Heterogeneity of Lipoprotein(a) Levels Among Hispanic or Latino Individuals Residing in the US.

Autor:	Joshi PH; Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas., Marcovina S; Medpace Reference Laboratories, Cincinnati, Ohio., Orroth K; Center for Observational Research, Amgen Inc, Thousand Oaks, California., López JAG; Global Development, Amgen Inc, Thousand Oaks, California., Kent ST; Center for Observational Research, Amgen Inc, Thousand Oaks, California., Kaplan R; Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, New York., Swett K; Department of Medicine (Cardiology), Albert Einstein College of Medicine, New York, New York., Sotres-Alvarez D; Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill., Thyagarajan B; Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis., Slipczuk L; Department of Medicine (Cardiology), Albert Einstein College of Medicine, New York, New York., Sofer T; Department of Biostatistics, Harvard Medical School, Boston, Massachusetts., Daviglus ML; Institute for Minority Health Research, University of Illinois, Chicago., Talavera GA; Department of Psychology, San Diego State University, San Diego, California., Schneiderman N; Department of Psychology, University of Miami, Miami, Florida., Rodriguez CJ; Department of Medicine (Cardiology), Albert Einstein College of Medicine, New York, New York.
Jazyk:	angličtina
Zdroj:	JAMA cardiology [JAMA Cardiol] 2023 Jul 01; Vol. 8 (7), pp. 691-696.
DOI:	10.1001/jamacardio.2023.1134
Abstrakt:	Importance: Lipoprotein(a) (Lp[a]) is a genetically determined risk-enhancing factor for atherosclerotic cardiovascular disease (ASCVD). The Lp(a) distribution among the diverse Hispanic or Latino community residing in the US has not been previously described, to the authors' knowledge. Objective: To determine the distribution of Lp(a) levels across a large cohort of diverse Hispanic or Latino adults living in the US and by key demographic groups. Design, Setting, and Participants: The Hispanic Community Health Study/Study of Latinos (HCHS/SOL) is a prospective, population-based, cohort study of diverse Hispanic or Latino adults living in the US. At screening, participants aged 18 to 74 years were recruited between 2008 and 2011 from 4 US metropolitan areas (Bronx, New York; Chicago, Illinois; Miami, Florida; San Diego, California). HCHS/SOL included 16 415 noninstitutionalized adults recruited through probability sampling of randomly selected households. The study population represents Hispanic or Latino participants from diverse self-identified geographic and cultural backgrounds: Central American, Cuban, Dominican, Mexican, Puerto Rican, and South American. This study evaluated a subset of HCHS/SOL participants who underwent Lp(a) measurement. Sampling weights and surveys methods were used to account for HCHS/SOL sampling design. Data for this study were analyzed from April 2021 to April 2023. Exposure: Lp(a) molar concentration was measured by a particle-enhanced turbidimetric assay with minimized sensitivity to apolipoprotein(a) size variation. Main Outcome and Measure: Lp(a) quintiles were compared using analysis of variance among key demographic groups, including self-identified Hispanic or Latino background. Median percentage genetic ancestry (Amerindian, European, West African) were compared across Lp(a) quintiles. Results: Lp(a) molar concentration was measured in 16 117 participants (mean [SD] age, 41 [14.8] years; 9680 female [52%]; 1704 Central American [7.7%], 2313 Cuban [21.1%], 1436 Dominican [10.3%], 6395 Mexican [39.1%], 2652 Puerto Rican [16.6%], 1051 South American [5.1%]). Median (IQR) Lp(a) level was 19.7 (7.4-59.7) nmol/L. Across Hispanic or Latino background groups, there was significant heterogeneity in median Lp(a) levels ranging from 12 to 41 nmol/L in those reporting a Mexican vs Dominican background. Median (IQR) West African genetic ancestry was lowest in the first quintile of Lp(a) level and highest in the fifth quintile (5.5% [3.4%-12.9%] and 12.1% [5.0%-32.5%]; respectively; P < .001), whereas the converse was seen for Amerindian ancestry (32.8% [9.9%-53.2%] and 10.7% [4.9%-30.7%], respectively; P < .001). Conclusions and Relevance: Results of this cohort study suggest that differences in Lp(a) level distribution across the diverse US Hispanic or Latino population may carry important implications for the use of Lp(a) level in ASCVD risk assessment for this group. Cardiovascular outcomes data are needed to better understand the clinical impact of differences in Lp(a) levels by Hispanic or Latino background.
Databáze:	MEDLINE
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