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American Journal of Human Genetics logoLink to American Journal of Human Genetics
. 1995 Jan;56(1):287–293.

Genetic variation in lipoprotein (a) levels in families enriched for coronary artery disease is determined almost entirely by the apolipoprotein (a) gene locus.

C A DeMeester 1, X Bu 1, R J Gray 1, A J Lusis 1, J I Rotter 1
PMCID: PMC1801290  PMID: 7825589

Abstract

Lipoprotein (a) (Lp[a]) is a cholesterol-rich lipoprotein resembling LDL but also containing a large polypeptide designated apolipoprotein (a) (apo[a]). Its levels are highly variable among individuals and, in a number of studies, are strongly correlated with the risk of coronary artery disease (CAD). In an effort to determine which genes control Lp(a) levels, we have studied 25 multiplex families (comprising 298 members) enriched for CAD. The apo(a) gene was genotyped among the families, using a highly informative pulse-field gel electrophoresis procedure. In addition, polymorphisms of the gene for the other major protein of Lp(a), apolipoprotein B (apoB), were examined. Quantitative sib-pair linkage analysis indicates that apo(a) is the major gene controlling Lp(a) levels in this CAD population (P = .001; 99 sib pairs), whereas the apoB gene demonstrated no significant quantitative linkage effect. We estimate that the apo(a) locus accounts for < or = 98% of variance of Lp(a) serum levels. Approximately 43% of this variation is explained by size polymorphisms within the apo(a) gene. These results indicate that the apo(a) gene is the major determinant of Lp(a) serum levels not only in the general population but also in a high-risk CAD population.

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  1. Albers J. J., Wahl P., Hazzard W. R. Quantitative genetic studies of the human plasma Lp(a) lipoprotein. Biochem Genet. 1974 Jun;11(6):475–486. doi: 10.1007/BF00486079. [DOI] [PubMed] [Google Scholar]
  2. Amos C. I., Elston R. C. Robust methods for the detection of genetic linkage for quantitative data from pedigrees. Genet Epidemiol. 1989;6(2):349–360. doi: 10.1002/gepi.1370060205. [DOI] [PubMed] [Google Scholar]
  3. Anderson M. A., Gusella J. F. Use of cyclosporin A in establishing Epstein-Barr virus-transformed human lymphoblastoid cell lines. In Vitro. 1984 Nov;20(11):856–858. doi: 10.1007/BF02619631. [DOI] [PubMed] [Google Scholar]
  4. Austin M. A., Sandholzer C., Selby J. V., Newman B., Krauss R. M., Utermann G. Lipoprotein(a) in women twins: heritability and relationship to apolipoprotein(a) phenotypes. Am J Hum Genet. 1992 Oct;51(4):829–840. [PMC free article] [PubMed] [Google Scholar]
  5. Azrolan N., Gavish D., Breslow J. L. Plasma lipoprotein(a) concentration is controlled by apolipoprotein(a) (apo(a)) protein size and the abundance of hepatic apo(a) mRNA in a cynomolgus monkey model. J Biol Chem. 1991 Jul 25;266(21):13866–13872. [PubMed] [Google Scholar]
  6. Berg K., Dahlén G., Frick M. H. Lp(a) lipoprotein and pre-beta1-lipoprotein in patients with coronary heart disease. Clin Genet. 1974;6(3):230–235. doi: 10.1111/j.1399-0004.1974.tb00657.x. [DOI] [PubMed] [Google Scholar]
  7. Boerwinkle E., Leffert C. C., Lin J., Lackner C., Chiesa G., Hobbs H. H. Apolipoprotein(a) gene accounts for greater than 90% of the variation in plasma lipoprotein(a) concentrations. J Clin Invest. 1992 Jul;90(1):52–60. doi: 10.1172/JCI115855. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Boerwinkle E., Menzel H. J., Kraft H. G., Utermann G. Genetics of the quantitative Lp(a) lipoprotein trait. III. Contribution of Lp(a) glycoprotein phenotypes to normal lipid variation. Hum Genet. 1989 Apr;82(1):73–78. doi: 10.1007/BF00288277. [DOI] [PubMed] [Google Scholar]
