Genetics
Median Lp(a) ranges from 12 to 41 nmol/L across Hispanic/Latino backgrounds in the US, tracking genetic ancestry, in 16,117 HCHS/SOL participants (JAMA Cardiol 2023)
Original title: Heterogeneity of Lipoprotein(a) Levels Among Hispanic or Latino Individuals Residing in the US
In the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), a population-based cohort of 16,415 diverse Hispanic or Latino adults recruited from four US cities (2008-2011), Lp(a) was measured in 16,117 participants (mean age 41 years, 52% women). Median Lp(a) was 19.7 nmol/L (IQR 7.4-59.7), but varied significantly by self-identified background, from 12 nmol/L in those of Mexican background to 41 nmol/L in those of Dominican background. West African genetic ancestry was lowest in the bottom Lp(a) quintile and highest in the top quintile (5.5% vs 12.1%, P<.001), with the opposite pattern for Amerindian ancestry (32.8% vs 10.7%, P<.001). The findings show substantial Lp(a) heterogeneity within the US Hispanic/Latino population tied to genetic ancestry, with implications for how Lp(a) is used in cardiovascular risk assessment for this group.
Original abstract
Importance: Lipoprotein(a) (Lp[a]) is a genetically determined risk-enhancing factor for atherosclerotic cardiovascular disease (ASCVD). The Lp(a) distribution among the diverse Hispanic or Latino community residing in the US has not been previously described, to the authors' knowledge.
Objective: To determine the distribution of Lp(a) levels across a large cohort of diverse Hispanic or Latino adults living in the US and by key demographic groups.
Design, Setting, And Participants: The Hispanic Community Health Study/Study of Latinos (HCHS/SOL) is a prospective, population-based, cohort study of diverse Hispanic or Latino adults living in the US. At screening, participants aged 18 to 74 years were recruited between 2008 and 2011 from 4 US metropolitan areas (Bronx, New York; Chicago, Illinois; Miami, Florida; San Diego, California). HCHS/SOL included 16 415 noninstitutionalized adults recruited through probability sampling of randomly selected households. The study population represents Hispanic or Latino participants from diverse self-identified geographic and cultural backgrounds: Central American, Cuban, Dominican, Mexican, Puerto Rican, and South American. This study evaluated a subset of HCHS/SOL participants who underwent Lp(a) measurement. Sampling weights and surveys methods were used to account for HCHS/SOL sampling design. Data for this study were analyzed from April 2021 to April 2023.
Exposure: Lp(a) molar concentration was measured by a particle-enhanced turbidimetric assay with minimized sensitivity to apolipoprotein(a) size variation.
Main Outcome And Measure: Lp(a) quintiles were compared using analysis of variance among key demographic groups, including self-identified Hispanic or Latino background. Median percentage genetic ancestry (Amerindian, European, West African) were compared across Lp(a) quintiles.
Results: Lp(a) molar concentration was measured in 16 117 participants (mean [SD] age, 41 [14.8] years; 9680 female [52%]; 1704 Central American [7.7%], 2313 Cuban [21.1%], 1436 Dominican [10.3%], 6395 Mexican [39.1%], 2652 Puerto Rican [16.6%], 1051 South American [5.1%]). Median (IQR) Lp(a) level was 19.7 (7.4-59.7) nmol/L. Across Hispanic or Latino background groups, there was significant heterogeneity in median Lp(a) levels ranging from 12 to 41 nmol/L in those reporting a Mexican vs Dominican background. Median (IQR) West African genetic ancestry was lowest in the first quintile of Lp(a) level and highest in the fifth quintile (5.5% [3.4%-12.9%] and 12.1% [5.0%-32.5%]; respectively; P < .001), whereas the converse was seen for Amerindian ancestry (32.8% [9.9%-53.2%] and 10.7% [4.9%-30.7%], respectively; P < .001).
Conclusions And Relevance: Results of this cohort study suggest that differences in Lp(a) level distribution across the diverse US Hispanic or Latino population may carry important implications for the use of Lp(a) level in ASCVD risk assessment for this group. Cardiovascular outcomes data are needed to better understand the clinical impact of differences in Lp(a) levels by Hispanic or Latino background.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.