EFFECT OF INSULIN-TREATMENT ON SERUM LIPOPROTEIN(A) IN NON-INSULIN-DEPENDENT DIABETES

In order to evaluate whether Lp(a), a lipoprotein that is potentially thrombogenic and atherogenic, is a potential risk factor for CAD in no n-insulin-dependent diabetes (NIDDM), we compared the Lp(a) and its di stribution in 145 NIDDM patients with that in 94 healthy control subje cts. Furthermore, we studied the effect of insulin treatment on serum Lp(a) in 108 patients with NIDDM. Male and female NIDDM patients had s imilar Lp(a) concentrations to healthy controls (median value 167 mg L (-1), range 15-1550 mg L(-1) vs. 157 mg L(-1), range 15-919 mg L(-1), NS and 92, range 15-1190 mg L(-1) vs. 103 mg L(-1), range 15-842 mg L( -1), NS). Also, the cumulative distribution of Lp(a) did not differ be tween the NIDDM patients and healthy subjects. Insulin treatment incre ased Lp(a) in diabetics with a Lp(a) concentration of less than 300 mg L(-1), but this effect was not related to the concomitant improvement in metabolic control (mean change (+/-SEM) of HbA(1c), from 9.80 +/- 0.15 to 800 +/- 0 12; P < 0.001). In subjects with elevated Lp(a) conc entrations (> 300 mg L(-1)) the Lp(a) concentration was unaffected by insulin, despite a similar improvement in glycaemic control. These res ults suggest that insulin may modulate the concentration of Lp(a).