Monday, June 30, 2008

Lp(a): Running With Scissors (Part 1)

I'm sure as a kid, your mother warned you over and over and over how dangerous running with sharp objects is...

Or sharp pencils... Or knives... Or chopsticks...

Or Lp(a)??! wtf??

Ben Harper and friends: THERE WILL BE LIGHT
Rome Concert Live
Courtesy of

I wish we could live forever...

Then melt into the sun
Melt into the sun
Time is gonna change you
Once it gets you on the run
Gets you on the run


I've been running
Ever since
Ever since I was a child
Some call it free
And some call it wild

There will be
There will be
There will be a light
There will be a light
There will be
There will be
There will be a light
There will be a light

Why is Lp(a) elevated for some individuals? Why is it directly correlated with premature vascular disease (when BP is elevated)?

It's estimated there are potentially three families of factors that influence Lp(a) which affects about 17-25% of the general population:
(a) Structure and metabolism of very-low-density lipoprotein (VLDL) such as triglycerides, phospholipids, apoC-II, C-III, E, A-II and uric acid (which are of course ALL related to insulin)
(b) Thrombosis-related centering on platelets
(c) Acute phase reactions represented by 1 hr and 2 hr erythrocyte sedimentation rates (ESR) (in other words, immune system stimulation)
(I'd add a 4th factor in the formula (d) kidney dysregulation which is the site of Lp(a) catabolism and recycling/disposal in the human body)

Nakajima K, Hata Y. Intraindividual variations in lipoprotein (a) levels and factors related to these changes. J Atheroscler Thromb. 1996;2(2):96-106. PMID: 9225216

At we have several reports addressing Lp(a). The challenge in controlling this one single, severe plaque-building factor can not be underestimated. It can be an unrelenting foe...

-Lp(a) Report I (2006): Lipoprotein(a): What it is, why it's important, and why you need to know if you've got it!

-Lp(a) Report II (2008): Unique Strategies for Lipoprotein(a) Reduction

-Lp(a) Lipoprotein Checklist

There appear to be distinct subpopulations affected by Lp(a) from my (anecdotal, untrained) nonscientific observations:

--high-carb consuming well known athletes (and unknown) who drop dead at endurance events of MIs (Brian Maxwell Northern Cal POWERBAR guru, Jim Fixx, and lucky survivor-Alberto Salazar)
--advanced stage chronic kidney disease (CKD)
--end-stage-renal-disease (ESRD) and dialysis patients
--individuals with kidney stones
--individuals with Metabolic Syndrome (MetSyn) with premature heart disease in the family tree (females affected before age 65; males affected before age 55)
--men with diabetes Type 2 and erectile dysfunction
--individuals with MetSyn who have survived cancer (a condition that really sets off acute phase reactions and the immune system to heal)
--youth and young children with MetSyn, esp PCOS or any other hormone derangements (ie, wheat addiction/prolactin, big-man-boobs, appear 4-mos pregnant and they are male )
--children with elevated insulin and apo B
--adults with elevated insulin and apo B (and this is much more toxic for women for some reason than men)
--women after menopause, esp if no hormone replacement occurs

Can we avoid the dangers of running with scissors (or chopsticks)?

I certainly believe so. (Heed the words of your mother)

Let's keep running... wild and free... until we melt with the sun...

Lp(a): PPAR-Delta... Dagger in the Heart of Lp(a) (Part II) coming soon...


Dr. William Davis said...


You never cease to amaze me: You have a real talent for honing in on the crucial questions, carving away the fat, and getting to the meat of the issue.

You've provided an eloquent (if edgy!) insight into this thing called Lp(a).

Dr. B G said...

Thank you Dr. 'D'!

The future piece will be one of the most 'speculative' posts... b/c there's such a paucity of medical science on Lp(a)!


Anonymous said...

I have *many* papers on LP(a) and this is one of the most informative things I've read on the subject.

Dr. B G said...


And you always have the best sources and amazing insights! Let's compare notes...