Lipoprotein(a) (Lp(a))
Lipoprotein(a) consists of an LDL-like particle covalently bound to apolipoprotein(a). Concentrations are over 90% genetically determined by the LPA locus, conferring independent causal risk for myocardial infarction, ischemic stroke, and calcific aortic valve stenosis.
Standard vs. Optimal Reference Rangesnmol/L
Standard reference intervals represent the statistical 95% distribution of unselected commercial populations. Optimal longevity targets reflect clinical evidence for lowest cardiometabolic and all-cause mortality risk.
Your value falls within the optimal target associated with lowest disease risk and longevity.
< 30 mg/dL (< 75 nmol/L)
General reference distribution across unselected commercial populations.
< 14 mg/dL (< 30 nmol/L)
Concentration target associated with minimal all-cause cardiometabolic mortality.
Molecular Mechanism & Clinical Purpose
Apolipoprotein(a) possesses structural homology with plasminogen, containing multiple kringle IV repeats. This molecular mimicry competitively inhibits tissue plasminogen activator-mediated fibrinolysis while delivering oxidized phospholipids directly to vascular endothelium, promoting both thrombosis and vascular calcification.
Differential Diagnosis
Elevated Levels (Lp(a) High)
- •Genetically determined LPA gene variants
- •End-stage renal disease / Nephrotic syndrome
- •Severe postmenopausal estrogen withdrawal
Low Levels (Lp(a) Low)
- •Genetically determined high kringle IV copy number
- •Severe hepatic failure
Technical Reference & Deep Dive
Biochemistry & Enzymatic Pathways
Longevity Risk Architecture & Epidemiology
Pre-Analytical Caveats & Diagnostic Workup
Pre-Analytical Considerations:
Standard testing requires a 10 to 12 hour overnight fast to minimize postprandial chylomicron interference, although Lp(a) direct immunoassay is less sensitive to prandial state than calculated LDL-C. Avoid strenuous high-intensity exercise 24 hours prior to blood draw. Serum separator tubes (SST) or EDTA plasma should be centrifuged within 2 hours. High-dose biotin (>5 mg/day) supplementation may interfere with competitive streptavidin-biotin immunoassays, requiring a 48-hour washout period.
Reflexive Testing Protocol:
- Advanced Lipoprotein Particle Quantification (NMR spectroscopy or ion mobility LDL-P)
- Lipoprotein(a) [Lp(a)] baseline evaluation for genetic cardiovascular risk stratification
- Coronary Artery Calcium (CAC) score via non-contrast cardiac CT to evaluate calcified plaque burden
- High-sensitivity C-Reactive Protein (hs-CRP) to assess systemic vascular inflammatory tone
- Carotid intima-media thickness (CIMT) duplex ultrasound to assess subclinical atherosclerosis
Clinical Citations & Primary Literature (1)
- [1]Lipoprotein(a) in Atherosclerotic Cardiovascular Disease and Aortic Stenosis - Lancet (2022). doi:10.1016/S0140-6736(22)01077-8
Associated Longevity Guides & Clinical Calculators
Medicine 3.0Explore comprehensive evidence-based clinical protocols, testing costs, and algorithmic calculators that incorporate Lipoprotein(a) (Lp(a)) into overall healthspan optimization.