LIPOPROTEIN(A) IN ANDROID OBESITY AND NIDDM

OBJECTIVE - To assess the level of serum lipoprotein(a) [Lp(a)] in non obese and obese NIDDM subjects with android body distribution. RESEARC H DESIGN AND METHODS - Serum Lp(a) levels were measured in 30 long-sta nding NIDDM patients (duration of diabetes 12.5 +/- 3 years, mean +/- SD), with 15 of the patients being obese of android distribution (BMI >30 kg/m(2) and waist-to-hip ratio >0.8). In addition, there were 15 a ndroid obese nondiabetic subjects and 10 healthy subjects serving as t he control group. RESULTS - All groups of patients in this study (diab etic, obese, and obese diabetic) showed significantly higher levels of Lp(a) than the healthy control group. Lp(a) concentrations were signi ficantly higher in NIDDM patients with android type of obesity than in nondiabetic androids (24.1 +/- 5.6 vs. 14.8 +/- 2.4 mg/dl, P < 0.001) . Significantly greater levels of Lp(a) were found in nonobese subject s with diabetes when compared with obese subjects without diabetes (22 .3 +/- 4.1 vs. 14.8 +/- 2.4 mg/dl, P < 0.001). Furthermore, Lp(a) seru m concentrations were not dependent on the degree of glycemic control (controlled NIDDM 23.6 +/- 5.0 vs. uncontrolled NIDDM 21.4 +/- 2.7 mg/ dl, NS), but were much greater in subjects with diabetes complicated b y vascular disease (complicated 26.3 +/- 5.0 vs. uncomplicated 20.5 +/ - 2.7 mg/dl, P < 0.001). No correlation was found between Lp(a) and ot her lipid parameters in this study CONCLUSIONS - Lp(a) levels are sign ificantly elevated in both android-obese and nonobese NIDDM patients r egardless of the degree of glycemic control. Lp(a) is an independent r isk factor showing greater elevations in those subjects complicated wi th diabetic vascular diseases.