EFFECT OF SPONTANEOUS CHANGES IN DIETARY COMPONENTS AND SERUM LIPOPROTEIN(A): DATA FROM THE BRISIGHELLA HEART STUDY

Objective: Serum lipoprotein(a) [Lp(a)] concentration is largely genetically determined and seems to be little affected by diet. The aim of this study was to evaluate the influence of a large number of dietary components on serum Lp(a). Design and method: We evaluated the clinical and laboratory data of 305 overall healthy subjects (M: 163, F:142, age: 18–80) belonging to the historical cohort of the Brisighella Heart Study and consecutively visited during the 2008 and the 2012 epidemiological surveys. By the administration of the “Seven Day Questionnaire” (a validated questionnaire) we estimated, for each subject, the average daily food (micro- and macro-) nutrients intake at the baseline and four years later. A stepwise linear regression was performed using, as independent variables, the variations on the average daily nutrients intake and, as depend variable, the variation in serum Lp(a) recorded over the 4-year period. The correlation was corrected for gender, age and BMI at baseline. Whereas one of the considered variables was non-normal distributed in population, it was transformed by the use of the logarithm function. Results: Between the 2008 and the 2012 the subjects of our cohort had significantly increased the estimated food daily intake of fibers, zinc, vitamin B2 and E and decreased the food intake of proteins (animal and vegetal proteins both), lipids, saturated fatty acids, minerals and phosphorus. In the stepwise linear regression (R2 = 0,138; p = 0,0009), variations in serum Lp(a) directly correlated with variations in the food daily intake of vitamin D [B = 0,319; 95% CI 0,120∼0,518; p = 0,001942] and inversely with those in monounsaturated fatty acids (MUFA) [B = −0,008; 95% CI −0,013 ∼ −0,002; p = 0,0068]. No other investigated dietary components was associated to Lp(a) levels. Conclusions: At the best of our knowledge, this is the first study investigating on a relatively large sample of free-living healthy subjects and with a mildly long follow-up. If our findings will be confirmed in other study-cohorts, we think it is worth it to investigate the presence of a causal relationship between dietetic nutrients and serum Lp(a) concentrations. However, the prognostic significance of our finding remains to be assessed too.