Abstract
Raised lipoprotein (a) [Lp(a)] concentrations have been reported in patients with non-insulin dependent diabetes mellitus (NIDDM), especially those with diabetic nephropathy. The purpose of this study was to demonstrate a direct relationship between Lp(a) levels and arteriosclerosis in diabetics. The relationship between plasma Lp(a) levels and aortic pulse wave velocity (PWV), glycemic control and proteinuria were studied in 133 NIDDM patients (71 men and 62 women). The incidence of a high-Lp(a) group (≥32 mg/dl) increased with the degree of proteinuria. In macroalbuminuria group, significant correlations were found between Lp(a) and PWV (r=0.55, p<0.05) and fibrinogen concentrations (r=0.53, p<0.05). Furthermore, PWV and plasma levels of fibrinogen in the high-Lp(a) group were significantly higher than those in the normal-Lp(a) group. On the other hand, in all subjects, Lp(a) levels were correlated with plasma levels of glycosylated hemoglobin A1c, fibrinogen and the duration of the disease. When compared with the degree of glycemic control, Lp(a) levels were significantly higher in diabetics with poor glycemic control.
From these results, it seems that plasma Lp(a) levels in diabetics are affected by hyperglycemia. However, in patients with advanced diabetic nephropathy, it may accelerate the development of arteriosclerosis in association with hyperfibrinogenemia.
