Increased Serum Levels of Lipoprotein(a) in Diabetes Mellitus and Their Reduction With Glycemic Control

To the Editor.— It has been said inThe Journal¹that serum levels of lipoprotein(a) (Lp[a]) are genetically determined and are poorly influenced either by dietary measures or by hypolipidemic drugs. Substantial epidemiologic²⁻⁴data support a potential relationship between serum levels of Lp(a) and atherosclerotic disease. Atherosclerotic disease is the most common complication of diabetes, especially in case of poor glycemic control⁵; however, the mechanism whereby such complication arises is not well understood. We have found high serum levels of Lp(a) in 10 poorly controlled insulin-dependent diabetics when compared withnondiabetic control subjects (46.1 ±6.3 and 20.6 ±4.9 mg/dL, respectively). Twenty-one days after control of blood glucose levels, Lp(a) levels were dramatically decreased (Table) and a significant correlation was found between the percentage reduction in serum Lp(a) level and the percentage decrease in the concentration of both fasting blood glucose (r=.877;P<.01) and glycosylated