Abstract
Lipoprotein (a) (Lp (a)) is an independent risk factor for cardiovascular diseases in non-diabetic people, but few studies have been done in diabetic patients. To investigate whether Lp (a) is a risk factor for cardiovascular disease in elderly people with diabetes, we examined the association of Lp (a) and serum lipid levels (total cholesterol: TC; triglycerides: TG; and high-density lipoprotein cholesterol: HDL-c) with the incidence of coronary artery disease and cerebrovascular disease. We studied 354 outpatients(131 men and 223 women, 60-97 years of age) with non-insulin-dependent diabetes mellitus. The mean concentration of Lp (a) was 21.1±19.6mg/dl and the median was 14.0mg/dl. The Lp (a) concentration did not correlate significantly with age or with sex, but it did correlate significantly with TC (r=0.152, p<0.05) and with the level of apoprotein B (r=0.168, p<0.05). The incidence of cerebrovascular disease was significantly higher in patients with high concentrations of Lp (a) (≥30mg/dl) than in those with low concentrations (<30mg/dl). Multivariate logistic regression analysis revealed that male sex, hypertension, a high level of HbA1c, a low level of HDL, and a high level of Lp (a) were independent risk factors for cerebrovascular disease. The incidence of coronary artery disease tended to the higher in those with high concentrations of Lp (a) (≥30mg/dl). However, multivariate logistic regression analysis revealed no significant correlation between Lp (a) concentration and the incidence of coronary artery disease. We conclude that a high concentration of Lp (a) is an independent risk factor for cerebrovascular disease in elderly patients with diabetes.
