Lipoprotein(a) as a risk factor for maternal cardiovascular disease mortality in kindreds with familial combined hyperlipidemia or familial hypertriglyceridemia

Most but not all epidemiologic studies have shown that lipoprotein(a) [Lp(a )] is a risk factor for cardiovascular disease (CVD). Lp(a) levels are also strongly genetically influenced. The purpose of this study was to evaluate the association between Lp(a) levels in adult offspring and parental CVD m ortality in 61 kindreds with familial forms of hyperlipidemia. The study sa mple consisted of offspring-parent pairs in which offspring had fasting Lp( a) measurements and parents had 20-year vital status data and standardized cause-of-death classification if deceased. Linear regression analyses, usin g a robust variance estimator, were performed separately for 241 offspring with known maternal history (114 mothers) and 194 offspring with known pate rnal history (93 fathers). Maternal history of CVD mortality was significan tly (p = 0.004) associated with 2.4-fold higher median Lp(a) levels in offs pring compared with those with no maternal history, independent of diabetes , lipid-lowering medications and hormone use. No association was observed b etween paternal CVD mortality and offspring Lp(a) levels (p = 0.505). Adjus ting for apolipoprotein(a) kringle 4 number did not alter these parent-spec ific associations. In conclusion, Lp(a) levels in offspring may be associat ed with maternal but not paternal history of CVD mortality. This parent-spe cific finding needs to be confirmed in other samples of high-risk families.