Epidemiology
Lp(a) above 50 mg/dL raises carotid plaque risk by 30% in a Chinese population distribution study of 411,634 adults (Atherosclerosis 2023)
Original title: Lipoprotein(a) distribution and its association with carotid arteriopathy in the Chinese population
In a cross-sectional study of 411,634 Chinese adults from 22 health check-up centres, median Lp(a) was 10.60 mg/dL (right-skewed distribution), with 16.75% at or above 30 mg/dL and 7.10% at or above 50 mg/dL; levels were higher in women, in northern China, and with increasing age. Among 75,305 participants who also underwent carotid ultrasound at 7 centres, those with Lp(a) >=50 mg/dL had higher risk of carotid intima-media thickness >=1.0 mm (OR 1.138, 95% CI 1.071-1.208) and carotid plaque (OR 1.296, 95% CI 1.219-1.377) than those with lower Lp(a). This is the first large-scale characterisation of Lp(a) distribution in China, linking elevated Lp(a) to greater carotid atherosclerosis burden and future cardiovascular risk.
Original abstract
Background And Aims: The distribution of lipoprotein(a) [Lp(a)] has not been well-studied in a large population in China. The relationship between Lp(a) and carotid atherosclerosis remains undefined. In this study, we aimed to investigate the distribution of Lp(a) levels and to assess their association with carotid arteriopathy in China.
Methods: In this cross-sectional study, 411,634 adults with Lp(a) measurements from 22 health check-up centers were used to investigate Lp(a) distribution in China. Among participants with Lp(a) data, carotid ultrasound was performed routinely at seven health check-up centers covering 75,305 subjects. Carotid intima-media thickness (cIMT) and carotid plaque were used as surrogate biomarkers of carotid arteriopathy. The multivariate logistic regression model was applied to evaluate the association of increased Lp(a) levels with carotid arteriopathy.
Results: The distribution of Lp(a) concentrations was right-skewed, with a median concentration of 10.60 mg/dL. The proportions of Lp(a) levels ≥30 mg/dL and ≥50 mg/dL were 16.75% and 7.10%, respectively. The median Lp(a) level was higher in females individuals in northern China, and increased with age. Spearman's analysis revealed weak correlations between the Lp(a) concentration as a continuous variable and other lipid profiles. The multiple logistic regression analysis showed that participants with Lp(a) levels ≥50 mg/dL had an increased risk of cIMT ≥1.0 mm (OR = 1.138, 95% CI, 1.071-1.208) and carotid plaque (OR = 1.296, 95% CI, 1.219-1.377) compared with those with Lp(a) levels <50 mg/dL.
Conclusions: This is the first study of the Lp(a) distribution in a large population in China. Our findings revealed a positive association between elevated Lp(a) levels (≥50 mg/dL) and increased prevalence of carotid atherosclerosis, which implies an increased risk of cardiovascular disease in the future.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.