LIPOPROTEIN(A) IN OBESITY BEFORE AND AFTER WEIGHT-REDUCTION

There is a strong association between elevated plasma Lp (a) concentra tions and increased incidence of cardiovascular disease. The aim of th e study was to investigate Lp(a) levels in obesity before and after we ight reduction. Obese bur otherwise healthy patients with weight probl ems were studied. Four hundred seventy-sir female patients (40.3+/-13. 3 years, body mass index 38.8 kg/m(2)) and 152 male patients (41.1+/-1 2.7 years, body mass inner 40.7 kg/m(2)) were examined after overnight fasting. One handred and four of these patients (76 female, 28 male) were studied after long-term dieting (1200 kcal/day: 20% protein, 30% fat and 50% carbohydrates). After 7.3+/-5.4 months the mean weight los s was 14.2+/-10.5 kg, and blood pressure, triglycerides, blood glucose and uric acid had declined Lp(a) concentrations decreased in patients with high Lp(a) levels. The decrease in Lp(a) level was correlated wi th weight loss. The correlation persisted even after removing the line ar effects of initial Lp(a) concentrations and all other variables mea sured. Lp(a) level did not correlate with either body mass index, wais t circumference, or the ratio of waist circumference to hip circumfere nce. Also, an inverse relationship between TG and Lp(a) was observed. High Lp(a) concentrations are reduced by weight reduction. The underly ing mechanisms are not known. The association of Lp(a) reduction with weight loss may be due to a low calorie diet rich in unsaturated fatty acids.