Heesen B J, Wolffenbuttel B H, Leurs P B, Sels J P, Menheere P P, Jäckle-Beckers S E, Nieuwenhuijzen Kruseman A C
Department of Internal Medicine, University Hospital, Maastricht, The Netherlands.
Eur J Clin Invest. 1993 Sep;23(9):580-4. doi: 10.1111/j.1365-2362.1993.tb00969.x.
The relationship between serum levels of lipoprotein(a) Lp(a)) and the presence of chronic diabetic complications was studied in 194 patients with non-insulin-dependent diabetes mellitus (NIDDM; 75 males, 119 females; age 66 +/- 11 years; duration of diabetes, 11 (range 1-35) years). They were taking various treatments (diet alone, oral hypoglycaemic agents and/or insulin). Metabolic status and prevalence of diabetic complications were assessed by detailed history, physical examination, laboratory analysis and ECG. Average metabolic control was moderate (HbA1c 8.2 +/- 1.7%). Median serum Lp(a) level was 183 U l-1 (range 8-2600 U l-1), which was significantly higher than in control subjects of comparable age (median 101; range 8-1747 U l-1; P < 0.05), while HDL-cholesterol levels were lower (1.14 +/- 0.38 vs. 1.35 +/- 0.35 mmol l-1; P = 0.001), and total cholesterol levels were comparable. No significant relationships between diabetes treatment or metabolic control and Lp(a) levels were observed. In the quartile of patients with the highest Lp(a) levels, total cholesterol and triglycerides were slightly higher (P < 0.05), whereas HDL-cholesterol was not different. With increasing Lp(a) levels, higher prevalences of preproliferative retinopathy and of coronary artery disease (CAD) were observed, but not of the other complications. No relationship was found between the degree of albuminuria and Lp(a) levels. We conclude that in NIDDM patients, Lp(a) levels are elevated compared with non-diabetic subjects, and that higher Lp(a) levels are associated with higher prevalences of CAD and of retinopathy.
对194例非胰岛素依赖型糖尿病（NIDDM）患者（75例男性，119例女性；年龄66±11岁；糖尿病病程11年（范围1 - 35年））进行了研究，以探讨血清脂蛋白（a）[Lp（a）]水平与慢性糖尿病并发症之间的关系。他们接受了各种治疗（单纯饮食、口服降糖药和/或胰岛素）。通过详细病史、体格检查、实验室分析和心电图评估代谢状况和糖尿病并发症的患病率。平均代谢控制处于中等水平（糖化血红蛋白HbA1c为8.2±1.7%）。血清Lp（a）水平中位数为183 U l-1（范围8 - 2600 U l-1），显著高于年龄相仿的对照组（中位数101；范围8 - 1747 U l-1；P < 0.05），而高密度脂蛋白胆固醇（HDL-胆固醇）水平较低（1.14±0.38 vs. 1.35±0.35 mmol l-1；P = 0.001），总胆固醇水平相当。未观察到糖尿病治疗或代谢控制与Lp（a）水平之间存在显著关系。在Lp（a）水平最高的四分位数患者中，总胆固醇和甘油三酯略高（P < 0.05），而HDL-胆固醇无差异。随着Lp（a）水平升高，增殖前期视网膜病变和冠状动脉疾病（CAD）的患病率升高，但其他并发症的患病率未升高。未发现蛋白尿程度与Lp（a）水平之间存在关系。我们得出结论，在NIDDM患者中，与非糖尿病受试者相比，Lp（a）水平升高，且较高的Lp（a）水平与CAD和视网膜病变的较高患病率相关。
