THE ROLE OF LIPOPROTEIN(A) IN THE VASCULAR COMPLICATIONS OF DIABETES-MELLITUS

Lipoprotein(a) has been identified as an independent risk factor for a therosclerotic vascular disease in non-diabetic populations. Because o f its potential role in the pathogenesis of both microvascular and mac rovascular complications in diabetes, there have recently been many re ports on lipoprotein(a) in diabetic populations. Some studies indicate an association between elevated lipoprotein(a) and macrovascular dise ase in non-insulin-dependent diabetes mellitus (NIDDM), but this link has not been found with insulin-dependent diabetes mellitus (IDDM). In IDDM, elevated lipoprotein(a) has been found in groups with diabetic nephropathy and retinopathy, raising the possibility that it plays a c ausative role. The relationship between glycaemic control and the lipo protein(a) level has not been fully resolved. Most studies have not fo und any connection in NIDDM, but some found higher lipoprotein(a) leve ls in hyperglycaemic IDDM patients. Potentially, lipoprotein(a) is an important factor linking the microvascular and macrovascular complicat ions of diabetes.