Lipoprotein(a) [Lp(a)] represents a class of lipoproteins with some structural similarity to low density lipoprotein (LDL), but containing a unique apoprotein, apoprotein(a). First reported in 1963, Lp(a) is now considered to have an independent role in the development of atherosclerotic lesions. The level of Lp(a) in the blood is under strong genetic influence and does not appear to be alterable by lifestyle factors known to influence other lipoproteins. Regular moderate exercise has been shown to favorably alter other lipoproteins, and recent attention has focused on whether Lp(a) level can be influenced by physical activity. Current data from cross-sectional and intervention studies show little effect of moderate exercise on serum Lp(a) concentration. One possible exception may be an elevation of serum Lp(a) concentration in adult endurance and power athletes who exercise intensely on a daily basis. However, not all studies have taken into account possible racial or ethnic differences in Lp(a) concentrations and the skewed distribution observed within most populations. Standard dietary intervention such as a low fat diet recommended for weight loss and control of other blood lipids has little effect on serum Lp(a) level. At present, serum Lp(a) concentration does not appear to be significantly altered by realistic dietary changes and moderate physical activity as recommended for health. The synergistic effect on cardiovascular disease risk when both LDL-cholesterol and Lp(a) are elevated highlight the importance of attending to those risk factors that can be modified by exercise and other lifestyle changes.

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Aim:To report an unusual cause of blindness in a patient newly diagnosed with insulin-dependent diabetes mellitis (IDDM). Method:A 19-year-old man presented with classical symptoms of hyperglycaemia. On presentation his visual acuity and ophthalmic examination were normal. He was prescribed twice-daily insulin therapy and six weeks later presented with visual loss. He had only light and dark perception and was noted to have bilateral, dense, mature cataracts.Outcome: Right cataract extraction and intraocular lens implant was performed with restoration of vision. Despite good diabetic control the left cataract did not resolve. Seven months later the patient had left cataract extraction and intraocular lens implant, again with good result. Conclusion:Mature dense cataracts rarely occur and appear not to resolve with control of hyperglycaemia, as in this case, and require surgical treatment.