非胰岛素依赖型糖尿病患者的颈动脉粥样硬化与血清脂蛋白(a)浓度

Carotid atherosclerosis and serum lipoprotein(a) concentrations in patients with NIDDM.

作者信息

Yamamoto M, Egusa G, Yamakido M

机构信息

Second Department of Internal Medicine, Hiroshima University School of Medicine, Japan.

出版信息

Diabetes Care. 1997 May;20(5):829-31. doi: 10.2337/diacare.20.5.829.

DOI:10.2337/diacare.20.5.829

PMID:9135950

Abstract

OBJECTIVE

To investigate the association of carotid atherosclerosis and serum lipoprotein(a) [Lp(a)] concentrations in subjects with NIDDM.

RESEARCH DESIGN AND METHODS

We measured carotid intima-media thickness (IMT) and Lp(a) concentrations in 117 NIDDM subjects. Subjects were divided into tertiles according to IMT values and number of plaques.

RESULTS

Serum Lp(a), but not lipid and apoprotein levels, increased significantly with increasing IMT (20.0 +/- 2.3, 24.7 +/- 3.3, and 39.8 +/- 4.3 mg/dl [mean +/- SE], respectively, P < 0.001). Serum Lp(a) increased with increasing number of plaques (18.4 +/- 2.5 mg/dl in 59 subjects with no plaques, 25.8 +/- 2.5 mg/dl in 24 subjects with 1 plaque, and 38.7 +/- 5.1 mg/dl in 34 subjects with more than 1 plaque; P < 0.05). Furthermore, the mean IMT and Lp(a) levels in the subjects with cerebrovascular disease (CD) were significantly higher than in those without CD (1.25 +/- 0.04 mm and 41.2 +/- 4.7 mg/dl vs. 1.08 +/- 0.03 mm and 22.2 +/- 1.9 mg/dl; P < 0.005). The mean IMT and Lp(a) levels were higher in subjects with ischemic heart disease (IHD) than in those without IHD, although statistical significance was not observed (1.21 +/- 0.06 mm and 31.7 +/- 4.7 mg/dl vs. 1.10 +/- 0.03 mm and 27.0 +/- 2.4 mg/dl, respectively).

CONCLUSIONS

Elevated serum Lp(a) concentrations are associated with carotid atherosclerosis in NIDDM subjects.

摘要

目的

研究非胰岛素依赖型糖尿病（NIDDM）患者颈动脉粥样硬化与血清脂蛋白(a) [Lp(a)]浓度之间的关系。

研究设计与方法

我们测量了117例NIDDM患者的颈动脉内膜中层厚度（IMT）和Lp(a)浓度。根据IMT值和斑块数量将患者分为三分位数。

结果

血清Lp(a)，而非脂质和载脂蛋白水平，随IMT增加而显著升高（分别为20.0±2.3、24.7±3.3和39.8±4.3mg/dl[均值±标准误]，P<0.001）。血清Lp(a)随斑块数量增加而升高（59例无斑块患者为18.4±2.5mg/dl，24例有1个斑块患者为25.8±2.5mg/dl，34例有1个以上斑块患者为38.7±5.1mg/dl；P<0.05）。此外，脑血管疾病（CD）患者的平均IMT和Lp(a)水平显著高于无CD患者（分别为1.25±0.04mm和41.2±4.7mg/dl，而无CD患者为1.08±0.03mm和22.2±1.9mg/dl；P<0.005）。缺血性心脏病（IHD）患者的平均IMT和Lp(a)水平高于无IHD患者，尽管未观察到统计学显著性差异（分别为1.21±0.06mm和31.7±4.7mg/dl，而无IHD患者为1.10±0.03mm和27.0±2.4mg/dl）。