  9. Boerwinkle E., Xiong W. J., Fourest E., Chan L. Rapid typing of tandemly repeated hypervariable loci by the polymerase chain reaction: application to the apolipoprotein B 3' hypervariable region. Proc Natl Acad Sci U S A. 1989 Jan;86(1):212–216. doi: 10.1073/pnas.86.1.212. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Cohen J. C., Chiesa G., Hobbs H. H. Sequence polymorphisms in the apolipoprotein (a) gene. Evidence for dissociation between apolipoprotein(a) size and plasma lipoprotein(a) levels. J Clin Invest. 1993 Apr;91(4):1630–1636. doi: 10.1172/JCI116370. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Coresh J., Beaty T. H., Kwiterovich P. O., Jr, Antonarakis S. E. Pedigree and sib-pair linkage analysis suggest the apolipoprotein B gene is not the major gene influencing plasma apolipoprotein B levels. Am J Hum Genet. 1992 May;50(5):1038–1045. [PMC free article] [PubMed] [Google Scholar]
  12. Dahlén G., Berg K., Frick M. H. Lp(a) lipoprotein/pre-beta1-lipoprotein, serum lipids and atherosclerotic disease. Clin Genet. 1976 Jun;9(6):558–566. doi: 10.1111/j.1399-0004.1976.tb01613.x. [DOI] [PubMed] [Google Scholar]
  13. Drayna D. T., Hegele R. A., Hass P. E., Emi M., Wu L. L., Eaton D. L., Lawn R. M., Williams R. R., White R. L., Lalouel J. M. Genetic linkage between lipoprotein(a) phenotype and a DNA polymorphism in the plasminogen gene. Genomics. 1988 Oct;3(3):230–236. doi: 10.1016/0888-7543(88)90084-5. [DOI] [PubMed] [Google Scholar]
  14. Etingin O. R., Hajjar D. P., Hajjar K. A., Harpel P. C., Nachman R. L. Lipoprotein (a) regulates plasminogen activator inhibitor-1 expression in endothelial cells. A potential mechanism in thrombogenesis. J Biol Chem. 1991 Feb 5;266(4):2459–2465. [PubMed] [Google Scholar]
  15. Fless G. M., Rolih C. A., Scanu A. M. Heterogeneity of human plasma lipoprotein (a). Isolation and characterization of the lipoprotein subspecies and their apoproteins. J Biol Chem. 1984 Sep 25;259(18):11470–11478. [PubMed] [Google Scholar]
  16. Frank S. L., Klisak I., Sparkes R. S., Mohandas T., Tomlinson J. E., McLean J. W., Lawn R. M., Lusis A. J. The apolipoprotein(a) gene resides on human chromosome 6q26-27, in close proximity to the homologous gene for plasminogen. Hum Genet. 1988 Aug;79(4):352–356. doi: 10.1007/BF00282175. [DOI] [PubMed] [Google Scholar]
  17. Frick M. H., Dahlén G., Berg K., Valle M., Hekali P. Serum lipids in angiographically assessed coronary atherosclerosis. Chest. 1978 Jan;73(1):62–65. doi: 10.1378/chest.73.1.62. [DOI] [PubMed] [Google Scholar]
  18. Gaubatz J. W., Heideman C., Gotto A. M., Jr, Morrisett J. D., Dahlen G. H. Human plasma lipoprotein [a]. Structural properties. J Biol Chem. 1983 Apr 10;258(7):4582–4589. [PubMed] [Google Scholar]
  19. Harpel P. C., Chang V. T., Borth W. Homocysteine and other sulfhydryl compounds enhance the binding of lipoprotein(a) to fibrin: a potential biochemical link between thrombosis, atherogenesis, and sulfhydryl compound metabolism. Proc Natl Acad Sci U S A. 1992 Nov 1;89(21):10193–10197. doi: 10.1073/pnas.89.21.10193. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Haseman J. K., Elston R. C. The investigation of linkage between a quantitative trait and a marker locus. Behav Genet. 1972 Mar;2(1):3–19. doi: 10.1007/BF01066731. [DOI] [PubMed] [Google Scholar]
  21. Hixson J. E., Britten M. L., Manis G. S., Rainwater D. L. Apolipoprotein(a) (Apo(a)) glycoprotein isoforms result from size differences in Apo(a) mRNA in baboons. J Biol Chem. 1989 Apr 15;264(11):6013–6016. [PubMed] [Google Scholar]
