Explain the Role of Lipoprotein ?
As discussed in the previous section, serum concentrations of Lp(a) are elevated in South Asians irrespective of their migrant status. Several studies have documented this elevation in Lp(a) levels in people of Indian origin when compared to other ethnic groups. Higher levels of Lp(a) have been associated with CAD especially if the is concoinitant elevations of LDL levels.
Levels of Lp(a) are largely genetically determined and genetic factors account for over 70 per cent of the variations in the Lp(a) levels in the population. This suggests the basis for a genetic predisposition to CAD among populations with elevated Lp(a) levels and concomitantly raised LDL levels. Proposed mechanisms of atherogenesis by Lp(a) include preferential uptake of Lp(a) into macrophages in atherosclerotic plaaues via binding to fibrin and plasminogen receptors. Because of the structural similarity between Lp(a) and plasminogen, it has also been suggested that the former interferes with plasminogen activation and creates a thrombogenic milieu.