Lipoprotein[a] and the lipid profile in patients with systemic sclerosis.

BACKGROUND: Systemic sclerosis (SSc) is an autoimmune disorder of the connective tissue characterized by widespread vascular lesions and fibrosis, associated with endothelial dysfunction, that might finally promote occlusive vascular complications. Little is known so far on the lipid profile of these patients. METHODS: To investigate the potential contribution of lipid abnormalities in genesis and progression of vascular occlusive complications, an extensive lipid profile, including total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, total cholesterol to HDL-C ratio, the atherogenic index of plasma, lipoprotein[a] (Lp[a]) and high-sensitive C Reactive Protein (Hs-CRP), was assessed in 31 consecutive female SSc patients and 33 matched healthy controls. RESULTS: When compared to healthy matched controls, SSc patients displayed statistically significant differences in median and 25-75th percentile distribution of Lp[a] (110 mg/l, 51-389 mg/l vs. 79 mg/l, 29-149 mg/l; P =0.005) and in the mean concentration of Hs-CRP (4.49 +/- 5.06 mg/l vs. 1.36 +/- 1.19 mg/l; P =0.001), but not in the other lipid parameters. When compared to the current NCEP or AHA/ACC goals, the values distributions and the relative percentage of patients with undesirable or abnormal vales were statistically different for Lp[a] (29% versus 3%) and Hs-CRP (42% vs. 12%) (both P <0.001). CONCLUSIONS: If further studies will strengthen these preliminary findings, owing to the growing evidence that Lp[a] might act in synergy with other defined prothrombotic conditions in the pathogenesis of a variety of vascular disorders, we hypothesize that Lp[a] measurement might be useful in SSc to identify and eventually treat subsets of patients more predisposed to develop thrombotic complications.