Key result
Microalbuminuric and proteinuric Type 1 diabetic patients had higher median Lp(a) concentrations (133 and 169 mg/l) than normoalbuminuric patients (73 mg/l; p=0.048 and p=0.027).
Why the study?
Are Lipoprotein(a) levels elevated in Type 1 diabetic patients with renal disease compared to those without renal disease or healthy subjects?
Cross-Sectional (n=207)
Are Lipoprotein(a) levels elevated in Type 1 diabetic patients with renal disease compared to those without renal disease or healthy subjects?
p-value: p=0.048 and 0.027
Median Lp(a) concentrations are modestly elevated in Type 1 diabetic patients with early and established renal disease and are associated with diastolic blood pressure and fibrinogen.
Lp(a) elevation in albuminuric Type 1 diabetes should not change practice; leaves open its role in nephropathy progression.
Lp(a) was measured in 64 normoalbuminuric, 52 microalbuminuric, and 37 proteinuric Type 1 diabetic patients and 54 healthy subjects. Microalbuminuric and proteinuric Type 1 diabetic patients had higher median Lp(a) values (133 (16-1932) and 169 (17-1149) mg l-1) than patients with normal AER (73 (15-1078) mg l-1; p = 0.048 and p = 0.027). Lp(a) in healthy subjects (110 (15-1630)mg l-1) did not differ from the diabetic subgroups. The frequency of Lp(a) values in the upper quarter of the normal distribution was similar in the diabetic groups and did not differ between diabetic and control subjects. The cumulative distribution of Lp(a) was similar in all groups. Lp(a) concentrations were not related to AER, age, gender, duration of diabetes, body mass index, glycaemic control, serum creatinine, free insulin or systolic blood pressure. Cholesterol, LDL-cholesterol, triglycerides, and apo B were higher in microalbuminuric and proteinuric than in normoalbuminuric Type 1 diabetic patients. Lp(a) was independently related to diastolic blood pressure, fibrinogen, and macroangiopathy. In conclusion, median Lp(a) concentrations tend to be higher in Type 1 diabetic patients with early and established renal disease, although the differences are small and the overlap between groups large. Lp(a) is related to diastolic blood pressure and fibrinogen, and this association of powerful risk factors suggests that Lp(a) may play a role in the pathogenesis of cardiovascular disease in Type 1 diabetic patients with proteinuria. Whether Lp(a) is an independent determinant of increased cardiovascular risk in these patients needs to be elucidated by prospective studies.
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Groop et al. (1994) conducted a cross-sectional in Type 1 diabetes with renal disease (n=207). Microalbuminuria and proteinuria vs. Normoalbuminuria was evaluated on Median Lp(a) concentration (p=0.048 and 0.027). Microalbuminuric and proteinuric Type 1 diabetic patients had higher median Lp(a) concentrations (133 and 169 mg/l) than normoalbuminuric patients (73 mg/l; p=0.048 and p=0.027).