Lipoprotein(a) Distribution and Cardiovascular Risk in Japan: Insights from a Multi-center LEAP Study
Abstract
AIM: Although lipoprotein(a) [Lp(a)] is recognized as an independent risk factor for cardiovascular disease (CVD), its distribution and risk thresholds in the Japanese population remain unclear. This study aimed to characterize the distribution of Lp(a) in Japanese clinical settings and evaluate its association with CVD risk, including coronary artery disease (CAD), atherosclerotic cardiovascular disease (ASCVD), and familial hypercholesterolemia (FH). METHODS: The LEAP study is a multicenter retrospective cohort analysis of 6,173 patients from six Japanese institutions. The Lp(a) values were harmonized to nmol/L using kit-specific conversion equations, enabling a consistent analysis across different immunoassays. Associations with CAD, ASCVD, chronic kidney disease (CKD), diabetes mellitus (DM), and FH were assessed. The risk thresholds were defined using a receiver operating characteristic analysis. RESULTS: The median Lp(a) concentration was 20.88 nmol/L, with a right-skewed distribution. Elevated Lp(a) levels were significantly associated with CAD, ASCVD, CKD, and FH. In contrast, DM was related to lower Lp(a). An ROC analysis identified 25 nmol/L as a screening threshold and 125 nmol/L as a high-risk boundary. The CAD prevalence increased stepwise across these categories: 20.2% (≤ 25 nmol/L), 30.3% (25-125 nmol/L), and 39.9% (＞125 nmol/L). CONCLUSION: This study provides the first nmol/L-standardized Lp(a) distribution in Japanese patients and proposes provisional thresholds for clinical risk stratification.
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BibTeX
@article{yamada2026lipoproteina,
title = {{Lipoprotein(a) Distribution and Cardiovascular Risk in Japan: Insights from a Multi-center LEAP Study}},
author = {Tomoaki Yamada and Hayato Tada and Masatsune Ogura and Sayaka Funabashi and Hiroshi Yoshida and Chika Hiraishi and Takae Ebihara and Takahiro Hadano and Takahiro Masaki and Yasuaki Takeji and Kazumi Fukatsu and Makiko Egawa and Yu Kataoka and Masahito Michikura and Daisuke Shishikura and Shimpei Fujioka and Tetsuo Sasano and Taketoshi Maehara and Masumi Ai and Mariko Shiba-Harada and Masayuki Yoshida},
journal = {Journal of Atherosclerosis and Thrombosis},
year = {2026},
month = aug,
doi = {10.5551/jat.66185},
url = {https://www.jstage.jst.go.jp/article/jat/33/8/33_66185/_article},
note = {CC BY-NC-SA},
}
RIS
TY - JOUR
TI - Lipoprotein(a) Distribution and Cardiovascular Risk in Japan: Insights from a Multi-center LEAP Study
AU - Tomoaki Yamada
AU - Hayato Tada
AU - Masatsune Ogura
AU - Sayaka Funabashi
AU - Hiroshi Yoshida
AU - Chika Hiraishi
AU - Takae Ebihara
AU - Takahiro Hadano
AU - Takahiro Masaki
AU - Yasuaki Takeji
AU - Kazumi Fukatsu
AU - Makiko Egawa
AU - Yu Kataoka
AU - Masahito Michikura
AU - Daisuke Shishikura
AU - Shimpei Fujioka
AU - Tetsuo Sasano
AU - Taketoshi Maehara
AU - Masumi Ai
AU - Mariko Shiba-Harada
AU - Masayuki Yoshida
PY - 2026
DA - 2026/08/01
JO - Journal of Atherosclerosis and Thrombosis
DO - 10.5551/jat.66185
UR - https://www.jstage.jst.go.jp/article/jat/33/8/33_66185/_article
AB - AIM: Although lipoprotein(a) [Lp(a)] is recognized as an independent risk factor for cardiovascular disease (CVD), its distribution and risk thresholds in the Japanese population remain unclear. This study aimed to characterize the distribution of Lp(a) in Japanese clinical settings and evaluate its association with CVD risk, including coronary artery disease (CAD), atherosclerotic cardiovascular disease (ASCVD), and familial hypercholesterolemia (FH). METHODS: The LEAP study is a multicenter retrospective cohort analysis of 6,173 patients from six Japanese institutions. The Lp(a) values were harmonized to nmol/L using kit-specific conversion equations, enabling a consistent analysis across different immunoassays. Associations with CAD, ASCVD, chronic kidney disease (CKD), diabetes mellitus (DM), and FH were assessed. The risk thresholds were defined using a receiver operating characteristic analysis. RESULTS: The median Lp(a) concentration was 20.88 nmol/L, with a right-skewed distribution. Elevated Lp(a) levels were significantly associated with CAD, ASCVD, CKD, and FH. In contrast, DM was related to lower Lp(a). An ROC analysis identified 25 nmol/L as a screening threshold and 125 nmol/L as a high-risk boundary. The CAD prevalence increased stepwise across these categories: 20.2% (≤ 25 nmol/L), 30.3% (25-125 nmol/L), and 39.9% (＞125 nmol/L). CONCLUSION: This study provides the first nmol/L-standardized Lp(a) distribution in Japanese patients and proposes provisional thresholds for clinical risk stratification.
SN - 1880-3873
SN - 1340-3478
ER -