Lipoprotein(a) in Disaggregated South Asian Groups: An Analysis of MASALA and the UK Biobank.
11 affiliations
- 1Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California, USA.
- 2University of California-San Diego School of Medicine, La Jolla, California, USA.
- 3Department of Medicine, University of California, San Francisco, California, USA.
- 4Division of Cardiovascular Medicine, University of California-San Diego Health, La Jolla, California, USA.
- 5Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota, USA.
- 6Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
- 7Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA.
- 8Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
- 9Baylor Scott & White Health, The Heart Hospital, Plano, Texas, USA.
- 10Division of Cardiovascular Medicine, University of Louisville School of Medicine, Kentucky, USA.
- 11Division of Cardiovascular Medicine, University of California-San Diego Health, La Jolla, California, USA. Electronic address: [email protected].
Abstract
Background
South Asian individuals have a high prevalence of elevated lipoprotein(a) [Lp(a)], but little is known about the variation between disaggregated South Asian subgroups.Objectives
The authors aimed to evaluate Lp(a) levels, nongenetic influences, and the association with incident atherosclerotic cardiovascular disease (ASCVD) in South Asian populations using data from the Meditators of Atherosclerosis in South Asians Living in America (MASALA) and the UK Biobank (UKB) studies.Methods
Lp(a) levels were assessed by South Asian country of origin and by state among Indian-origin participants. The association between nongenetic factors and Lp(a) levels was evaluated in multivariable linear regression models. Cox proportional hazards models evaluated the association between Lp(a) and ASCVD events in UKB participants.Results
Among 2,074 MASALA participants born in the South Asian subcontinent (mean age: 56.7 ± 9.6 years), median [Q1-Q3] Lp(a) was 20.7 [10.5-43.0] mg/dL with significant variation by country of origin (P = 0.035). Median Lp(a) was 23 [11-48], 19 [10-37], 22 [11-47], and 17 [10-34] mg/dL in participants from Bangladesh, India, Pakistan, and Sri Lanka, respectively. Vegetarian diet, statin use, postmenopausal status, and fewer years in the United States were associated with higher Lp(a) levels while alcohol consumption was associated with lower Lp(a) levels. However, these associations were all very modest. Among 6,845 UKB participants (mean age: 55.1 ± 8.7 years; median Lp(a): 31 [13-65] nmol/L), the associations between Lp(a) and ASCVD did not vary by country of origin or South Asian ethnicity (P interaction > 0.05).Conclusions
There is modest variation in Lp(a) levels, but no difference in the association between Lp(a) and ASCVD outcomes, across South Asian subgroups.
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BibTeX
@article{bal2026lipoproteina,
title = {{Lipoprotein(a) in Disaggregated South Asian Groups: An Analysis of MASALA and the UK Biobank.}},
author = {Kavenpreet S Bal and Mikaila P Reyes and Alka M Kanaya and Pam Taub and Michael Y Tsai and Namratha R Kandula and Nadia Islam and Michael J Wilkinson and Mattheus Ramsis and Ehtisham Mahmud and Nilay S Shah and Anandita Kulkarni and Dinesh Kalra and Harpreet S Bhatia},
journal = {JACC. Advances},
year = {2026},
month = oct,
doi = {10.1016/j.jacadv.2026.103329},
url = {https://europepmc.org/article/MED/42868967},
note = {CC BY},
}
RIS
TY - JOUR
TI - Lipoprotein(a) in Disaggregated South Asian Groups: An Analysis of MASALA and the UK Biobank.
AU - Kavenpreet S Bal
AU - Mikaila P Reyes
AU - Alka M Kanaya
AU - Pam Taub
AU - Michael Y Tsai
AU - Namratha R Kandula
AU - Nadia Islam
AU - Michael J Wilkinson
AU - Mattheus Ramsis
AU - Ehtisham Mahmud
AU - Nilay S Shah
AU - Anandita Kulkarni
AU - Dinesh Kalra
AU - Harpreet S Bhatia
PY - 2026
DA - 2026/10/13
JO - JACC. Advances
DO - 10.1016/j.jacadv.2026.103329
UR - https://europepmc.org/article/MED/42868967
AB - Background South Asian individuals have a high prevalence of elevated lipoprotein(a) [Lp(a)], but little is known about the variation between disaggregated South Asian subgroups.Objectives The authors aimed to evaluate Lp(a) levels, nongenetic influences, and the association with incident atherosclerotic cardiovascular disease (ASCVD) in South Asian populations using data from the Meditators of Atherosclerosis in South Asians Living in America (MASALA) and the UK Biobank (UKB) studies.Methods Lp(a) levels were assessed by South Asian country of origin and by state among Indian-origin participants. The association between nongenetic factors and Lp(a) levels was evaluated in multivariable linear regression models. Cox proportional hazards models evaluated the association between Lp(a) and ASCVD events in UKB participants.Results Among 2,074 MASALA participants born in the South Asian subcontinent (mean age: 56.7 ± 9.6 years), median [Q1-Q3] Lp(a) was 20.7 [10.5-43.0] mg/dL with significant variation by country of origin (P = 0.035). Median Lp(a) was 23 [11-48], 19 [10-37], 22 [11-47], and 17 [10-34] mg/dL in participants from Bangladesh, India, Pakistan, and Sri Lanka, respectively. Vegetarian diet, statin use, postmenopausal status, and fewer years in the United States were associated with higher Lp(a) levels while alcohol consumption was associated with lower Lp(a) levels. However, these associations were all very modest. Among 6,845 UKB participants (mean age: 55.1 ± 8.7 years; median Lp(a): 31 [13-65] nmol/L), the associations between Lp(a) and ASCVD did not vary by country of origin or South Asian ethnicity (P interaction > 0.05).Conclusions There is modest variation in Lp(a) levels, but no difference in the association between Lp(a) and ASCVD outcomes, across South Asian subgroups.
SN - 2772-963X
ER -