Lipoprotein (a) [Lp (a)] is known to appear in high levels in patients with ischemic heart disease (IHD). The purpose of this study was to determine Lp (a) levels and to investigate the association of Lp (a) and atherosclerotic risk factors in diabetic patients. Thirty-three women and 27 men, aged 27-72 years, were studied. The mean (±SD) levels of plasma Lp (a) were elevated in the diabetics compared to the controls (34.0±36.7vs. 18.3±10.4mg/dl, P<0.01). Lp (a) concentrations increased significantly as the urinary albumin concentrations (mg/g·creatinine) increased; the groups with concentrations below 30mg/g·cr, 30-300, and above 300 showed increases in Lp (a) concentrations (mean±SD) of 18.8±3.8, 29.8±10.2, and 35.1±31mg/dl, respectively. Therefore, plasma Lp (a) concentrations were elevated in diabetic patients from the microalbuminuria stage. The levels of Lp (a) remarkably increased in the diabetics with chronic renal failure (80.3±48mg/dl). There were, nonetheless, significant positive correlations between Lp (a) and urinary albumin concentrations. However, no correlations were noted between Lp (a) and other factors such as age, duration of diabetes, ideal body weight, fasting plasma glucose, glycosylated hemoglobin, BUN, creatinine, lipoprotein lipids or apoproteins. In patients with chronic renal failure, Lp (a) levels tended to decrease during hemodialysis treatment. An increased rate of Lp (a) synthesis and/or decreased catabolism may have contributed to the elevated levels of Lp (a) in patients with diabetic nephropathy. Along with other known cardiovascular risk factors such as elevated blood pressure, atherogenic abnormalities of plasma lipids and lipoproteins, increased levels of Lp (a) may play an important role in accelerating the development of atherosclerosis in this condition.
