Testing
Only 3% of 150,000 Chinese health-checkup attendees were tested for Lp(a), yet it still predicted carotid plaque and thickening, cross-sectional study finds (J Atheroscler Thromb 2025)
Original title: Prevalence of Lipoprotein(a) Measurement and its Association with Arteriosclerosis in Asymptomatic Individuals in China
This cross-sectional study drew a random sample of 30,000 medical examiners from each of five Chinese health check-up centres (150,000 total) to assess Lp(a) testing rates and, among those tested, its association with vascular structure. Lp(a) was measured in only 4,400 participants (3.02%); among those tested, median Lp(a) was 15.85 mg/dL and 15.00% had levels at or above 30 mg/dL. Multiple logistic regression found Lp(a) significantly associated with carotid intima-media thickness of 1.0 mm or above (OR 1.008, 95% CI 1.001-1.014, P = 0.020) and carotid plaques (OR 1.010, 95% CI 1.004-1.016, P = 0.001), but not with brachial-ankle pulse wave velocity at either the 1400 or 1800 threshold. The authors conclude Lp(a) testing rates at Chinese health checkups remain very low despite Lp(a)'s positive association with carotid vascular sclerosis and plaque, and call for improved testing rates and provider awareness of Lp(a)-related vascular risk.
Original abstract
Aims: Lipoprotein(a) [Lp(a)] is an independent risk factor for atherosclerotic cardiovascular disease (ASCVD), and its level is genetically determined. Although guidelines and consensuses in various cardiovascular fields have emphasized the importance of Lp(a), screening for Lp(a) in China has not been well studied.
Methods: A cross-sectional study was conducted using a random sample of 30,000 medical examiners from each of the five health check-up centres. The distribution of Lp(a) was described for those who completed Lp(a) testing, and logistic regression modelling was used to evaluate the relationship between Lp(a) levels and vascular structure and function in the population who underwent carotid ultrasound and brachial‒ankle pulse wave velocity (baPWV) measurements.
Results: Lp(a) was measured in only 4400 (3.02%) of the 150,000 participants. Among those tested for Lp(a), the median concentration was 15.85 mg/dL. The proportion of participants with Lp(a) levels ≥ 30 mg/dL was 15.00%. Multiple logistic regression analysis revealed a significant correlation between Lp(a) and cIMT ≥ 1.0 mm (OR: 1.008, 95% CI: 1.001-1.014, P=0.020) and carotid artery plaques (OR: 1.010, 95% CI: 1.004-1.016, P=0.001) but no correlation with baPWV ≥ 1400 (OR: 0.999, 95% CI: 0.993-1.005, P=0.788) or baPWV ≥ 1800 (OR: 1.002, 95% CI: 0.993-1.011, P=0.634).
Conclusions: The detection rate of Lp(a) at health checkups is low, and Lp(a) is positively associated with cervical vascular sclerosis and plaque but not with baPWV. Therefore, the testing rate of Lp(a) and the awareness of the risk of vascular structural changes due to Lp(a) should be further improved.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.