Distribution of Lipoprotein(a) Levels and Clinical Associations in a Lebanese Adult Population: A Retrospective Observational Study

TL;DR

This study examines Lipoprotein(a) levels in a Lebanese population and finds higher levels in females but no strong links to common cardiovascular risk factors.

Contribution

Provides population-specific data on Lp(a) levels in Lebanon and identifies a link between elevated Lp(a) and atrial fibrillation.

Findings

Mean Lp(a) levels were higher in females (28 mg/dL) than males (23 mg/dL).

25.9% of the population had Lp(a) levels ≥30 mg/dL, but no significant associations with cardiovascular risk factors were found.

Lp(a) levels >50 mg/dL were significantly associated with atrial fibrillation.

Abstract

Background: Lipoprotein(a) (Lp(a)) is a genetically determined lipid particle associated with atherosclerotic cardiovascular disease. Despite growing evidence supporting the clinical relevance of Lp(a) in cardiovascular risk stratification and the emergence of potential therapies targeting elevated Lp(a) levels, Lp(a) testing remains underutilized, with reported rates below 20–30%. This study aims to explore Lp(a) levels in the Lebanese population and their association with the vascular and metabolic burden of diseases. Methods: We conducted a retrospective observational study of patients who underwent Lp(a) level testing at the American University of Beirut Medical Center between 2010 and 2023. Data were extracted using the EPIC electronic medical record system, and statistical analyses were performed using IBM SPSS Statistics Version 28. Results: This study included 456 patients; the mean age was 50 ± 13, and the mean Lp(a) level was 25 ± 28 mg/dL. Mean Lp(a) was higher in females than in males (28 ± 32 mg/dL versus 23 ± 25 mg/dL), and 25.9%, 12.9%, and 7.6% of the population had Lp(a) levels ≥ 30, ≥50, and ≥70 mg/dL respectively. Logistic regression analysis showed no significant association between Lp(a) levels and cardiovascular factors including dyslipidemia, hypertension, coronary artery disease, previous coronary artery bypass graft, and previous myocardial infarction. Similarly, no significant correlation was found between Lp(a) and LDL, HDL, total cholesterol, triglyceride, and HbA1c. Subgroup analysis showed a significant relationship between Lp(a) levels > 50 mg/dL and atrial fibrillation. Conclusions: This study explores the distribution of Lp(a) levels in a Middle Eastern tertiary-care population and provides population-specific descriptive data, addressing an important gap in the existing literature.

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