Moussa M A A, Alsaeid M, Abdella N, Refai T M K, Al-Sheikh N, Gomez J E
Department of Community Medicine and Behavioural Sciences, Faculty of Medicine, Kuwait University, Kuwait.
Ann Nutr Metab. 2004 Sep-Oct;48(5):329-34. doi: 10.1159/000081200. Epub 2004 Oct 1.
BACKGROUND/AIMS: Lipoprotein(a) synthesis and catabolism could be influenced by insulin or by diabetes metabolic complications in patients with type-1 diabetes. The aim of the study was to investigate the relation of plasma lipoprotein(a) concentrations with metabolic cardiovascular risk factors in Kuwaiti children with uncomplicated type-1 diabetes.
This case-control study included 115 (44 males and 71 females) diabetic children aged 6-18 years matched by age and sex to 115 non-diabetic children as controls.
There was no significant difference between the mean lipoprotein(a) concentrations in type-1 diabetic children (27.34 mg/dl) and their controls (22.80 mg/dl). Total cholesterol, apolipoprotein A1 and B levels were significantly higher in diabetic children than controls. In diabetic children, significant correlations were found between lipoprotein(a) levels and glycated hemoglobin (r = 0.249, p = 0.011), total cholesterol (r = 0.208, p = 0.025), and apolipoprotein B (r = 0.349, p < 0.001). The proportion of diabetic children with lipoprotein(a) >30 mg/dl was significantly higher in those having poor glycemic control (glycated hemoglobin >9.0%, p = 0.013), raised total cholesterol (p = 0.033), or with a family history of cardiovascular disease (p = 0.006).
Plasma lipoprotein(a) levels were not elevated in young type-1 diabetic children compared to non-diabetic controls; however, lipoprotein(a) levels were significantly higher in diabetic children with poor glycemic control. Moreover, there were significant correlations between lipoprotein(a) and the metabolic cardiovascular risk factors total cholesterol, atherogenic index, apolipoprotein B and apolipoprotein B/A1 ratio.
背景/目的:1型糖尿病患者的脂蛋白(a)合成与分解代谢可能受胰岛素或糖尿病代谢并发症的影响。本研究旨在探讨科威特无并发症1型糖尿病儿童血浆脂蛋白(a)浓度与代谢性心血管危险因素之间的关系。
本病例对照研究纳入了115名(44名男性和71名女性)6至18岁的糖尿病儿童,按年龄和性别匹配115名非糖尿病儿童作为对照。
1型糖尿病儿童的平均脂蛋白(a)浓度(27.34mg/dl)与其对照组(22.80mg/dl)之间无显著差异。糖尿病儿童的总胆固醇、载脂蛋白A1和B水平显著高于对照组。在糖尿病儿童中,脂蛋白(a)水平与糖化血红蛋白(r = 0.249,p = 0.011)、总胆固醇(r = 0.208,p = 0.025)和载脂蛋白B(r = 0.349,p < 0.001)之间存在显著相关性。血糖控制不佳(糖化血红蛋白>9.0% , p = 0.013)、总胆固醇升高(p = 0.033)或有心血管疾病家族史(p = 0.006)的糖尿病儿童中,脂蛋白(a)>30mg/dl的比例显著更高。
与非糖尿病对照组相比,年轻的1型糖尿病儿童血浆脂蛋白(a)水平未升高;然而,血糖控制不佳的糖尿病儿童脂蛋白(a)水平显著更高。此外,脂蛋白(a)与代谢性心血管危险因素总胆固醇、致动脉粥样硬化指数、载脂蛋白B和载脂蛋白B/ A1比值之间存在显著相关性。