THE RELATIONSHIP BETWEEN INFANT AND PARENT LP(A) LEVELS

Since atherogenesis may begin in childhood, and elevated serum lipopro tein(a) (Lp(a)) concentrations increase cardiovascular risk, we explor ed the early expression of the apolipoprotein(a) (apo(a)) gene and rel ationships between infants' and parents' serum levels. In a consecutiv e series of 1032 babies aged 3-5 days the distribution of apo(a) level s was positively skewed as in adults but with lower levels: 50th and 9 5th percentiles were the equivalent of 30 mg/l and 130 mg/l of Lp(a) i n serum. Concentrations were re-measured in 51 infants when aged 8.5 /- 2 months together with parental values. Levels at 3-5 days and 8.5 months were highly correlated (r = 0.73, P < 0.0001, n = 51) with a tw ofold increase at 8.5 months. Regression coefficients between 8.5 mont hs concentrations and those of fathers, of mothers, and the average le vel of both parents were 0.439, 0.521 and 0.93, respectively (P < 0.00 01 for each), and infant and parental levels were then not different. The positive and negative predictive values of first post-natal week c apillary blood apo(a) measurements detecting a parent with serum Lp(a) above 300 mg/l were 95% and 70%. We conclude that the apo(a) gene is virtually fully expressed before 1 year during which apo(a) levels tra ck closely and are predictive of parental values. Childhood Lp(a) meas urements may identify families at enhanced cardiovascular risk and fac ilitate targeted prevention.