SERUM LIPOPROTEIN(A) IN PATIENTS WITH DIABETES-MELLITUS

OBJECTIVE - To investigate subjects with different types of diabetes m ellitus regarding their serum levels of lipoprotein(a). High serum Lp( a) concentration is associated with a high risk of coronary heart dise ase. Diabetic patients are prone to developing coronary heart disease. RESEARCH DESIGN AND METHODS - The subjects were 66 type I diabetic pa tients, 100 type II diabetic patients treated with diet alone or diet combined with oral hypoglycemic agents, and 46 insulin-requiring type II diabetic patients. Subjects were compared with 142 nondiabetic outp atients. RESULTS - Subjects with insulin-requiring type II diabetes me llitus were found to have an increase both in serum Lp(a) concentratio n and in prevalence of serum Lp(a) concentration >30 mg/dl compared wi th the other groups of diabetic patients and nondiabetic control subje cts. A nonsignificant increase in the prevalence of coronary heart dis ease was also found in insulin-requiring type II diabetic patients. Th e levels of serum concentrations of Lp(a) were not significantly relat ed to the degree of glycemic control, duration of diabetes, presence o f macrovascular disease, or intake of female hormone therapy. High lev els of Lp(a) in this group of diabetic patients could not be explained by the presence of albuminuria. CONCLUSIONS - insulin-requiring type II diabetic patients have high levels of Lp(a). Chronic hyperinsulinem ia might be an eventual causal factor.