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ObjectiveLipoprotein(a) (Lp(a)) is an important genetically determined risk factor for atherosclerotic vascular disease (ASCVD). With the development of Lp(a)-lowering therapies, this study sought to characterise patterns of Lp(a) levels in a global ASCVD population and identify racial, ethnic, regional and gender differences.MethodsA multicentre cross-sectional epidemiological study to estimate the prevalence of elevated Lp(a) in patients with a history of myocardial infarction, ischaemic stroke or peripheral artery disease conducted at 949 sites in 48 countries in North America, Europe, Asia, South America, South Africa and Australia between April 2019 and July 2021. Low-density lipoprotein cholesterol (LDL-C) and Lp(a) levels were measured either as mass (mg/dL) or molar concentration (nmol/L).ResultsOf 48 135 enrolled patients, 13.9% had prior measurements of Lp(a). Mean age was 62.6 (SD 10.1) years and 25.9% were female. Median Lp(a) was 18.0 mg/dL (IQR 7.9-57.1) or 42.0 nmol/L (IQR 15.0-155.4). Median LDL-C was 77 mg/dL (IQR 58.4-101.0). Lp(a) in women was higher, 22.8 (IQR 9.0-73.0) mg/dL, than in men, 17.0 (IQR 7.1-52.2) mg/dL, p50 mg/dL, 20.7% had levels >70 mg/dL, 12.9% were >90 mg/dL and 26.0% of patients exceeded 150 nmol/L.ConclusionsGlobally, Lp(a) is measured in a small minority of patients with ASCVD and is highest in black, younger and female patients. More than 25% of patients had levels exceeding the established threshold for increased cardiovascular risk, approximately 50 mg/dL or 125 nmol/L.Trial registration number

Additional file 1: Figure S1. Schematic of continuous CSF collection in the free-moving mice in the movement-response rotating cage. The mouse is connected to the sensor-integrated balance arm via a steel wire anchor attached on the skull.

Potential role of hepatocyte growth factor in the maintenance of renal structure: Anti-apoptotic action of HGF on epithelial cells.BackgroundMesangial cells (MC) are known to secrete various vasoactive substances that may control endothelial and epithelial cell growth. Therefore, the cell-cell interactions among these cells may be important in the control of renal function. However, the exact mechanisms of maintaining the cell-cell interactions are not yet understood. We have focused on the role of hepatocyte growth factor (HGF) in the regulation of cell-cell interactions, since HGF has many protective functions in the kidney. To investigate the role of HGF in renal injury, we examined (1) the effects of HGF on epithelial injury induced by serum deprivation, and (2) the role of local HGF production in the maintenance of renal structure.MethodsApoptotic changes in epithelial cells were assessed by nuclear morphology and DNA fragmentation assay. Transfection of human HGF vector into epithelial cells was performed by a highly efficient viral-liposome method. The effects of secreted HGF on the growth of renal cells were examined using a co-culture system.ResultsThe addition of recombinant HGF (rHGF) stimulated the growth of rat and porcine epithelial cells. Moreover, the decrease in number of epithelial cells by serum deprivation was significantly attenuated by rHGF. Interestingly, apoptotic changes in epithelial cells induced by serum deprivation were also significantly attenuated by rHGF (P < 0.01). As a model of gene therapy, the effects of overexpression of human HGF gene in epithelial cells on apoptosis induced by serum deprivation were examined. Transfection of human HGF vector into epithelial cells also attenuated epithelial cell death induced by serum deprivation through the inhibition of apoptosis, accompanied by increased HGF production (P < 0.01). In addition, HGF also prevented endothelial injury induced by tumor necrosis factor-α and dexamethasone. Given the presence of a local HGF system, we measured local HGF secreted from renal cells. Immunoreactive HGF was observed in the conditioned medium of MC, but not epithelial cells, while the specific receptor of HGF, c-met, was expressed in epithelial cells. Of importance, co-culture of MC with epithelial cells resulted in a significant increase in number of epithelial cells, which was significantly abolished by neutralizing anti-HGF antibody.ConclusionsOverall, these results demonstrate that local production of HGF in MC may maintain the growth of epithelial and endothelial cells through its anti-apoptotic action.