SERUM-LIPOPROTEIN (A) IN TYPE-1 DIABETIC CHILDREN AND ADOLESCENTS - RELATIONSHIPS WITH HBA1C AND SUBCLINICAL COMPLICATIONS

In a population of 106 young type I diabetic patients, we evaluated wh ether a relationship exists between lipoprotein (Lp)(a) or apolipoprot eins and the degree of metabolic control (HbA1c, fructosamine) or the subclinical complications. The patients were subdivided according to p uberty and to the presence or not of subclinical complications (no com plications [n = 32]; retinopathy at fluorescein angiography [n = 28]; neuropathy diagnosed by reduced peroneal motor nerve conduction veloci ty [n = 30]; nephropathy determined by presence of micro-albuminuria [ n = 15]). Lp(a) concentrations were not significantly increased in the whole group of diabetic patients. There was no difference between gir ls and boys, nor between the prepubertal children and the others. Ther e were no significant correlations between the markers of metabolic co ntrol and Lp(a). Nevertheless, if the diabetic patients were divided i nto two groups according to the levels of HbA1c (< 7.6 or greater than or equal to 6% Hb), Lp(a) tends to be higher in the poorly controlled , but not to any significant degree. On the other hand, significant in creases of total cholesterol, triglycerides, low density lipoprotein c holesterol and apolipoprotein B levels were observed in poorly control led patients, Lp(a) concentrations were significantly lower in patient s with subclinical neuropathy or nephropathy than in patients without these complications, but not in patients with retinopathy versus no re tinopathy. These results are confirmed by categorical analysis (i.e. L p(a) less than or equal to 30 vs > 30 mg/dl). Conclusion Lp(a) levels are not significantly increased in poorly controlled insulin-dependent diabetes mellitus patients. High levels of Lp(a), in young diabetic p atients, are not markers for subclinical complications (retinopathy, n europathy and nephropathy). On the contrary, low Lp(a) levels were fou nd in subjects with subclinical neuropathy or nephropathy.