Lp(a) is a significant risk factor for atherosclerotic cardiovascular disease in NIDDM.

Derangements of the blood coagulation-fibrinolytic system are thought to be associated with the development of cardiovascular disease. Previous studies have identified the alterations in patients with advanced atherosclerosis, however, studies on subjects without apparent cardiovascular complications are scarce. To evaluate the potential risk of thrombosis, we examined the serum lipid levels and fibrinolytic parameters in 54 subjects of different types of primary hyperlipoproteinemia (HL) and 18 normolipidemic controls. Plasma tissue-type plasminogen activator (t-PA) and plasminogen activator inhibitor-1 (PAI-1) antigen levels were significantly higher in type IV HL than in the controls. Serum triglyceride concentrations were correlated with t-PA (r = 0.537, p < 0.01) and PAI-1 (r = 0.249, p < 0.05) antigen levels, while serum cholesterol levels did not. The current study demonstrated that hypertriglyceridemia, but not hypercholesterolemia, is associated with the alterations of fibrinolytic system.

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A patient with diabetes mellitus caused by secondary hemochromatosis was treated using recombinant human erythropoietin and phlebotomy. A total of 12 g of iron had been infused in the patient because of iron deficiency anemia. Blood glucose level was 17.3 mmol/L, and hemoglobin A1c level was 9.0% at admission. He was treated using phlebotomy (400 mL per week), along with subcutaneous injection of 3,000 U of recombinant human erythropoietin three times a week. After approximately 100 days, a total of 5,500 mL of blood (2.75 g iron) could be removed. Serum ferritin level decreased from 10,000 micrograms/L to 4,807 micrograms/L. Fasting and maximum serum C-peptide immunoreactivity values during 100-g oral glucose tolerance tests were improved from 0.14 nmol/L to 0.42 nmol/L and from 1.84 nmol/L to 2.61 nmol/L, respectively. This case suggests that pancreatic beta-cell recovers in diabetes caused by hemochromatosis by reducing iron overload during a short period.