Parhofer in his article explains that the lipoprotein(a) concentration is mostly genetically determined. Furthermore, he recommends that it needs to be measured only once, with a second measurement for confirmation if required (1).
Although the therapeutic options available so far are limited—as explained by the author in his review article—the general recommendation of a once-only measurement should be challenged. Kostner et al. described that lipoprotein(a) concentrations can be affected by a number of non-genetic factors. These include liver disease, terminal renal failure, diabetes mellitus, but also the effects of alcohol, medications, and hormones. As a result, values may be raised as well as lowered (2). Depending on the comorbidity/medication, follow-up measurements of lipoprotein(a) concentrations may make sense. Kostner et al. provide a detailed overview for different patient groups and make recommendations regarding examination intervals (2). Another study also reported individual, large variations in measurements. For this reason, repeat measurements are certainly worth discussing (3). From the perspective of laboratory medicine, consideration should be given to the commercial assay that was used to measure lipoprotein(a) and whether the respective measuring method is independent of apo(a) isoforms. In follow-ups, it is therefore important to assess whether the measurements were obtained by using the same method each time.
Dr. med. Ramona Dolscheid-Pommerich
Prof. Dr. med. Dipl. Biol. Birgit Stoffel-Wagner
Institut für Klinische Chemie und Klinische Pharmakologie
Conflict of interest statement
The authors declare that no conflict of interest exists.
|1.||Parhofer KG: The treatment of disorders of lipid metabolism. Dtsch Arztebl Int 2016; 113: 261–8 VOLLTEXT|
|2.||Kostner KM, März W, Kostner GM: When should we measure lipoprotein (a)? Eur Heart J 2013; 34: 3268–76 CrossRef MEDLINE|
|3.||Chennamsetty I, Scharnagl H, Kleber ME, März W, Kostner GM: Lipoprotein (a): when to measure and how to treat? J Lab Med 2015; 39: 7–81 CrossRef|