LIPOPROTEIN(A) IN TYPE-1 DIABETIC-PATIENTS WITH RENAL-DISEASE

Lp(a) was measured in 64 normoalbuminuric, 52 microalbuminuric, and 37 proteinuric Type 1 diabetic patients and 54 healthy subjects. Microal buminuric and proteinuric Type 1 diabetic patients had higher median L p(a) values (133 (16-1932) and 169 (17-1149) mg l(-1)) than patients w ith normal AER (73 (15-1078) mg l(-1); p=0.048 and p=0.027). Lp(a) in healthy subjects (110 (15-1630)mg l(-1)) did not differ from the diabe tic subgroups. The frequency of Lp(a) values in the upper quarter of t he normal distribution was similar in the diabetic groups and did not differ between diabetic and control subjects. The cumulative distribut ion of Lp(a) was similar in all groups. Lp(a) concentrations were not related to AER, age, gender, duration of diabetes, body mass index, gl ycaemic control, serum creatinine, free insulin or systolic blood pres sure. Cholesterol, LDL-cholesterol, triglycerides, and apo B were high er in microalbuminuric and proteinuric than in normoalbuminuric Type 1 diabetic patients. Lp(a) was independently related to diastolic blood pressure, fibrinogen, and macroangiopathy. In conclusion, median Lp(a ) concentrations tend to be higher in Type 1 diabetic patients with ea rly and established renal disease, although the differences are small and the overlap between groups large. Lp(a) is related to diastolic bl ood pressure and fibrinogen, and this association of powerful risk fac tors suggests that Lp(a) may play a role in the pathogenesis of cardio vascular disease in Type 1 diabetic patients with proteinuria. Whether Lp(a) is an independent determinant of increased cardiovascular risk in these patients needs to be elucidated by prospective studies.