Effect of Insulin-Dependent Diabetes Mellitus on Lipids and Lipoproteins: A Study of Identical Twins

Dubrey, Simon W; Reaveley, D. A.; Leslie, David G.; O'Donnell, M.; O'Connor, B.; Seed, Mary

doi:10.1042/cs0840537

Cited by 6 publications

(3 citation statements)

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“…Serum Lp(a) levels in patients with (n = 11) and without (n= 15) nephropathy were 42.5 +29.5 mg/dl and 62.2+42.8 mg/dl, respectively. This difference was not significant, Dubrey et al [36] reported that albumin secretion does not affect serum apo(a) levels in IDDM. We previously reported a similar finding in NIDDM [13].…”

Section: Discussionmentioning

confidence: 79%

“…We have previously reported [13] that the Lp(a) concentration was negatively correlated with the apo(a) molecular weight. Dubrey et al [36] studied the effect of IDDM on serum lipid and lipoprotein levels in identical twins and found that IDDM per se has no influence on serum Lp(a) levels, although the correlation within each twin pair was significant. Subjects with the same apo(a) phenotypes within a family show similar plasma Lp(a) levels [20][21][22].…”

Section: Discussionmentioning

confidence: 99%

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Serum lipoprotein(a) concentrations and apolipoprotein(a) phenotypes in the families of NIDDM patients

et al. 1995

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We studied the quantitative and qualitative characteristics of lipoprotein(a) [Lp(a)] as a function of apolipoprotein(a) [apo(a)] phenotype in 87 members (42 males, 45 females) of 20 diabetic families, 26 of whom were diagnosed with non-insulin-dependent diabetes mellitus (NIDDM) with moderate glycaemic control (HbA1c 7.1 +/- 1.2%). Apo(a) phenotyping was performed by a sensitive, high-resolution technique using SDS-agarose/gradient PAGE (3-6%). To date, 26 different apo(a) phenotypes, including a null type, have been identified. Serum Lp(a) levels of NIDDM patients and non-diabetic members of the same family who had the same apo(a) phenotypes were compared, while case control subjects were chosen from high-Lp(a) non-diabetic and low-Lp(a) nondiabetic groups with the same apo(a) phenotypes in the same family. Serum Lp(a) levels were significantly higher in NIDDM patients than in non-diabetic subjects (39.8 +/- 33.3 vs 22.3 +/- 19.5 mg/dl, p < 0.05). The difference in the mean Lp(a) level between the diabetic and non-diabetic groups was significantly (p < 0.05) greater than that between the high-Lp(a) non-diabetic and low-Lp(a) non-diabetic groups. An analysis of covariance and a least square means comparison indicated that the regression line between serum Lp(a) levels [log Lp(a)] and apo(a) phenotypes in the diabetic patient group was significantly (p < 0.01) elevated for each apo(a) phenotype, compared to the regression line of the control group. These data together with our previous findings that serum Lp(a) levels are genetically controlled by apo(a) phenotypes, suggest that Lp(a) levels in diabetic patients are not regulated by smaller apo(a) isoforms, and that serum Lp(a) levels are greater in diabetic patients than in non-diabetic family members, even when they share the same apo(a) phenotypes.

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Section: Discussionmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Serum lipoprotein(a) concentrations and apolipoprotein(a) phenotypes in the families of NIDDM patients

et al. 1995

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“…Serum and urinary creatinine were measured on a BM/Hitachi 717 automatic analyzer (Boehringer Mannheim, Lewes, U.K.). Serum total cholesterol and high-density and low-density cholesterol fractions as well as triglyceride concentrations were estimated, as described previously (15).…”

Section: Biochemical Analysesmentioning

confidence: 99%

Erythrocyte Sodium-Lithium Countertransport Activity in Non-Nephropathic Diabetic Twins

Hardman

Dubrey²,

Leslie³

et al. 1996

Diabetes Care

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An elevation in Na-Li countertransport activity has been noted in non-nephropathic normotensive twin pairs both discordant and concordant for IDDM. The potential genetic contribution to the altered behavior of the countertransporter was similar in both types of twins studied, and individual Na-Li countertransport activities were not significantly related to either duration of diabetes or metabolic control.

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Exercise electrocardiography and aortic Doppler velocimetry in asymptomatic identical twins discordant for type 1 (insulin dependent) diabetes.

Dubrey

Akhras

Song

et al. 1994

Heart

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Objective-To determine the influence of insulin dependent diabetes on the prevalence of myocardial ischaemia and on global left ventricular systolic performance. Design-Stress treadmill electrocardiograms and simultaneous Doppler measurement of aortic maximum acceleration were obtained during exercise on symptom free subjects. The electrocardiograms were scored blindly according to the Minnesota code. Participants-39 identical twin pairs (22 male) discordant for insulin dependent diabetes and 39 non-diabetic controls of similar age and sex were examined. The twins and controls had a mean age of 37 (range 25-69) with a mean (SD) duration of diabetes in the diabetic twin of 17 (7) years. Those selected were normotensive and had no renal impairment. Results-Systolic blood pressure was significantly higher in the diabetic twins than in their non-diabetic cotwins both at rest (p < 0.05) and at peak exercise (p < 0.01). Electrocardiographic evidence of ischaemia was not correlated within twin pairs and was found in similar numbers of diabetic twins, their non-diabetic cotwins, and control subjects. Abnormal electrocardiograms were found in a similar number of diabetic twins (23%), non-diabetic cotwins (18%), and controls (15%). There was a significant correlation in Doppler measurements of global left ventricular systolic function within the identical twins; no significant difference was found for these Doppler measurements in the diabetic twins, non-diabetic cotwins, or controls. Conclusion-Exercise characteristics and cardiac function seem to be subject to shared genetic or shared environmental influences or both, whereas electrocardiographic features of ischaemia seem to be environmentally determined. In a selected cohort of diabetic identical twins without evidence of nephropathy there was no evidence that diabetes influenced the prevalence of myocardial ischaemia or global left ventricular systolic function. (Br Heart J 1994;71:341-348) Premature coronary artery disease is an important cause of morbidity and mortality in juvenile onset insulin dependent diabetes mellitus.'-2 The excess mortality from coronary artery disease is predominantly attributed to diabetic patients with persistent proteinuria, a hallmark of diabetic nephropathy.3 A less striking but considerably increased risk of coronary artery disease has also been reported in insulin dependent diabetes even in the absence of diabetic nephropathy.34 This effect could be due either to an influence of diabetes on risk factors for coronary artery disease or to an unrecognised genetic susceptibility to coronary disease. Risk factors for coronary artery disease are, however, only minimally altered by insulin dependent diabetes when renal function is normal and if diabetic control is good.56 To examine the effect of insulin dependent diabetes on the prevalence of myocardial ischaemia, in the absence of diabetic nephropathy, we have studied genetically identical twins discordant for diabetes. Myocardial ischaemia was estimated with exercise electroca...

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Effect of Insulin-Dependent Diabetes Mellitus on Lipids and Lipoproteins: A Study of Identical Twins

Cited by 6 publications

References 1 publication

Serum lipoprotein(a) concentrations and apolipoprotein(a) phenotypes in the families of NIDDM patients

Serum lipoprotein(a) concentrations and apolipoprotein(a) phenotypes in the families of NIDDM patients

Erythrocyte Sodium-Lithium Countertransport Activity in Non-Nephropathic Diabetic Twins

Exercise electrocardiography and aortic Doppler velocimetry in asymptomatic identical twins discordant for type 1 (insulin dependent) diabetes.

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