Murakami J, Kumasaka K, Kawano K, Murakami T, Hayashi Y, Arakawa Y
Department of Clinical Pathology, Nihon University School of Medicine, Tokyo.
Rinsho Byori. 1994 Dec;42(12):1273-8.
Lp(a) has been considered as an independent risk factor for atherosclerosis, mainly for coronary heart disease. Recent epidemiologic studies have demonstrated elevation of Lp(a) serum concentration in diabetes mellitus. Atherosclerosis is the most common cause of death in diabetic patients, but there is little information available concerning the importance of Lp(a) in these patients. We investigated the relationship between Lp(a) serum concentration and the presence of chronic diabetic complications. Lp(a) was determined in 14 IDDM patients and 62 NIDDM patients. Median Lp(a) serum concentration in diabetics was 21.8 mg/dl, which was significantly higher than in nondiabetic controls described before. Glucose, HbA1c, fructosamine, total cholesterol, triglycerides, HDL-cholesterol, apolipoprotein A1, B and E were not associated with raised Lp(a) values. With increasing Lp(a) levels, higher prevalences of retinopathy and of albuminuria were observed. We conclude that in diabetic patients, Lp(a) levels are elevated compared with non-diabetic subjects, and that higher Lp(a) levels are associated with higher prevalences of retinopathy and of albuminuria.
脂蛋白(a)[Lp(a)]被认为是动脉粥样硬化，主要是冠心病的一个独立危险因素。近期的流行病学研究表明糖尿病患者血清Lp(a)浓度升高。动脉粥样硬化是糖尿病患者最常见的死亡原因，但关于Lp(a)在这些患者中的重要性，几乎没有可用信息。我们研究了血清Lp(a)浓度与慢性糖尿病并发症的存在之间的关系。对14例胰岛素依赖型糖尿病（IDDM）患者和62例非胰岛素依赖型糖尿病（NIDDM）患者测定了Lp(a)。糖尿病患者的血清Lp(a)浓度中位数为21.8mg/dl，显著高于之前描述的非糖尿病对照组。血糖、糖化血红蛋白（HbA1c）、果糖胺、总胆固醇、甘油三酯、高密度脂蛋白胆固醇（HDL-胆固醇）、载脂蛋白A1、B和E与升高的Lp(a)值无关。随着Lp(a)水平升高，视网膜病变和蛋白尿的患病率更高。我们得出结论，糖尿病患者的Lp(a)水平高于非糖尿病受试者，且较高的Lp(a)水平与视网膜病变和蛋白尿的较高患病率相关。
