Lp(a) Metabolism

Lp(a) is an LDL-like lipoprotein of unknown function that is found in a wide range of concentrations in plasma among individuals. In the years since its discovery over 60 years ago much has been learned about the metabolism of Lp(a). It has been found that the production rate of the apo(a) component of Lp(a) is the major factor that determines the Lp(a) concentration in plasma, something that is largely under genetic control. The factors that control the clearance of Lp(a) are poorly understood and there is evidence supporting the concept that Lp(a) clearance is mediated through multiple receptor pathways rather than predominantly through a single pathway as occurs for LDL. This chapter highlights the factors that are thought to control Lp(a) production and clearance as well as the effects of lipid altering drugs on Lp(a) metabolism.