INFLUENCE OF ENDOGENOUS AND ENVIRONMENTAL-FACTORS ON VARIATIONS OF SERUM-LIPOPROTEIN (A) CONCENTRATIONS IN A LARGE POPULATION OF INSULIN-TREATED DIABETIC-PATIENTS

Variations of serum Lp(a) concentrations were studied in a large popul ation of insulin-treated diabetic patients in relation to the type of diabetes, insulin treatment and long-term complications. Lp(a) concent rations were measured by immunonephelometry in 740 diabetic patients [ 493 insulin-dependent diabetic (IDDM) patients and 247 insulin-treated Type 2 diabetic (ITD) patients]. Concentrations and distributions wer e compared with those of 128 non-diabetic controls. Correlations were investigated with lipidic and glycaemic parameters, daily lipid intake , body mass index(BMI), macrovascular and nephropathic complications, and insulin therapy. Both groups of insulin-treated patients (IDDM and ITO) displayed significantly higher Lp(a) concentrations when compare d to controls. No relationship was found with macrovascular complicati ons and nephropathy, except in IDDM patients in whom Lp(a) was elevate d when creatinine concentration was above 120 mu mol/L Mean variations of Lp(a) were correlated with BMI and triglyceride variations in IDDM patients and only with triglycerides in ITD patients. These results s uggest a direct and/or indirect (via serum triglycerides) potential ro le of exogenous insulin in the modulation of serum Lp(a) concentration s. BMI and lipid daily fat intake could be considered as additional mo dulating factors of Lp(a) serum concentrations in ITD patients.