Testing
Physiological within-day variation in lipoprotein(a) decreases by up to 7.0 percent from fasting levels (J Atheroscler Thromb 2026)
Original title: Physiological within-day Variation in Lipoprotein(a): Is a Once-in-a-lifetime Measurement Sufficient for Cardiovascular Risk Evaluation?
This observational study measured lipoprotein(a) concentrations at seven time points throughout the day in 34 patients using a latex turbidimetric immunoassay. Lp(a) concentrations decreased by 2.9±5.2 nmol/L at 14:00 (p＜0.05), 3.6±4.8 nmol/L at 20:00 (p＜0.001), and 2.9±5.1 nmol/L at 24:00 (p＜0.05) relative to fasting levels. The mean percent decrease reached -6.2±0.1% at 17:30 and -7.0±0.1% at 24:00. While the decline is statistically significant, the absolute changes are small, suggesting that a single baseline measurement remains clinically adequate for most patients, though re-evaluation may be warranted for borderline elevations.
Original abstract
Aims: Lipoprotein(a) (Lp(a)) is a strong risk factor for cardiovascular events, independent of low-density lipoprotein cholesterol (LDL-C). Because the Lp(a) concentration is largely determined by genetic factors, some dyslipidemia guidelines recommend a once-in-a-lifetime measurement of Lp(a). Furthermore, a non-fasting lipid profile assessment is allowed for initial screening of dyslipidemia. Although the LDL-C concentration decreases slightly throughout the day, the within-day variation of Lp(a) remains unknown. We aimed to investigate whether the Lp(a) concentration remains stable throughout the day.
Methods: Lp(a) concentrations were measured at seven time points throughout the day in 34 patients using a latex turbidimetric immunoassay. The Lp(a) values are expressed in molar units, which are equivalent to those determined by a mass spectrometry-based reference measurement procedure.
Results: We found that the Lp(a) concentrations decreased by 2.9±5.2 nmol/L at 14:00 (p＜0.05), 3.6±4.8 nmol/L at 20:00 (p＜0.001), and 2.9±5.1 nmol/L at 24:00 (p＜0.05). The mean percent Lp(a) decreased significantly at 17:30 (-6.2±0.1%) and 24:00 (-7.0±0.1%) from the fasting level.
Conclusion: The Lp(a) concentration decreases slightly, but significantly, throughout the day. Considering physiological variations, it is preferable to re-evaluate the Lp(a) concentration in those with a borderline elevation.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 16 October 2026. Methods.