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(Arteriosclerosis, Thrombosis, and Vascular Biology. 1999;19:1075-1082.)
© 1999 American Heart Association, Inc.

Original Contributions

Dose-Dependent Inverse Relationship Between Alcohol Consumption and Serum Lp(a) Levels in Black African Males

Pierre Fontana; Vincent Mooser; Pascal Bovet; Conrad Shamlaye; Bernard Burnand; Vincent Lenain; Santica M. Marcovina; Walter Riesen; Roger Darioli

From the Medical Policlinic (P.F., R.D.), the Institute of Social and Preventive Medicine (P.F., P.B., B.B.), and the Department of Internal Medicine (V.M., V.L.), University of Lausanne, Switzerland; the Unit for Prevention and Control of Cardiovascular Diseases (P.B., C.S.), Ministry of Health, Seychelles; the Northwest Lipid Research Laboratory (S.M.M.), Seattle, Wash; and the Canton Laboratory of Clinical Hematology and Chemistry (W.R.), St-Gallen, Switzerland.

Correspondence to Roger Darioli, MD, Policlinique Médicale Universitaire, César-Roux 19, CH-1005 Lausanne, Switzerland ( E-mail roger.darioli{at}chuv.hospvd.ch) or Vincent Mooser, MD, Department of Internal Medicine, BH 19-135, CH-1011 CHUV Lausanne, Switzerland (

Abstract—Serum or plasma levels of Lp(a) vary widely between individuals and are higher in Africans and their descendants compared with white persons. In whites, high serum levels of Lp(a) are associated with the premature development of atherosclerosis. In both ethnic groups, serum Lp(a) levels are highly genetically determined and only a few environmental or physiological factors, like testosterone or estrogen, have been shown to lower serum Lp(a) levels. In whites, alcohol consumption is associated with lower serum Lp(a) levels. However, the mechanism underlying this association and whether it holds true for blacks is not known. To address these questions, we analyzed serum Lp(a) levels in 333 middle-aged males of African descent from the Seychelles Islands (Indian Ocean). In addition, we analyzed the size of the apo(a) isoforms and the serum levels of albumin and sex hormones in a subset of 279 subjects. Serum Lp(a) levels were similar in teetotalers (median, 32.5 mg/dL; n=42) and occasional drinkers (median, 34.1 mg/dL; n=112). In contrast, individuals consuming 10 to 80 g of ethanol/d (n=83) and heavy drinkers (>80 g of ethanol/d, n=96) had a 9% and 32% lower median Lp(a) level than teetotalers, respectively (P=0.01). The size distribution of the apo(a) isoforms and the mean serum levels of albumin, estradiol, and luteinizing hormone were similar in teetotalers and occasional drinkers compared with moderate and heavy drinkers. These latter 2 groups had lower serum levels of testosterone and sex hormone–binding globulin. These data indicate that alcohol intake is associated in a dose-dependent manner with lower serum Lp(a) levels in males of African descent and that this association is not related to the size of the apo(a) isoforms, to the synthetic function of the liver, or to sex hormone biochemical status.

Key Words: lipoprotein(a) • alcohol • black African • population study • atherosclerosis

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