Epidemiology
German LIFE Child cohort finds Lp(a) is unrelated to BMI, age or sex in 512 children, and stays stable in 94% on repeat testing (Pediatr Res 2024)
Original title: Lipoprotein(a) serum concentrations in children in relation to body mass index, age and sex
In the population-based LIFE Child (German civilisation diseases cohort) study, 756 blood samples from 248 children with obesity and 264 matched healthy children aged 5 to 18 were analysed for Lp(a), with repeat measurements available for 154 children over one to four follow-up visits roughly a year apart. At first visit, median Lp(a) in the 512-child cohort was 9.7 mg/dL (interquartile range 4.0-28.3), with 11.5% between 30-50 mg/dL and 12.5% at 50 mg/dL or above. Lp(a) showed no association with BMI (beta 0.004, P = 0.49), age, or sex, but correlated positively with LDL cholesterol (beta 0.05, P < 0.0001). On repeated measurement, a child's Lp(a) risk category remained stable in 94% of cases. Because Lp(a) in youth is unaffected by BMI, age or sex and stays in the same risk category over time, a single childhood measurement may reliably flag children with lifelong elevated ASCVD risk and support reverse family cascade screening.
Original abstract
Background: Lipoprotein(a) (Lp(a)) is an inherited risk factor for atherosclerotic cardiovascular disease (ASCVD). Limited data exist on Lp(a) values in children. We aimed to evaluate whether Lp(a) concentrations in youth are influenced by BMI.
Methods: 756 blood samples of 248 children with obesity and 264 matched healthy children aged 5 and 18 years, enrolled in the population-based LIFE Child (German civilization diseases cohort) study, were analyzed. Repeat measurements were available in 154 children (1-4 follow ups, ~1 year apart).
Results: The median Lp(a) concentration in the total cohort (n = 512) at first visit was 9.7 mg/dL (IQR 4.0-28.3). Lp(a) concentrations between 30-50 mg/dL were observed in 11.5%, while 12.5% exhibited Lp(a) ≧50 mg/dL. There was no association of Lp(a) with body mass index (BMI) (ß = 0.004, P = 0.49). Lp(a) levels did not correlate with age or sex, while Lp(a) was associated positively with low-density lipoprotein cholesterol (ß = 0.05, P < 0.0001). The Lp(a) risk category remained stable in 94% of all children in repeated measurements.
Conclusions: The data showed no association of Lp(a) levels in children with BMI, age or sex. Measurement of Lp(a) in youth may be useful to identify children at increased lifetime risk for ASCVD.
Impact: In youth, Lp(a) levels are not affected by age, sex and BMI. Lp(a) risk categories remain stable over time in repeated measurements in children. Measurement of Lp(a) in children may be useful as an additional factor to identify children at increased lifetime risk for ASCVD and for reverse family screening.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.