Relationship between Lipoprotein(a) and Lung Function assessed in Community-Dwelling Older Adults: Longitudinal and Cross-Sectional Analyses

Abstract Background: Lipoprotein(a) [Lp(a)] has recently been gaining increasing interest, with numerous studies pointing to a causal relationship with cardiovascular disease, coronary heart disease, as well as aortic valve stenosis. However, so far only a few studies have assessed the association between Lp(a) and pulmonary health and there have been some inconsistent findings regarding this topic. This study’s aim is to examine whether high level of serum Lp(a) is associated with better lung function in a dataset of relatively healthy older women and men in a sex-specific manner. Methods: We used the longitudinal data collected at two time points 7.4 ±1.5 years apart from 679 participants (52% females, 68 [65-71] years old) in the Berlin Aging Study II (BASE-II). Several lipid parameters, including Lp(a), and lung function were measured in these subjects as part of a comprehensive medical assessment. The baseline dataset was collected between 2009 to 2014, and the follow-up data were collected between 2018 and 2020. Multiple linear regression models adjusting for covariates (BMI, physical inactivity, smoking status, alcohol intake, and a morbidity index) were applied to strengthen evidence for the relationship observed between Lp(a) and lung function in a sex-specific manner. Results: Forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) were higher in men and declined with age in both sexes. Men had lower Lp(a) levels than women. Average lung function measurements were higher in both men and women with higher Lp(a) levels. However, this association was statistically apparent in men only. Conclusions: The data suggest that Lp(a) might act as a protective and possibly sex specific factor in pulmonary health, a putative role which has not been anticipated so far. Future studies will be required to further establish the relationship between Lp(a) and lung function also with regard to possible causality and sex differences, as well as to further investigate the exact function Lp(a) plays in lung physiology.