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Metabolism of Lp(a)
| Plasma concentration determined chiefly by rate of hepatic synthesis of apo(a) |
| Catabolized primarily by hepatic and renal pathways, however they do not govern plasma Lp(a) levels |
| Apo(a) genotype, which governs the synthetic rate & size of apo(a), accounts for 90% of plasma concentration |
| Hepatic secretion lower for large apo(a) isoforms & since most individuals are heterozygous for two different isoforms, so typically the smallest isoform dominates in plasma |
