CAROTID ATHEROSCLEROSIS AND SERUM LIPOPROTEIN(A) CONCENTRATIONS IN PATIENTS WITH NIDDM

OBJECTIVE - To investigate the association of carotid atherosclerosis and serum lipoprotein(a) [Lp(a)] concentrations in subjects with NIDDM . RESEARCH DESIGN AND METHODS - We measured carotid intima-media thick ness (IMT) and Lp(a) concentrations in 117 NIDDM subjects. Subjects we re divided into tertiles according to IMT values and number of plaques . RESULTS - Serum Lp(a), but not lipid and apoprotein levels, increase d significantly with increasing IMT (20.0 +/- 2.3, 24.7 +/- 3.3, and 3 9.8 +/- 4.3 mg/dl [mean +/- SE], respectively; P < 0.001). Serum Lp(a) increased with increasing number of plaques (18.4 +/- 2.5 mg/dl in 59 subjects with no plaques, 25.8 +/- 2.5 mg/dl in 24 subjects with 1 pl aque, and 38.7 +/- 5.1 mg/dl in 34 subjects with more than 1 plaque; P < 0.05). Furthermore, the mean IMT and Lp(a) levels in the subjects w ith cerebrovascular disease (CD) were significantly higher than in tho se without CD (1.25 +/- 0.04 mm and 41.2 +/- 4.7 mg/dl vs. 1.08 +/- 0. 03 mm and 22.2 +/- 1.9 mg/dl; P < 0.005). The mean IMT and Lp(a) level s were higher in subjects with ischemic heart disease (IHD) than in th ose without IHD, although statistical significance was not observed (1 .21 +/- 0.06 mm and 31.7 +/- 4.7 mg/dl vs. 1.10 +/- 0.03 mm and 27.0 /- 2.4 mg/dl, respectively).CONCLUSIONS - Elevated serum Lp(a) concent rations are associated with carotid atherosclerosis in NIDDM subjects.