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Association of lipoprotein(a) levels and apolipoprotein(a) phenotypes with coronary artery disease in Type 2 diabetic patients and in non‐diabetic subjects
Author(s) -
Gazzaruso C.,
Garzaniti A.,
Falcone C.,
Geroldi D.,
Finardi G.,
Fratino P.
Publication year - 2001
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1046/j.1464-5491.2001.00536.x
Subject(s) - medicine , lipoprotein(a) , coronary artery disease , diabetes mellitus , apolipoprotein b , odds ratio , type 2 diabetes , lipoprotein , endocrinology , gastroenterology , cardiology , cholesterol
Aims We investigated whether in Type 2 diabetic patients lipoprotein(a) (Lp(a)) levels and apolipoprotein(a) (apo(a)) polymorphism are associated with angiographically documented coronary artery disease (CAD). We also examined whether there are differences in the distributions of Lp(a) levels and apo(a) phenotypes between CAD patients with and without diabetes. Methods A hundred and seven diabetic patients with CAD, 274 diabetic patients without CAD, 201 non‐diabetic patients with CAD, and 358 controls were enrolled. Results Diabetic patients with CAD showed Lp(a) levels (21.2 ± 17.7 vs. 15.1 ± 17.8 mg/dl; P = 0.0018) and a percentage of subjects with at least one apo(a) isoform of low molecular weight (MW) (67.2% vs. 27.7%; P = 0.0000) significantly greater than diabetic patients without CAD. Multivariate analysis showed that in diabetic patients Lp(a) levels and apo(a) phenotypes were significantly associated with CAD; odds ratios (ORs) of high Lp(a) levels for CAD were 2.17 (1.28–3.66), while ORs of the presence of at least one apo(a) isoform of low MW were 5.35 (3.30–8.60). Lp(a) levels (30.2 ± 23.7 vs. 21.2 ± 17.7 mg/dl; P = 0.0005) and the percentage of subjects with at least one apo(a) isoform of low MW (87.0% vs. 67.2%; P = 0.0001) were significantly higher in CAD patients without than in those with diabetes. Conclusions Our data suggest that Lp(a) levels and apo(a) phenotypes are independently associated with CAD in Type 2 diabetic patients; thus both these parameters may be helpful in selecting diabetic subjects at high genetic cardiovascular risk. However, Lp(a) levels and apo(a) polymorphism seem to be cardiovascular risk factors less important in diabetic than in non‐diabetic subjects. Diabet. Med. 18, 589–594 (2001)