Elevated lipoprotein(a) is more prevalent in autoimmune or inflammatory disease than in controls (JACC Adv 2026)

Original title: Elevated Lipoprotein(a) Is Highly Prevalent in Autoimmune or Inflammatory Disease: A Multisite Study

JACC Adv · 1 August 2026 · 7

Ocher R, Cuomo R, Bhatia HS, Ramsis M, Mahmud E, Taub PR, Wilkinson MJ

This cross-sectional study of 49,431 patients from five University of California Health Systems found that elevated lipoprotein(a) is more common in autoimmune or inflammatory disease than in controls. Among patients with autoimmune or inflammatory disease, 28.3% had Lp(a) >50 mg/dL compared with 24.6% of controls (adjusted odds 1.22 [1.15-1.29]), and 21.3% had Lp(a) >70 mg/dL compared with 17.2% of controls. The association was strongest in gout, inflammatory bowel disease, and ankylosing spondylitis. The findings confirm a link between systemic inflammation and higher lipoprotein(a) prevalence, though causality remains unproven.

Original abstract

Background: There is a complex interplay between inflammation and lipoprotein(a) [Lp(a)].

Objectives: Examine whether individuals with autoimmune or inflammatory diseases (AIIDs) are more likely to have elevated Lp(a).

Methods: Cross-sectional study assessing the relationship between Lp(a) and 6 AIIDs using data from electronic health records from 5 University of California Health Systems between January 1, 2012 and December 31, 2024. Included patients had at least 1 Lp(a) measurement and were stratified by the presence of one or more AIID diagnosis vs individuals with atherosclerotic cardiovascular disease (ASCVD) vs controls (without AIIDs or ASCVD).

Results: A total of 49,431 patients with at least 1 Lp(a) measurement were included (7,995 with AIID, 8,633 with ASCVD, 34,741 controls). Those with AIIDs had a mean (SD) age of 61.1 (13.7) years, 45.7% were women, and 66.9% were White individuals. Among those with AIIDs, 28.3% (n = 2,259) had Lp(a) >50 mg/dL vs 24.6% (n = 8,560) of controls (P < 0.001) and 21.3% had Lp(a) >70 mg/dL vs 17.2% of controls (P < 0.001). The adjusted odds (95% CI) of Lp(a) >50 mg/dL was 1.22 (1.15-1.29) in those with AIIDs vs controls and was especially high in those with gout (1.33 [1.23-1.44]), inflammatory bowel disease (1.26 [1.06-1.49]), and ankylosing spondylitis (1.21 [1.09-1.34]). The prevalence of Lp(a) >50 mg/dL for AIIDs was between that of controls and those with ASCVD.

Conclusions: Individuals with AIIDs are more likely to have elevated Lp(a) (>50 mg/dL and >70 mg/dL). Further study of the relationship between inflammation and Lp(a) in this population is needed.

Summary written by lp-a.org from the published abstract; figures as published. Page updated 28 August 2026. Methods.