LIPOPROTEIN(A) LEVELS IN RELATION TO DIABETIC COMPLICATIONS IN PATIENTS WITH NON-INSULIN-DEPENDENT DIABETES

The relationship between serum levels of lipoprotein(a) (Lp(a)) and th e presence of chronic diabetic complications was studied in 194 patien ts with non-insulin-dependent diabetes mellitus (NIDDM; 75 males, 119 females; age 66 +/- 11 years; duration of diabetes, 11 (range 1-35) ye ars). They were taking various treatments (diet alone, oral hypoglycae mic agents and/or insulin). Metabolic status and prevalence of diabeti c complications were assessed by detailed history, physical examinatio n, laboratory analysis and ECG. Average metabolic control was moderate (HbA1c 8.2 +/- 1.7%). Median serum Lp(a) level was 183 U l-1 (range 8 -2600 U l-1), which was significantly higher than in control subjects of comparable age (median 101; range 8-1747 U l-1; P<0.05), while HDL- cholesterol levels were lower (1.14 +/- 0.38 vs. 1.35 +/- 0.35 mmol l- 1; P=0.001), and total cholesterol levels were comparable. No signific ant relationships between diabetes treatment or metabolic control and Lp(a) levels were observed. In the quartile of patients with the highe st Lp(a) levels, total cholesterol and triglycerides were slightly hig her (P < 0.05), whereas HDL-cholesterol was not different. With increa sing Lp(a) levels, higher prevalences of preproliferative retinopathy and of coronary artery disease (CAD) were observed, but not of the oth er complications. No relationship was found between the degree of albu minuria and Lp(a) levels. We conclude that in NIDDM patients, Lp(a) le vels are elevated compared with nondiabetic subjects, and that higher Lp(a) levels are associated with higher prevalences of CAD and of reti nopathy.