Torres-Tamayo M, Zamora-González J, Bravo-Ríos L E, Cardoso-Saldaña G, Mendoza-Morfín F, Posadas-Romero C
Departamento de Endocrinología Pediátrica, Hospital General del Centro Médico Nacional La Raza, IMSS, México D.F.
Rev Invest Clin. 1997 Nov-Dec;49(6):437-43.
To determine lipoprotein(a) in children and adolescents with IDDM and assess its relation with Lp(a) levels in their first degree relatives.
In a cross-sectional study we included 141 IDDM patients, (58 male and 83 female) with mean ages 12.2 +/- 2.8 and 12.6 +/- 3.1 years, respectively. Patients with microalbuminuria, hepatopathy, thyroid dysfunction, infectious disease, acute decompensation or surgery three months prior to the study, were excluded. Clinical history, physical examination, blood chemistry, glycosilated hemoglobin, microalbuminuria and lipid profile including total cholesterol triglycerides, HDL-C, Apo A-I, Apo B and Lp(a) were determined. Parents and non-diabetic siblings were also studied when feasible.
Mean plasma concentration of total cholesterol, HDL-C and Apo A-I were significantly higher in diabetic boys compared to their non-diabetic sibs. Mean Lp(a) plasma values and the prevalence of Lp(a) > 30 mg/dL were similar in the IDDM patients, their healthy sibs and parents. Hypercholesterolemia and hypertriglyceridemia were more frequent among the IDDM patients. No correlation was found between HbA1, and Lp(a) concentrations. However, a correlation was observed between Lp(a) plasma concentrations of parents and their diabetic and healthy offspring.
Diabetes mellitus does not seem to affect Lp(a) levels. These data are consistent with a genetic regulation of Lp(a) plasma levels.
测定1型糖尿病儿童及青少年的脂蛋白(a)水平,并评估其与一级亲属脂蛋白(a)水平的关系。
在一项横断面研究中,我们纳入了141例1型糖尿病患者(男性58例,女性83例),平均年龄分别为12.2±2.8岁和12.6±3.1岁。排除患有微量白蛋白尿、肝病、甲状腺功能障碍、传染病、急性失代偿或在研究前三个月内进行过手术的患者。测定患者的临床病史、体格检查、血液生化、糖化血红蛋白、微量白蛋白尿以及血脂谱,包括总胆固醇、甘油三酯、高密度脂蛋白胆固醇(HDL-C)、载脂蛋白A-I(Apo A-I)、载脂蛋白B(Apo B)和脂蛋白(a)。在可行的情况下,也对患者的父母和非糖尿病兄弟姐妹进行了研究。
糖尿病男孩的总胆固醇、HDL-C和Apo A-I的平均血浆浓度显著高于其非糖尿病的兄弟姐妹。1型糖尿病患者、其健康的兄弟姐妹和父母的脂蛋白(a)平均血浆值以及脂蛋白(a)>30 mg/dL的患病率相似。1型糖尿病患者中高胆固醇血症和高甘油三酯血症更为常见。未发现糖化血红蛋白(HbA1)与脂蛋白(a)浓度之间存在相关性。然而,观察到父母与他们的糖尿病及健康后代的脂蛋白(a)血浆浓度之间存在相关性。
糖尿病似乎不影响脂蛋白(a)水平。这些数据与脂蛋白(a)血浆水平的遗传调控一致。