Lipoprotein (A), Metabolic Syndrome and Coronary Calcium Score in a Large Occupational Cohort

Nutr Metab Cardiovasc Dis. 2013 Dec;23(12):1239-46. doi: 10.1016/j.numecd.2013.02.009. Epub 2013 Jun 17.


Background and aims: Whether lipoprotein (a) [Lp(a)] concentration is associated with metabolic syndrome (MetS) and pre-clinical atherosclerosis in different ethnic groups is uncertain. The association between Lp(a), MetS and a measure of pre-clinical atherosclerosis was studied in a large Asian cohort.

Methods and results: Data were analyzed from a South Korean occupational cohort who underwent a cardiac computed tomography (CT) estimation of CAC score and measurements of cardiovascular risk factors (n = 14,583 people). The key exposure was an Lp(a) concentration in the top quartile (>38.64 mg/dL)) with a CAC score >0 as the outcome variable and measure of pre-clinical atherosclerosis. Logistic regression was used to describe the associations. 1462 participants had a CAC score >0. In the lowest Lp(a) quartile (<11.29 mg/dL), 25.8% had MetS, compared with 16.1% in the highest Lp(a) quartile (>38.64 mg/dL (p < 0.001). MetS, and component features, were inversely related to Lp(a) concentration (all p < 0.0001). In the highest Lp(a) quartile group, there was an association between Lp(a) and CAC score >0 in men (OR 1.21[1.05, 1.40], p = 0.008), and women (OR 1.62[1.03, 2.55], p = 0.038), after adjustment for age, sex, lipid lowering therapy, and multiple cardiovascular risk factors. There was no evidence of an interaction between highest quartile Lp(a) and either high LDLc (>147 mg/dL) (p = 0.99), or MetS (p = 0.84) on the association with CAC score >0.

Conclusion: Lp(a) levels are inversely related to MetS and its components. There was a robust association between Lp(a) concentration >38.6 mg/dL and marker of early atherosclerosis in both men and women, regardless of LDLc, level MetS or other cardiovascular risk factors.

Keywords: Atherosclerosis; BMI; CAC; CVD; Cardio-metabolic risk factors; Cardiovascular disease (CVD); Coronary artery calcium (CAC) score; DBP; FRS; Framingham Risk Score; HDLc; Lp(a); MetS; Metabolic syndrome (MetS); SBP; TG; body mass index; cardiovascular disease; coronary artery calcium score; diastolic blood pressure; high density lipoprotein cholesterol; metabolic syndrome; systolic blood pressure; triglyceride.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Atherosclerosis / blood*
  • Biomarkers / blood
  • Body Mass Index
  • Calcium / metabolism*
  • Cohort Studies
  • Female
  • Humans
  • Insulin Resistance
  • Lipoprotein(a) / blood*
  • Logistic Models
  • Male
  • Metabolic Syndrome / blood*
  • Middle Aged
  • Republic of Korea
  • Risk Factors
  • Tomography, X-Ray Computed


  • Biomarkers
  • Lipoprotein(a)
  • Calcium