedgehog, has raised considerable interest and speculation regarding its possible physiological role. Lp(a) has variable circulating concentrations (<0.1 - >100 mg/ml) which are highly genetically determined in humans. These characteristics gave rise to several theories concerning the origins and evolution of Lp(a). Lp(a) has a protective role after injury since Lp(a) particles bind to macrophages and platelets membrane receptors, leading to fibrin activation and injury healing. On the other hand, Lp(a) seems to be implicated in the formation of atheromatic plaques but also in cerebrovascular events and stenosis of the aortic valve. The main genetic factor determining plasma Lp(a) levels is the Lp(a) gene (LPA). Most Caucasian people have normal plasma Lp(a) concentrations, but there is important distribution variation according to race. Women seem to have increased Lp(a) levels compared with men, while diabetes mellitus type 2 favours lower plasma Lp(a) levels. Nutrition, hormones and several drugs may also influence circulating Lp(a) levels.

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