Figueroa A C, Gil R L, Pedragós A C, González G C, Marqués R B, Díaz J A, Llanos J O, Pérez A P
Servicios de Endocrinología, Hospital de la Santa Creu y Sant Pau, Barcelona.
Rev Clin Esp. 1996 Feb;196(2):87-91.
To determine the distribution of lipoprotein(a) levels and prevalence of hyperLp(a) in diabetes mellitus type I (IDDM). To analyze the effect of glycemic control and microalbuminuria on Lp(a) levels.
Cross-sectional study of 263 subjects with IDDM with a mean age of 19.2 +/- 11.6 years and an evolutive course of 6.3 +/- 6.5 years. Apart from Lp(a), measurements were obtained from serum levels of lipids, apolipoproteins AI and B, fructosamine, glycosilated hemoglobin (HbA1c), and albuminuria in all patients.
Mean serum concentrations of Lp(a) were 16.5 +/- 18.1 mg/dl and 18.5% of patients had Lp(a) levels > 30 mg/dl [hyperLp(a)]. With a multivariate regression analysis, the only variable correlated with Lp(a) levels was cholesterol LDL (p < 0.001). Patients with hyperLp(a) did not differ from the other patients in any of the other variables analyzed, and patients with HbA1c higher and lower than 8% had similar mean serum Lp(a) concentrations (14.0 +/- 16 vs. 17.9 +/- 20). Lp(a) concentration was also similar among patients with albuminuria higher and lower than 20 micrograms/min (16.6 +/- 20 vs. 17.7 +/- 16).
Control of glycemia and microalbuminuria have no effect on Lp(a) concentrations in diabetes mellitus type I. HyperLp(a) is not indicative of a poor glycemic control.
确定Ⅰ型糖尿病（IDDM）患者脂蛋白(a)水平的分布及高脂蛋白(a)血症的患病率。分析血糖控制和微量白蛋白尿对脂蛋白(a)水平的影响。
对263例IDDM患者进行横断面研究，患者平均年龄19.2±11.6岁，病程6.3±6.5年。除脂蛋白(a)外，还检测了所有患者的血脂、载脂蛋白AI和B、果糖胺、糖化血红蛋白（HbA1c）以及白蛋白尿的血清水平。
脂蛋白(a)的平均血清浓度为16.5±18.1mg/dl，18.5%的患者脂蛋白(a)水平>30mg/dl[高脂蛋白(a)血症]。多因素回归分析显示，与脂蛋白(a)水平相关的唯一变量是低密度脂蛋白胆固醇（p<0.001）。高脂蛋白(a)血症患者在其他分析变量中与其他患者无差异，HbA1c高于和低于8%的患者平均血清脂蛋白(a)浓度相似（14.0±16与17.9±20）。白蛋白尿高于和低于20微克/分钟的患者脂蛋白(a)浓度也相似（16.6±20与17.7±16）。
血糖和微量白蛋白尿的控制对Ⅰ型糖尿病患者的脂蛋白(a)浓度无影响。高脂蛋白(a)血症并非血糖控制不佳的指标。
