LIPOPROTEIN(A) AS A RISK FACTOR FOR CEREBROVASCULAR-DISEASE AND DEMENTIA

The aim of the present study was to evaluate the contribution of lipop rotein(a) (Lp(a)) to the development of cerebrovascular disease or dem entia. The serum Lp (a) level and other lipid parameters were measured in 202 patients suffering from cerebrovascular disease or dementia an d compared with data for 72 age-matched controls. The serum Lp (a) lev el was significantly (p< 0.05) higher in the brain infarction group (- median of Lp (a) 17.3 mg/dl, mean log Lp(a) 1.199) and especially in t he atherothrombotic infarction group (19.5 mg/dl, 1.246), as compared with the controls (12.9 mg/dl, 1.056). In the patients with vascular d ementia, the serum Lp(a) level was significantly higher (15.4 mg/dl, 1 .227) than that in the controls, but in the patients with dementia of the Alzheimer type, the Lp (a) level was not increased (8.7 mg/dl, 1.0 79). The increase in mean Lp(a) level was related to the severity of d ementia in the vascular dementia group. The percentage of patients wit h serum Lp(a) levels of more than 30 mg/dl was significantly (p< 0.05) higher in the brain infarction (18.6%) and transient ischemic attack groups (28.6%) than among the controls (5.5%). An especially high leve l of significance (p< 0.01) was noted in the atherothrombotic infarcti on group (26.1%) and in the vascular dementia group (25.6%). Based on stepwise discriminant analysis, Lp (a) was selected as a potent single lipoprotein parameter for discriminating between atherothrombotic inf arction and lacunar infarction, or between vascular dementia and demen tia of the Alzheimer type. It is concluded that Lp (a) may be a risk f actor for cerebral atherosclerosis including vascular dementia.