Associations between elevated lipoprotein(a) and clinical characteristics: sex-specific differences in Polish patients

Introduction Lipoprotein(a) (Lp[a]) is a highly atherogenic variant of low-density lipoprotein, which is an independent causal risk factor for atherosclerotic cardiovascular disease.Sex-based differences regarding Lp(a) are incompletely characterized. AimWe aimed to assess sex-specific differences in the associations between elevated lipoprotein(a) and clinical characteristics in Polish patients. MethodsIn this observational, cross-sectional study, we included consecutive patients hospitalized between March 1st, 2024 and October 8th, 2024 in the Clinical Department of Internal Medicine, Endocrinology, Diabetology, and Nephrology of our hospital.The threshold of 30 mg/dL was used to divide patients into high ( 30 mg/dL) and low (<30 mg/dL) Lp(a) groups.In the exploratory analysis, we defined within-sex differences between high and low Lp(a) groups.In the confirmatory stage, we assessed the interaction between sex and Lp(a) group for variables identified in the exploratory phase. ResultsAmong 367 women and 195 men included in the analysis, high Lp(a) was noted in 84 (22.9%) women and 33 men (16.9%).In the exploratory phase, we found withinsex differences for numerous clinical and echocardiographic parameters.In the confirmatory phase, a significant Lp(a) group -sex interaction was found for prior PCI (interaction OR 0.14; 95% CI 0.02-0.93;P = 0.04) and for SGLT2i use (interaction OR 3.82; 95% CI 1.15-13.28;P = 0.03). ConclusionsWe found two sex-specific associations between Lp(a) and clinical characteristics.Given the cross-sectional exploratory character of this analysis, our findings should be interpreted with caution.