Genetics
A critical review examines how Middle Eastern genetic diversity and high consanguinity rates may uniquely shape Lp(a) distribution, a data-scarce region (JACC Asia 2025)
Original title: Cardiovascular Implications of Lipoprotein(a) and its Genetic Variants: A Critical Review From the Middle East
This critical review by El-Menyar and colleagues examines lipoprotein(a), described as the most widespread monogenic dyslipidaemic disorder, in the context of Middle Eastern populations, where dyslipidaemia is a prevalent cardiovascular risk factor but Lp(a)-specific data remain scarce. It surveys how genetic studies have established Lp(a) as a heritable, independent cardiovascular risk factor, shifting perception of Lp(a) and the LPA gene from a biomarker to a viable therapeutic target, and notes that serum Lp(a) levels differ significantly across racial and ethnic groups, with a few independent genetic variants outside the LPA gene region also affecting levels. The authors argue that Middle Eastern populations' genetic diversity and higher consanguinity rates may uniquely influence Lp(a) distribution and its cardiovascular associations in ways not yet well characterised, and call for dedicated regional research to fill this data gap.
Original abstract
Dyslipidemia, a significant risk factor for cardiovascular diseases (CVDs), is prevalent in the Middle East (ME) countries. With a variable prevalence, elevated lipoprotein (a) [Lp(a)] is the most widespread monogenic dyslipidemic disorder. Genetic studies have established Lp(a) as a heritable and independent risk factor for CVD. This discovery has shifted the perception of Lp(a) and the LPA gene from mere biomarkers of atherosclerotic risk to a viable target for therapeutic intervention. Significant differences in serum Lp(a) levels have been observed across racial and ethnic groups, with few independent genetic variants affecting Lp(a) levels outside the LPA gene region. Data specific to the ME and Arab populations remains scarce. ME populations exhibit genetic diversity and higher consanguinity rates, which may uniquely influence Lp(a) distribution and associated variations. This review examines the genetic and observational factors that shape Lp(a) levels and their role in CVD risk, focusing on ME populations.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 17 August 2026. Methods.