LIPOPROTEIN(A) IN DIABETIC SUBJECTS COMPARED TO MATCHED NONDIABETIC CONTROLS IN THE GENERAL-POPULATION

Background and Aim: To assess the level of lipoprotein(a) [Lp(a)] in d iabetic subjects treated with insulin or oral hypoglycaemic agents (OH A) compared to non-diabetic controls in a Caucasian population and to evaluate the association between Lp (a) and other coronary risk factor s. Methods and Results: The diabetic population treated with insulin o r OHA in the Danish municipality of Horsens was delineated using the p rescription method. A random sample of 240 users of antidiabetic medic ation, aged 40 to 75 years were asked to participate in the study. For each diabetic person in the younger half of the sample two age and ge nder matched controls were randomly selected from the Central Populati on Register: Lp(a) was measured by nephelometry. Insulin treated diabe tic persons with fasting C-peptide below 0.30 nmol/l were registered a s having insulin-dependent diabetes mellitus (IDDM). Resting as well a s 24-hour ambulatory blood pressure, exercise test, collection of thre e overnight urines and an inter-view were obtained. One hundred sevent y-eight diabetic subjects and 194 control persons were included. In th e IDDM group the level of Lp(a) did not differ from that of the contro l group (p=0.39). Lp(a) was positively correlated with triglyceride in the bivariate analysis (p=0.028) but not significantly in the multiva riate analysis (p=0.057), No association was found between Lp (a) and other risk factors (p>0.1). In the NIDDM group the level of Lp(a) was significantly elevated compared to the control group (p=0.026). A stro ng positive association was demonstrated between Lp(a) and triglycerid e in both bivariate (p=0.00002) and multivariate analysis (p<0.0001). No significant correlation was shown between Lp(a) and other risk fact ors (p>0.1). Conclusion: In the general Caucasian population Lp(a) is elevated in NIDDM treated with insulin or OHA, but not in IDDM. Ly(a) and triglyceride is highly significantly correlated in NIDDM, and a we aker association is found in IDDM. No association could be shown betwe en Lp(a) and other coronary risk factors. (C) 1998, Medikal Press.