Recent research has demonstrated that the major site of apolipoprotein(a) synthesis, the characteristic protein of lipoprotein(a) (Lp(a)), is the liver and that patients affected by liver cirrhosis have low serum concentrations of Lp(a). Nevertheless, it is still not clear whether Lp(a) behaviour in these patients is related to reduced hepatic protein synthesis, or to decreased serum lipid levels or to both these conditions. In order to investigate further the behaviour of Lp(a) and, in particular, its relationship with some indices of blood lipids and coagulation, 30 patients affected by liver cirrhosis have been studied. Significantly low serum values of Lp(a) were observed in patients with more severe hepatic injury included in classes B and C according to the Child-Pugh score. Lipoprotein(a) was directly correlated with prothrombin plasma activity and with apolipoprotein B-100 and albumin concentrations in serum. This study confirms low serum levels of Lp(a) in cirrhotic patients and suggests that its decrease could be partly due to impaired liver protein synthesis.
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