[The relationship of lipoprotein(a) to metabolic control in infantile-juvenile diabetes mellitus].

Lipoprotein (a) has become of great interest as a biochemical marker for predicting the risk of developing cardiovascular alterations, with increased levels suggesting patients at a higher risk. We have realized a study of the plasma concentrations of lipoprotein (a) and other constituents of lipoprotein metabolism in children diagnosed with diabetes mellitus type I in relationship to the levels of metabolic control, the time of evolution of the disease and the presence or not of microalbuminuria (albumin in the urine greater than 30 micrograms/min). The study population was comprised of 211 children, between the ages of 3 and 18 years of age, divided into three groups according to the time of evolution of the disease: beginners (n = 15), time of evolution less than or equal to 5 years (n = 99) and more than 5 years (n = 92). All determinations were performed on specimens collected after 10 hours of fasting and before the morning dose of insulin. The following determinations were made: total cholesterol, triglycerides, cHDL, cLDL, cVLDL, Apo AI, Apo B, lipoprotein (a), albumin excretion rate (AER), glucose, fructose, glycosylated hemoglobin and creatinine clearance. We found significant differences between the groups in function of the existence of microalbuminuria and if the time of evolution of the disease exceeded 5 years. In conclusion, it appears that metabolic control does not influence the concentrations of lipoprotein (a), with an increased risk of cardiovascular alterations in those patients with a long disease evolution an those that have microalbuminuria.