Association of Lipoprotein(a) With Cardiovascular and Cerebrovascular Disease in a Nationally Representative Cohort of Germany.

Gelfert, Gloria G; Endres, Matthias; Nave, Alexander H; Scheidt-Nave, Christa; Grittner, Ulrike; Kuhnert, Ronny

doi:10.1016/j.jacadv.2025.102015

Journal Article

DZNE-2025-01058

Association of Lipoprotein(a) With Cardiovascular and Cerebrovascular Disease in a Nationally Representative Cohort of Germany.

Gelfert, G. G. ; Grittner, U. ; Kuhnert, R. ; Scheidt-Nave, C. ; Endres, M.DZNE* ; Nave, A. H.

2025
Elsevier B.V. [Amsterdam]

JACC: advances 4(8), 102015 (2025) [10.1016/j.jacadv.2025.102015]

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Please use a persistent id in citations: doi:10.1016/j.jacadv.2025.102015

Abstract: Population-based data on the distribution of lipoprotein(a) (Lp[a]) within the German population are lacking.The aim of the study was to determine the age- and sex-specific Lp(a) distribution in Germany and analyze its association with different types of cardiovascular disease (CVD).We analyzed cross-sectional data from the German National Health Interview and Examination Survey 1998, a population-based study representing the German adult population's health status from 1997 to 1999. We examined serum Lp(a) according to demographics and investigated associations between Lp(a) and history of self-reported CVD. We tested Lp(a) in spline analysis on continuous scales and as dichotomous Lp(a) thresholds.In the German National Health Interview and Examination Survey 1998 (n = 6,657), median Lp(a) was 15.3 mg/dL (Q1-Q3: 5.6, 43.1). Lp(a) levels ≥50 mg/dL were present in 21.6%. Men had substantially higher median Lp(a) than women (22.1 mg/dL vs 10.3 mg/dL). Median Lp(a) levels were significantly higher in individuals with than without a history of atherosclerotic cardiovascular disease (ASCVD) but did not significantly differ between people with and without venous thrombosis. In logistic regression analysis with splines, higher Lp(a) levels were associated with a higher probability of a history of CVD. In logistic regression analyses, Lp(a) ≥50 mg/dL was associated with a history of ASCVD (OR: 1.36 [95% CI: 1.04-1.78]; P = 0.023).About 1 in 5 German individuals from a prestatin era population had Lp(a) levels ≥50 mg/dL. Higher levels were independently associated with ASCVD, but not with venous thrombosis. These findings provide a basis for future prospective studies to define the role of Lp(a) in CVD risk in the German population.

Keyword(s): cardiovascular disease ; cardiovascular risk ; epidemiology ; lipoprotein(a) ; prevention ; venous thrombosis