Lp(a) level varies widely among Hispanic US adults

Key takeaways:

• Median Lp(a) level varies by self-identified Hispanic or Latino background.
• The heterogeneity in Lp(a) level is likely related to differences in genetic ancestry.

Median lipoprotein(a) levels vary widely among Hispanic or Latino U.S. adults, with the highest median values seen among those self-identifying as Cuban, Dominican or Puerto Rican, researchers reported.

“There is significant heterogeneity across ancestral groups, with median Lp(a) levels ranging in order from highest to lowest among African, South Asian, white, Hispanic, and East Asian individuals,” Parag H. Joshi, MD, MHS, assistant professor of medicine at the University of Texas Southwestern Medical Center, and colleagues wrote in JAMA Cardiology. “The distribution of Lp(a) levels among Hispanic or Latino individuals in the U.S. is not well known, particularly considering their diverse geographic background and varying genetic admixture of European, Native American and West African ancestries. We hypothesize that there is considerable heterogeneity in Lp(a) levels across individuals from various Hispanic or Latino backgrounds due to diversity in genetic admixture.”

Joshi and colleagues analyzed data from 16,117 participants in the Hispanic Community Health Study/Study of Latinos, a prospective, population-based, cohort study of diverse Hispanic or Latino adults living in the U.S. recruited 2008 to 2011 from four metropolitan areas (Bronx, New York; Chicago; Miami; San Diego). The mean age of participants was 41 years; 52% were women. The cohort includes participants from diverse self-identified geographic and cultural backgrounds: Central American, Cuban, Dominican, Mexican, Puerto Rican and South American. All underwent Lp(a) measurement. Researchers compared Lp(a) quintiles among key demographic groups.

Within the cohort, 7.7% of participants identified as Central American, 21.1% identified as Cuban, 10.3% as Dominican, 39.1% as Mexican, 16.6% as Puerto Rican and 5.1% as South American.

The median Lp(a) level was 19.7 nmol/L across Hispanic or Latino background groups; however, there was significant heterogeneity in median Lp(a) levels, ranging from 12 nmol/L in those reporting a Mexican background to 41 nmol/L in those reporting a Dominican background. The highest median Lp(a) values were seen in those self-identifying as Cuban (30.4 nmol/L), Dominican (41 nmol/L) or Puerto Rican (28 nmol/L) background. Researchers observed lower median Lp(a) values among participants who self-identified as Central American (16.5 nmol/L), Mexican (12.4 nmol/L), or South American (15.1 nmol/L) background (P < .001)

Median West African genetic ancestry was lowest among participants in the first quintile of Lp(a) level and highest among participants in the fifth quintile, at 5.5% and 12.1%; respectively (P < .001). Researchers also found that American Indian ancestry was highest for participants in the first quintile of Lp(a) measurements and lowest in the highest quintile, at 32.8% and 10.7%, respectively (P < .001).

Parag H. Joshi

“The heterogeneity in Lp(a) levels within the Hispanic or Latino population in the U.S. may have important implications for atherosclerotic CVD risk assessment in this undertreated group,” the researchers wrote. “A study of Lp(a) associations with ASCVD events in the Hispanic Community Health Study/Study of Latinos is planned.”