LOW LIPOPROTEIN (A) LEVELS DURING ACUTE VIRAL-HEPATITIS

High serum concentrations of lipoprotein (a) [Lp(a)] are considered a risk factor for premature atherosclerosis. Besides apolipoprotein B-10 0, Lp(a) consists of apolipoprotein (a) [apo(a)], which shows a remark able size polymorphism, The serum concentration of Lp(a) is considerab ly influenced by this apo(a) phenotype, Because Lp(a) is synthesized i n the liver, we wondered whether and to what extent Lp(a) levels might be affected by acute liver disease, We compared Lp(a) serum concentra tions in 74 patients (54% male, 46% female; mean age, 46 years) with a cute viral hepatitis (32, 28, and 14 with hepatitis A, B, and C, respe ctively) with those in 404 healthy controls (57% men, 43% women; mean age, 47 years). In addition, the intraindividual course of Lp(a) conce ntration during and after acute hepatitis was followed in a subgroup o f 23 patients (15, 6, and 2 with hepatitis AB, and C, respectively), D uring acute hepatitis, median Lp(a) concentrations in the patient grou p were significantly diminished compared with controls (7 vs, 17 mg/dL ; P < .0001, Mann-Whitney test), Any bias by an unequal isoform distri bution was excluded because there was no significant difference in the isoform distribution between patients and controls (P > .10, chi(2) t est), Furthermore, the decrease in Lp(a) concentration during acute he patitis was independent of the molecular weight of the apo(a) isoform, Longitudinally observed patients showed a marked increase in Lp(a) co ncentration during convalescence (7 to 32 mg/dL; P < .0001, Wilcoxon t est). Our results show that acute hepatitis is associated with decreas ed Lp(a) serum levels. Further studies are needed to evaluate whether Lp(a) serum concentration might be clinically useful as a parameter of liver function.