Willems D, Dorchy H, Dufrasne D
Department of Clinical Chemistry, Brugmann University Hospital, Brussels, Belgium.
Eur J Pediatr. 1996 Mar;155(3):175-8. doi: 10.1007/BF01953933.
UNLABELLED: In a population of 106 young type I diabetic patients, we evaluated whether a relationship exists between lipoprotein (Lp)(a) or apolipoproteins and the degree of metabolic control (HbA1c, fructosamine) or the subclinical complications. The patients were subdivided according to puberty and to the presence or not of subclinical complications (no complications [n = 32]; retinopathy at fluorescein angiography [n = 28]; neuropathy diagnosed by reduced peroneal motor nerve conduction velocity [n = 30]; nephropathy determined by presence of micro-albuminuria [n = 15]. Lp(a) concentrations were not significantly increased in the whole group of diabetic patients. There was no difference between girls and boys, nor between the prepubertal children and the others. There were no significant correlations between the markers of metabolic control and Lp(a). Nevertheless, if the diabetic patients were divided into two groups according to the levels of HbA1c (<7.6 or > or = 6% Hb), Lp(a) tends to be higher in the poorly controlled, but not to any significant degree. On the other hand, significant increases of total cholesterol, triglycerides, low density lipoprotein cholesterol and apolipoprotein B levels were observed in poorly controlled patients. Lp(a) concentrations were significantly lower in patients with subclinical neuropathy or nephropathy than in patients without these complications, but not in patients with retinopathy versus no retinopathy. These results are confirmed by categorical analysis (i.e. Lp(a) < or = 30 vs > 30 mg/dl). CONCLUSION: Lp(a) levels are not significantly increased in poorly controlled insulin-dependent diabetes mellitus patients. High controlled insulin-dependent diabetes mellitus patients. High levels of Lp(a), in young diabetic patients, are not markers for subclinical complications (retinopathy, neuropathy and nephropathy). On the contrary, low Lp(a) levels were found in subjects with subclinical neuropathy or nephropathy.
未标记:在106名年轻的I型糖尿病患者群体中,我们评估了脂蛋白(Lp)(a)或载脂蛋白与代谢控制程度(糖化血红蛋白、果糖胺)或亚临床并发症之间是否存在关联。患者根据青春期以及是否存在亚临床并发症进行了细分(无并发症[n = 32];荧光素血管造影显示视网膜病变[n = 28];经腓总运动神经传导速度降低诊断为神经病变[n = 30];通过微量白蛋白尿的存在确定为肾病[n = 15])。糖尿病患者的整个群体中Lp(a)浓度没有显著升高。女孩和男孩之间、青春期前儿童与其他儿童之间均无差异。代谢控制指标与Lp(a)之间没有显著相关性。然而,如果根据糖化血红蛋白水平(<7.6%或≥6% Hb)将糖尿病患者分为两组,Lp(a)在控制不佳的患者中往往较高,但未达到显著程度。另一方面,在控制不佳的患者中观察到总胆固醇、甘油三酯、低密度脂蛋白胆固醇和载脂蛋白B水平显著升高。亚临床神经病变或肾病患者的Lp(a)浓度显著低于无这些并发症的患者,但视网膜病变患者与无视网膜病变患者之间无差异。这些结果通过分类分析得到了证实(即Lp(a)≤30与>30 mg/dl)。 结论:在控制不佳的胰岛素依赖型糖尿病患者中,Lp(a)水平没有显著升高。在年轻糖尿病患者中,高Lp(a)水平不是亚临床并发症(视网膜病变、神经病变和肾病)的标志物。相反,在有亚临床神经病变或肾病的患者中发现Lp(a)水平较低。
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