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Letters |15 January 1994

Lipoprotein(a) Levels in the Nephrotic Syndrome

Wendy Y. Craig, PhD; Robert F. Richie, MD

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  • Foundation for Blood Research; Scarborough, ME
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TO THE EDITOR:
We read with interest the article by Wanner and colleagues [1] reporting that plasma lipoprotein(a) (Lp[a]) levels are elevated in patients with the nephrotic syndrome. The authors speculated that decreased oncotic pressure might stimulate hepatic protein secretion, and as apolipoprotein(a) (apo[a]) is synthesized by the liver, this might result in elevated plasma levels. Also, if the kidney has a role in Lp(a) catabolism, deterioration of function might lead to increased plasma Lp(a) levels. We suggest further possibilities related to the physical characteristics of Lp(a) itself.
Lipoprotein(a) is a large particle, similar in composition to low-density lipoprotein, except that the unique protein component, apo(a), is attached by covalent linkage to apolipoprotein B (apo B). Apolipoprotein(a) isoforms range in molecular weight from 238 to 643 kDa [2]; the molecular weight of apo B is 512 to 550 kDa. Further, apo(a) is heavily sialated [3], a factor that leads to significant negative charge.
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Craig WY, Richie RF. Lipoprotein(a) Levels in the Nephrotic Syndrome. Ann Intern Med. ;120:165–166. doi: 10.7326/0003-4819-120-2-199401150-00014

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Published: Ann Intern Med. 1994;120(2):165-166.

DOI: 10.7326/0003-4819-120-2-199401150-00014

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