  22. Kamboh M. I., Ferrell R. E., Kottke B. A. Expressed hypervariable polymorphism of apolipoprotein (a). Am J Hum Genet. 1991 Nov;49(5):1063–1074. [PMC free article] [PubMed] [Google Scholar]
  23. Kondo I., Berg K. Inherited quantitative DNA variation in the LPA ("apolipoprotein (a)") gene. Clin Genet. 1990 Feb;37(2):132–140. doi: 10.1111/j.1399-0004.1990.tb03490.x. [DOI] [PubMed] [Google Scholar]
  24. Kraft H. G., Köchl S., Menzel H. J., Sandholzer C., Utermann G. The apolipoprotein (a) gene: a transcribed hypervariable locus controlling plasma lipoprotein (a) concentration. Hum Genet. 1992 Nov;90(3):220–230. doi: 10.1007/BF00220066. [DOI] [PubMed] [Google Scholar]
  25. Kraft H. G., Menzel H. J., Hoppichler F., Vogel W., Utermann G. Changes of genetic apolipoprotein phenotypes caused by liver transplantation. Implications for apolipoprotein synthesis. J Clin Invest. 1989 Jan;83(1):137–142. doi: 10.1172/JCI113849. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Lackner C., Cohen J. C., Hobbs H. H. Molecular definition of the extreme size polymorphism in apolipoprotein(a). Hum Mol Genet. 1993 Jul;2(7):933–940. doi: 10.1093/hmg/2.7.933. [DOI] [PubMed] [Google Scholar]
  27. Lawn R. M. Lipoprotein(a) in heart disease. Sci Am. 1992 Jun;266(6):54–60. doi: 10.1038/scientificamerican0692-54. [DOI] [PubMed] [Google Scholar]
  28. Lindahl G., Gersdorf E., Menzel H. J., Duba C., Cleve H., Humphries S., Utermann G. The gene for the Lp(a)-specific glycoprotein is closely linked to the gene for plasminogen on chromosome 6. Hum Genet. 1989 Jan;81(2):149–152. doi: 10.1007/BF00293891. [DOI] [PubMed] [Google Scholar]
  29. Lindahl G., Gersdorf E., Menzel H. J., Seed M., Humphries S., Utermann G. Variation in the size of human apolipoprotein(a) is due to a hypervariable region in the gene. Hum Genet. 1990 May;84(6):563–567. doi: 10.1007/BF00210810. [DOI] [PubMed] [Google Scholar]
  30. Loscalzo J. Lipoprotein(a). A unique risk factor for atherothrombotic disease. Arteriosclerosis. 1990 Sep-Oct;10(5):672–679. doi: 10.1161/01.atv.10.5.672. [DOI] [PubMed] [Google Scholar]
  31. McLean J. W., Tomlinson J. E., Kuang W. J., Eaton D. L., Chen E. Y., Fless G. M., Scanu A. M., Lawn R. M. cDNA sequence of human apolipoprotein(a) is homologous to plasminogen. Nature. 1987 Nov 12;330(6144):132–137. doi: 10.1038/330132a0. [DOI] [PubMed] [Google Scholar]
  32. Miles L. A., Plow E. F. Lp(a): an interloper into the fibrinolytic system? Thromb Haemost. 1990 Jun 28;63(3):331–335. [PubMed] [Google Scholar]
  33. Miller G., Lipman M. Release of infectious Epstein-Barr virus by transformed marmoset leukocytes. Proc Natl Acad Sci U S A. 1973 Jan;70(1):190–194. doi: 10.1073/pnas.70.1.190. [DOI] [PMC free article] [PubMed] [Google Scholar]
  34. Nakano K., Swindle M. M., Spinale F., Ishihara K., Kanazawa S., Smith A., Biederman R. W., Clamp L., Hamada Y., Zile M. R. Depressed contractile function due to canine mitral regurgitation improves after correction of the volume overload. J Clin Invest. 1991 Jun;87(6):2077–2086. doi: 10.1172/JCI115238. [DOI] [PMC free article] [PubMed] [Google Scholar]
  35. Perombelon Y. F., Soutar A. K., Knight B. L. Variation in lipoprotein(a) concentration associated with different apolipoprotein(a) alleles. J Clin Invest. 1994 Apr;93(4):1481–1492. doi: 10.1172/JCI117126. [DOI] [PMC free article] [PubMed] [Google Scholar]
  36. Pressman S., Rotter J. I. Epstein-Barr virus transformation of cryopreserved lymphocytes: prolonged experience with technique. Am J Hum Genet. 1991 Aug;49(2):467–467. [PMC free article] [PubMed] [Google Scholar]
