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. 2023 Jul 1;8(7):691-696.
doi: 10.1001/jamacardio.2023.1134.

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

Parag H Joshi  1 , Santica Marcovina  2 , Kate Orroth  3 , J Antonio G López  4 , Shia T Kent  3 , Robert Kaplan  5 , Katrina Swett  6 , Daniela Sotres-Alvarez  7 , Bharat Thyagarajan  8 , Leandro Slipczuk  6 , Tamar Sofer  9 , Martha L Daviglus  10 , Gregory A Talavera  11 , Neil Schneiderman  12 , Carlos J Rodriguez  6
Affiliations

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

Parag H Joshi et al. JAMA Cardiol. .

Abstract

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.

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Conflict of interest statement

Conflict of Interest Disclosures: Dr Joshi reported receiving grants from Make Well Known Foundation, Amgen, Novartis, Novo Nordisk, and NASA outside the submitted work. Dr Marcovina reported receiving grants from Amgen and consulting fees from Novartis, Denka, and Roche Diagnostics outside the submitted work. Drs Orroth, López, and Kent reported being employees and shareholders of Amgen Inc. Dr Sotres-Alvarez reported receiving grants from National Heart, Lung, and Blood Institute during the conduct of the study. Dr Thyagarajan reported receiving grants from the National Institutes of Health and the Be Well Foundation during the conduct of the study. Dr Slipczuk reported receiving grants from Amgen and Philips and consulting fees from Amgen, Bristol Myers Squibb, Philips, and Regeneron outside the submitted work. Dr Daviglus reported receiving grants from the National Institutes of Health during the conduct of the study. Dr Talavera reported receiving grants from the National Institutes of Health during the conduct of the study. Dr Rodriguez reported receiving grants and advisory board fees from Amgen; grants from the National Institutes of Health and the American Heart Association; and nonfinancial support from Merck during the conduct of the study. No other disclosures were reported.

Figures

Figure 1.
Figure 1.. Hispanic Community Health Study/Study of Latinos (HCHS/SOL) Lipoprotein(a) (Lp[a]) Distribution With Population Percentiles at Common Clinical Thresholds
Lp(a) distribution in the HCHS/SOL population among 16 117 participants. All numbers are unweighted, and all descriptive analyses use weighted medians and percentages.
Figure 2.
Figure 2.. Hispanic Community Health Study/Study of Latinos (HCHS/SOL) Lipoprotein(a) Distribution by Self-identified Hispanic or Latino Background
Lipoprotein(a) distribution among individuals from the following Hispanic or Latino ethnicities: Mexican (A), Dominican (B), Central American (C), Cuban (D), South American (E), and Puerto Rican (F) among a total of 15 551 individuals. Numbers are unweighted, and all descriptive analyses use weighted medians and percentages. Hispanic or Latino background group categorization was based on self-identification from the baseline HCHS/SOL visit interviewer-administered personal information questionnaire.
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References

    1. Rodriguez CJ, Allison M, Daviglus ML, et al. ; American Heart Association Council on Epidemiology and Prevention; American Heart Association Council on Clinical Cardiology; American Heart Association Council on Cardiovascular and Stroke Nursing . Status of cardiovascular disease and stroke in Hispanics/Latinos in the US: a science advisory from the American Heart Association. Circulation. 2014;130(7):593-625. doi:10.1161/CIR.0000000000000071 - DOI - PMC - PubMed
    1. Reyes-Soffer G, Ginsberg HN, Berglund L, et al. ; American Heart Association Council on Arteriosclerosis, Thrombosis and Vascular Biology; Council on Cardiovascular Radiology and Intervention; and Council on Peripheral Vascular Disease . Lipoprotein(a): a genetically determined, causal, and prevalent risk factor for atherosclerotic cardiovascular disease: a scientific statement from the American Heart Association. Arterioscler Thromb Vasc Biol. 2022;42(1):e48-e60. doi:10.1161/ATV.0000000000000147 - DOI - PMC - PubMed
    1. Tsimikas S, Marcovina SM. Ancestry, lipoprotein(a), and cardiovascular risk thresholds: JACC review topic of the week. J Am Coll Cardiol. 2022;80(9):934-946. doi:10.1016/j.jacc.2022.06.019 - DOI - PubMed
    1. Enkhmaa B, Anuurad E, Berglund L. Lipoprotein (a): impact by ethnicity and environmental and medical conditions. J Lipid Res. 2016;57(7):1111-1125. doi:10.1194/jlr.R051904 - DOI - PMC - PubMed
    1. Conomos MP, Laurie CA, Stilp AM, et al. . Genetic diversity and association studies in US Hispanic/Latino populations: applications in the Hispanic Community Health Study/Study of Latinos. Am J Hum Genet. 2016;98(1):165-184. doi:10.1016/j.ajhg.2015.12.001 - DOI - PMC - PubMed

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