[Lipoprotein and apolipoprotein levels in young insulin-dependent diabetic patients. Relations with glycosylated hemoglobin and fructosamine].

The pathogenesis of premature atherosclerosis in diabetic patients has not yet been fully elucidated, but it seems to be related to changes in circulating lipoproteins and to a poor metabolic balance. In this study plasma levels of triglycerides (TG), total cholesterol (TC), HDL- and LDL-cholesterols, apolipoproteins (Apo) A1 and B were measured in 120 young patients aged from 4 to 32 years (mean +/- 1 SD: 17 +/- 6 years) whose diabetes had been present for a mean period of 10 +/- 6 years (range: less than one year to 25 years). The results obtained were analysed in relation to glycosylated haemoglobin (N: 6.8 +/- 0.6 per cent) and plasma fructosamine (N: 1.9 +/- 0.2 mmol/l) levels. The patients were divided into 3 groups according to their HbA 1 level: (group 1: less than 9 per cent, group 2: 9 per cent less than or equal to HbA1 less than 11 per cent; group 3: greater than or equal to 11 per cent. The most significant increases of TG, TC, LDL-C and ApoB levels were observed in group 3, i.e. in patients whose diabetes was the most poorly controlled (HbA 1: 12.9 +/- 1.3 per cent; fructosamine: 4.6 +/- 0.9 mmol/l). These parameters were significantly correlated with HbA1 (p less than 0.01) and even more significantly with fructosamine (p less than 0.001). No significant difference in HDL-C and ApoA1 levels was found in the 3 groups of patients. Thus, TG, TC, LDL-C and ApoB are increased in young diabetics whose HbA1 and fructosamine levels exceed reference values by more than 5 standard deviations.