  37. Rader D. J., Cain W., Zech L. A., Usher D., Brewer H. B., Jr Variation in lipoprotein(a) concentrations among individuals with the same apolipoprotein (a) isoform is determined by the rate of lipoprotein(a) production. J Clin Invest. 1993 Feb;91(2):443–447. doi: 10.1172/JCI116221. [DOI] [PMC free article] [PubMed] [Google Scholar]
  38. Rainwater D. L., Manis G. S., VandeBerg J. L. Hereditary and dietary effects on apolipoprotein[a] isoforms and Lp[a] in baboons. J Lipid Res. 1989 Apr;30(4):549–558. [PubMed] [Google Scholar]
  39. Rhoads G. G., Dahlen G., Berg K., Morton N. E., Dannenberg A. L. Lp(a) lipoprotein as a risk factor for myocardial infarction. JAMA. 1986 Nov 14;256(18):2540–2544. [PubMed] [Google Scholar]
  40. Ridker P. M., Hennekens C. H., Stampfer M. J. A prospective study of lipoprotein(a) and the risk of myocardial infarction. JAMA. 1993 Nov 10;270(18):2195–2199. [PubMed] [Google Scholar]
  41. Sandholzer C., Boerwinkle E., Saha N., Tong M. C., Utermann G. Apolipoprotein(a) phenotypes, Lp(a) concentration and plasma lipid levels in relation to coronary heart disease in a Chinese population: evidence for the role of the apo(a) gene in coronary heart disease. J Clin Invest. 1992 Mar;89(3):1040–1046. doi: 10.1172/JCI115645. [DOI] [PMC free article] [PubMed] [Google Scholar]
  42. Sandholzer C., Saha N., Kark J. D., Rees A., Jaross W., Dieplinger H., Hoppichler F., Boerwinkle E., Utermann G. Apo(a) isoforms predict risk for coronary heart disease. A study in six populations. Arterioscler Thromb. 1992 Oct;12(10):1214–1226. doi: 10.1161/01.atv.12.10.1214. [DOI] [PubMed] [Google Scholar]
  43. Scanu A. M., Fless G. M. Lipoprotein (a). Heterogeneity and biological relevance. J Clin Invest. 1990 Jun;85(6):1709–1715. doi: 10.1172/JCI114625. [DOI] [PMC free article] [PubMed] [Google Scholar]
  44. Scanu A. M. Lipoprotein(a). A genetic risk factor for premature coronary heart disease. JAMA. 1992 Jun 24;267(24):3326–3329. doi: 10.1001/jama.267.24.3326. [DOI] [PubMed] [Google Scholar]
  45. Schriewer H., Assmann G., Sandkamp M., Schulte H. The relationship of lipoprotein (a) (Lp(a)) to risk factors of coronary heart disease: initial results of the prospective epidemiological study on company employees in Westfalia. J Clin Chem Clin Biochem. 1984 Sep;22(9):591–596. doi: 10.1515/cclm.1984.22.9.591. [DOI] [PubMed] [Google Scholar]
  46. Utermann G., Duba C., Menzel H. J. Genetics of the quantitative Lp(a) lipoprotein trait. II. Inheritance of Lp(a) glycoprotein phenotypes. Hum Genet. 1988 Jan;78(1):47–50. doi: 10.1007/BF00291233. [DOI] [PubMed] [Google Scholar]
  47. Utermann G., Kraft H. G., Menzel H. J., Hopferwieser T., Seitz C. Genetics of the quantitative Lp(a) lipoprotein trait. I. Relation of LP(a) glycoprotein phenotypes to Lp(a) lipoprotein concentrations in plasma. Hum Genet. 1988 Jan;78(1):41–46. doi: 10.1007/BF00291232. [DOI] [PubMed] [Google Scholar]
  48. Utermann G. The mysteries of lipoprotein(a). Science. 1989 Nov 17;246(4932):904–910. doi: 10.1126/science.2530631. [DOI] [PubMed] [Google Scholar]
  49. Utermann G., Weber W. Protein composition of Lp(a) lipoprotein from human plasma. FEBS Lett. 1983 Apr 18;154(2):357–361. doi: 10.1016/0014-5793(83)80182-3. [DOI] [PubMed] [Google Scholar]
  50. Wade D. P., Clarke J. G., Lindahl G. E., Liu A. C., Zysow B. R., Meer K., Schwartz K., Lawn R. M. 5' control regions of the apolipoprotein(a) gene and members of the related plasminogen gene family. Proc Natl Acad Sci U S A. 1993 Feb 15;90(4):1369–1373. doi: 10.1073/pnas.90.4.1369. [DOI] [PMC free article] [PubMed] [Google Scholar]

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