Gazzaruso C, Garzaniti A, Buscaglia P, D'Annunzio G, Porta A, Vandelli G, Lorini R, Finardi G, Fratino P, Geroldi D
Department of Internal Medicine and Medical Therapeutics, IRCCS Policlinico San Matteo, University of Pavia, Italy.
Acta Diabetol. 1998 Apr;35(1):13-8. doi: 10.1007/s005920050095.
To investigate plasma concentrations of lipoprotein(a) [Lp(a)] and apolipoprotein(a) [apo(a)] polymorphism in relation to the presence of microvascular and neurological complications in type 1 diabetes mellitus, 118 young diabetic patients and 127 age-matched controls were recruited. Lp(a) levels were higher in patients than in controls, but the apo(a) isoforms distribution did not differ between the two groups [higher prevalence of isoforms of high relative molecular mass (RMM) in both groups]. Microalbuminuric patients had Lp(a) levels significantly greater than normoalbuminuric patients, and normoalbuminuric patients showed higher Lp(a) levels than controls. Patients with retinopathy or neuropathy showed similar Lp(a) levels to those without retinopathy or neuropathy. No differences in apo(a) isoforms frequencies were observed between subgroups with and without complications (higher prevalence of isoforms of high RMM in every subgroup). However, among patients with retinopathy, those with proliferative retinopathy had higher Lp(a) levels and a different apo(a) isoforms distribution (higher prevalence of isoforms of low RMM) than those with non-proliferative and background retinopathy (higher prevalence of isoforms of high RMM). Our data suggest that young type 1 diabetic patients without microalbuminuria have Lp(a) levels higher than healthy subjects of the same age. Lp(a) levels are further increased in microalbuminuric patients. High Lp(a) levels and apo(a) isoforms of low RMM seem to be associated with the presence of proliferative retinopathy, but have no relation to neuropathy.
为了研究1型糖尿病患者血浆脂蛋白(a)[Lp(a)]浓度和载脂蛋白(a)[apo(a)]多态性与微血管及神经并发症的关系，招募了118名年轻糖尿病患者和127名年龄匹配的对照者。患者的Lp(a)水平高于对照者，但两组间apo(a)异构体分布无差异（两组中相对分子质量高的异构体患病率均较高）。微量白蛋白尿患者的Lp(a)水平显著高于正常白蛋白尿患者，正常白蛋白尿患者的Lp(a)水平高于对照者。有视网膜病变或神经病变的患者与无视网膜病变或神经病变的患者Lp(a)水平相似。有并发症和无并发症亚组间apo(a)异构体频率无差异（每个亚组中相对分子质量高的异构体患病率均较高）。然而，在有视网膜病变的患者中，增殖性视网膜病变患者的Lp(a)水平较高，apo(a)异构体分布不同（相对分子质量低的异构体患病率较高），而非增殖性和背景性视网膜病变患者（相对分子质量高的异构体患病率较高）。我们的数据表明，无微量白蛋白尿的年轻1型糖尿病患者的Lp(a)水平高于同龄健康受试者。微量白蛋白尿患者的Lp(a)水平进一步升高。高Lp(a)水平和相对分子质量低的apo(a)异构体似乎与增殖性视网膜病变的存在有关，但与神经病变无关。
