Background:
Lipoprotein (a) (Lp [a]) is associated with premature
atherosclerosis in menopausal women without
metabolic syndrome (MS). MS is the main confounder in the relationship between Lp(a) and
atherosclerosis in menopausal women. We have evaluated the relationship between Lp(a) and small dense-
low density lipoprotein (sd-
LDL) in 228 menopausal women participating to Progetto Atena. Methods: Lp(a) was measured and
LDL particle separation was performed: mean
LDL diameter and
LDL score (% of sd-
LDL) particles calculated. Results: Women without MS and elevated Lp(a) have increased number of sd-
LDL (p < .05) and higher
LDL score compared with those below the median of the studied population (p < .05). The association between Lp(a) and sd-
LDL was evaluated taking into account different adjustment models. Women with elevated levels of Lp(a) show the following OR of having a small
LDL diameter (in the lowest quartile): 1.02, p = .003; adjusted for age; 1.02, p = .002; adjusted for age, and
triglycerides, or a high
LDL score (in the highest quartile): 1.02, p = .006; adjusted for age; 1.02, p = .002; adjusted for age and
triglycerides. Conclusions: In this group of menopausal women without MS, the independent association of Lp(a) with sd-
LDL might explain at least in part the association of Lp(a) with premature
atherosclerosis.