| Lipoprotein(a) prevalence trends in Portuguese children and adolescents: a real-world perspective |
Isabel Morais Ribeiro1 
, Susete Vieira1
, Miguel Saraiva2
, Mónica Tavares1
, José Carlos Oliveira3
, Isabel Mangas Palma2
, Helena Ferreira Mansilha1
|
1Nutrition Unit, Pediatric Department, Centro Materno-Infantil do Norte Dr. Albino Aroso (CMIN), Centro Hospitalar Universitário Santo António, Porto, Portugal
2Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário de Santo António, Porto, Portugal
3Department of Clinical Chemistry, Centro Hospitalar Universitário de Santo António, Porto, Portugal |
Correspondence:
Helena Ferreira Mansilha, Email: helenamansilha@chporto.min-saude.pt
|
|
Received: 7 February 2025 • Revised: 21 August 2025 • Accepted: 22 August 2025 |
|
|
| Abstract |
Background
Lipoprotein(a) (Lp(a)) is a plasma lipoprotein with atherogenic, prothrombotic, and proinflammatory properties. Elevated Lp(a) levels are linked to the development of early atherosclerosis in childhood and contribute to a higher risk of cardiovascular disease (CVD) in adulthood.
Purpose
This study aimed to assess the clinical significance of Lp(a) levels in Portuguese pediatric patients who underwent serum Lp(a) testing as part of a lipid disorder screening prompted by obesity, hypercholesterolemia, and/or a family history of premature CVD. We also evaluated the correlation between Lp(a) levels and CVD risk factors.
Methods
This cross-sectional retrospective study included 792 pediatric patients. Data on demographics, clinical history, body mass index, and laboratory values, including Lp(a), were collected. Lp(a) levels were categorized into 3 groups: <75 nmol/L, 75–125 nmol/L, and >125 nmol/L. A multivariate analysis was used to identify factors associated with Lp(a) ≥ 75 nmol/L.
Results
The most prevalent comorbidities in this sample were obesity and associated low-grade inflammation, each affecting at least one-third of participants. The median Lp(a) level was 31.80 nmol/L, with 9.1% and 21.6% of children having intermediate (75–125 nmol/L) and high (>125 nmol/L) Lp(a) levels, respectively. Higher total cholesterol, non–high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol (LDL-C) levels were correlated with elevated Lp(a) levels. The multivariate analysis identified an elevated LDL-C level as a predictor of a higher Lp(a) level.
Conclusion
This study highlights the alarming prevalence of elevated Lp(a) levels in Portuguese pediatric patients who underwent serum Lp(a) testing due to lipid disorder screening, with >30% at intermediate/high CVD risk. As Lp(a) levels are mostly genetically determined and tend to persist into adulthood, these findings emphasize the importance of including Lp(a) screening in the cardiovascular risk assessment of children with CVD risk factors to enable timely prevention strategies for adultonset CVD. |
| Key Words:
Lipoprotein(a), Cardiovascular disease, Cardiovascular risk, Dyslipidemia, Low-density lipoprotein cholesterol |
|
PDF Links
Download Citation
