Genetics
Hegele group finds Lp(a) is paradoxically halved in patients with severe hypertriglyceridaemia (J Int Med Res 2024)
Original title: Reduced lipoprotein (a) in patients with severe hypertriglyceridaemia
This case-control study from the Lipid Genetics Clinic at London Health Sciences Centre in Ontario reviewed 4,400 patient charts and identified 154 patients with severe hypertriglyceridaemia (triglycerides at or above 10 mmol/L), comparing them with 272 normolipidaemic controls. Median Lp(a) was significantly lower in patients with severe hypertriglyceridaemia than in controls (5.0 vs. 10.2 mg/dL). No correlation was found between Lp(a) and triglycerides or non-HDL cholesterol, though Lp(a) and apoB were modestly correlated in both severe hypertriglyceridaemia patients (r = 0.235) and controls (r = 0.175), with no significant differences across genetic subgroups of severe hypertriglyceridaemia. The unexpected finding that severe hypertriglyceridaemia is associated with lower, not higher, Lp(a) is not yet mechanistically explained and is presented as hypothesis-generating for future study.
Original abstract
Objective: To investigate the relationship between plasma lipoprotein (a) (Lp[a]) and lipid profiles in patients with severe hypertriglyceridaemia (HTG).
Methods: This case-control study undertook a retrospective chart review of patients from the Lipid Genetics Clinic at London Health Sciences Centre in Ontario, Canada. Plasma Lp(a) was compared between patients with severe HTG and healthy normolipidaemic control subjects. Severe HTG was defined by plasma triglycerides (TG) ≥ 10 mmol/l. Pairwise correlations between Lp(a), TG, apolipoprotein B (apo B) and non-high-density lipoprotein cholesterol (non-HDL-C) were evaluated.
Results: This study reviewed 4400 patients and identified 154 patients with severe HTG, which were compared with 272 control subjects. The median Lp(a) was significantly lower in patients with severe HTG compared with control subjects (5.0 versus 10.2 mg/dl, respectively). No correlation was observed between Lp(a) and TG or non-HDL-C. Lp(a) and apo B were modestly correlated in patients with severe HTG (r = 0.235) and control subjects (r = 0.175). There were no significant differences between the genetic subgroups of patients with severe HTG.
Conclusions: Patients with severe HTG have lower plasma Lp(a) than normolipidaemic control subjects. The basis for this relationship is not immediately apparent but is hypothesis-generating and warrants further investigation.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.