Lipoprotein(a)

UK laboratories print a variety of upper limits, commonly 75 or 90 nmol/L. Older reports print mg/dL, and the conversion to nmol/L is only approximate because it depends on the size of the particle and on the method used.

Lipoprotein(a) is a particle similar to LDL cholesterol but with an extra protein attached. The level is set mainly by the genes a person inherits and stays much the same throughout adult life, so it is usually measured only once. Lifestyle changes and standard cholesterol medicines have little effect on it.

Doctors request it, usually once, where there is a family pattern of early heart disease or stroke, or to add detail to a standard lipid profile. UK guidance suggests measuring it at least once in adults with a strong family history.

• Inherited variation, which accounts for most of the difference between people
• An underactive thyroid
• Kidney disease, particularly with protein loss in the urine
• The menopause, in the general population

• An overactive thyroid
• Some newer lipid medicines, such as PCSK9 inhibitors, lower it modestly
• Severe liver disease

• The number depends on the method: nmol/L and mg/dL figures from different labs are not directly comparable
• It rises for a few weeks after an acute illness or inflammation

No fasting needed. Because the level is largely inherited and stable, a single result is usually enough and repeat testing adds little.

Written by a UK consultant physician. Typical UK adult reference ranges; your laboratory's own printed range takes precedence.