Martinez M T, Ramos O, Carretero N, Calvillán M, Gutierrez-López M D, Cuesta P, Serrano-Ríos M
Hospital Clinico San Carlos, Universidad Complutense de Madrid, Spain.
Diabete Metab. 1994 Sep-Oct;20(5):454-7.
To study serum Lp (a) levels and other metabolic cardiovascular risk factors in children with type 1 diabetes mellitus (DM) as compared to sex and age matched nondiabetic children. The correlation of Lp (a) serum levels and other lipid parameters with HbA1c concentration in diabetic children was investigated.
Transversal observational study.
36 C-peptide negative Type 1 diabetic children without microalbuminuria and no macromicrovascular nor neurological complications, aged 8 to 15 years; 17 boys, 19 girls. Mean duration of Type 1 diabetes was 4.99 +/- 3.04 years, daily insulin needs 32.79 +/- 12.64 Units. 41 healthy children with no family history of diabetes mellitus, aged 8 to 15 years, 26 boys, 15 girls, were studied in parallel as the control group.
Serum total cholesterol and triglycerides were assayed by enzymatic methods, High-density lipoprotein (HDL) cholesterol by enzymatic method after precipitation of very-low-density (VLDL) and low-density lipoprotein (LDL) fractions. The LDL fraction was estimated after serum precipitation as the difference between total cholesterol and supernatant cholesterol concentrations. Apo-AI, apoA-II and apo-B were measured by radial immunodiffusion assays. Serum Lp(a) was measured by a monoclonal anti-Lp(a) antibody (ELISA) method and whole blood glycosylated hemoglobin A1c (HbA1c) by high resolution liquid chromatography.
HbA1c concentration in diabetic children was 7.51 +/- 1.54% vs 4.16 +/- 0.35% in nondiabetic children. Lp(a) serum levels did not significantly differ among both groups (25 +/- 22 mg/dl in diabetics; 22 +/- 22 mg/dl in controls). Significant correlation was found between HbA1c levels and each of TC, LDL and TG serum concentrations in the diabetic group. Lp (a) levels were only correlated with glycated hemoglobin in the two patients showing the highest levels of HbA1c; in the diabetic group: HbA1c 10.9 and 11.5%.
In 36 children aged 8-15 years with uncomplicated Type 1 diabetes for less than 15 years duration, Lp (a) serum levels were positively correlated with HbA1c only in two of them showing the poorest metabolic control.
研究1型糖尿病（DM）患儿与性别和年龄匹配的非糖尿病儿童相比的血清脂蛋白（a）[Lp（a）]水平及其他代谢性心血管危险因素。研究糖尿病患儿中Lp（a）血清水平及其他血脂参数与糖化血红蛋白A1c（HbA1c）浓度的相关性。
横向观察性研究。
36例8至15岁的C肽阴性1型糖尿病患儿，无微量白蛋白尿，无大微血管和神经并发症；17例男孩，19例女孩。1型糖尿病平均病程为4.99±3.04年，每日胰岛素需求量为32.79±12.64单位。41例无糖尿病家族史的健康儿童，年龄8至15岁，26例男孩，15例女孩，作为对照组并行研究。
采用酶法测定血清总胆固醇和甘油三酯，采用酶法在极低密度脂蛋白（VLDL）和低密度脂蛋白（LDL）组分沉淀后测定高密度脂蛋白（HDL）胆固醇。血清沉淀后，通过总胆固醇与上清液胆固醇浓度之差估算LDL组分。采用放射免疫扩散法测定载脂蛋白A-I（Apo-AI）、载脂蛋白A-II（apoA-II）和载脂蛋白B（apo-B）。采用单克隆抗Lp（a）抗体（ELISA）法测定血清Lp（a），采用高分辨率液相色谱法测定全血糖化血红蛋白A1c（HbA1c）。
糖尿病患儿的HbA1c浓度为7.51±1.54%，非糖尿病儿童为4.16±0.35%。两组间Lp（a）血清水平无显著差异（糖尿病患儿为25±22mg/dl；对照组为22±22mg/dl）。糖尿病组中，HbA1c水平与总胆固醇（TC）、低密度脂蛋白（LDL）和甘油三酯（TG）血清浓度均呈显著相关。仅在HbA1c水平最高的两名患者中，Lp（a）水平与糖化血红蛋白相关；糖尿病组中，HbA1c分别为10.9%和11.5%。
在36例病程小于15年、无并发症的8至15岁1型糖尿病患儿中，仅在代谢控制最差的两名患儿中，血清Lp（a）水平与HbA1c呈正相关。
