LEVELS OF LIPOPROTEIN(A), APOLIPOPROTEIN-B, AND LIPOPROTEIN CHOLESTEROL DISTRIBUTION IN IDDM - RESULTS FROM FOLLOW-UP IN THE DIABETES CONTROL AND COMPLICATIONS TRIAL

Levels of lipoprotein(a) [Lp(a)], apolipoprotein (ape) B, and Lipoprot ein cholesterol distribution using density-gradient ultracentrifugatio n were measured as part of a cross-sectional study at the final follow -up examination (mean 6.2 years) in the Diabetes Control and Complicat ions Trial, Compared with the subjects in the conventionally treated g roup (n = 680), those subjects receiving intensive diabetes therapy (n = 667) had a lower level of Lp(a) (Caucasian subjects only, median 10 .7 vs, 12.5 mg/dl, respectively; P = 0.03), lower apo B (mean 83 vs, 8 6 mg/dl, respectively; P = 0.01), and a more favorable distribution of cholesterol in the lipoprotein fractions as measured by density-gradi ent ultracentrifugation with less cholesterol in the very-low-density lipoprotein and the dense low-density Lipoprotein fractions and greate r cholesterol content of the more buoyant low-density lipoprotein, Com pared with a nondiabetic Caucasian control group (n = 2,158), Lp(a) le vels were not different in the intensive treatment group (median 9.6 v s, 10.7 mg/dl, respectively; NS) and higher in the conventional treatm ent group (9.6 vs, 12.5 mg/dl, respectively; P < 0.01), No effect of r enal dysfunction as measured by increasing albuminuria or reduced crea tinine clearance on Lp(a) levels could be demonstrated in the diabetic subjects. Prospective follow-up of these subjects will determine whet her these favorable lipoprotein differences in the intensive treatment group persist and whether they influence the onset of atherosclerosis in insulin-dependent diabetes.