LIPOPROTEIN (A) AND OTHER RISK-FACTORS IN PATIENTS WITH NON-INSULIN-DEPENDENT DIABETES-MELLITUS

Background: Studies have established a relationship between lipoprotei n (a) [Lp(a)] levels and cardiovascular disease, but few have studied Lp(a) in patients with non-insulin-dependent diabetes mellitus (NIDDM) . Methods: We determined Lp(a) concentrations, levels of glycated hemo globin, and the personal and family history of atherosclerosis in 88 p atients with NIDDM (53 men and 35 women; age, 33-70 years) and 90 age- and sex-matched controls. Twenty-three patients with NIDDM had cardio vascular disease (CVD group) and 65 did not (non-CVD group). Results: Lp(a) levels were higher in CVD than non-CVD patients (P<0.01). Trigly ceride levels negatively correlated with Lp(a) (r=-0.51, P<0.05), inde pendently of the metabolic control of diabetes. Patients with poor met abolic control (glycated hemoglobin >7.5%) had higher Lp(a) levels tha n the control group (P<0.05). Lp(a) levels were higher than 0.30 g/l i n 11% of patients without CVD and 55% of those with CVD (P<0.05). Clus ter analysis showed that Lp(a), as well as total cholesterol, triglyce rides, apolipoprotein B-100, and age were independently related to CVD in patients with NIDDM (P<0.001 for triglycerides and P<0.05 for the other variables). Conclusions: Lp(a) levels can be considered an indep endent risk factor for the development of atherosclerosis in NIDDM.