Lipoprotein(a) and cardiovascular disease in diabetic patients

Qi, Qibin; Qi, Lü

doi:10.2217/clp.12.46

Cited by 22 publications

(14 citation statements)

References 92 publications

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“…As expected, overall macroangiopathy, including CAD, was significantly more frequent in patients with higher Lp (a) , consistent with previous transversal or longitudinal studies in diabetic [ 10 , 11 ] and non-diabetic patients [ 26 – 28 ]. Macroangiopathy prevalence increased already in the 3 rd quartile, suggesting enhanced vulnerability of large vessels at modestly high Lp (a) levels in diabetes.…”

Section: Discussionsupporting

confidence: 91%

The mixed benefit of low lipoprotein(a) in type 2 diabetes

2017

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Background: Lipoprotein(a) (Lp(a)), a variant low-density lipoprotein (LDL), is a major genetic risk factor for cardiovascular disease. It is unknown whether an inverse relationship exists between Lp(a) and β-cell function (BCF), as for LDL-cholesterol (LDL-C) lowering by statins. We therefore assessedthe cardiometabolic phenotype of 340 men with type 2 diabetes mellitus (T2DM) in relation to Lp(a), focusing on BCF and hyperbolic product [BxS], which adjusts BCF to insulin sensitivity and secretion. Methods: Two groups were analyzed according to Lp(a) quartiles (Q): a (very-)low Lp(a) (Q1;n = 85) vs a normal-to-high Lp(a) group (Q2-Q4;n = 255). Results: In the overall cohort, mean Lp(a) was 52 nmol.L −1 . Median Lp(a) was 6 nmol.L −1 (Q1) vs 38 nmol.L

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Section: Discussionsupporting

confidence: 91%

The mixed benefit of low lipoprotein(a) in type 2 diabetes

2017

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“…Lp(a) is an LDL‐like particle consisting of an apolipoprotein. A moiety linked to one molecule of apolipoprotein B(100), and there has been highly suggestive evidence for a potentially causal role of Lp(a) in affecting CVD risk in general populations. However, plasma Lp(a) levels were observed to be inversely associated with type 2 diabetes mellitus, prediabetes and insulin resistance in several recent studies, and epidemiological studies of Lp(a) and CVD risk in diabetes mellitus generated inconsistent results.…”

Section: Discussionmentioning

confidence: 99%

Vildagliptin reduces plasma stromal cell‐derived factor‐1α in patients with type 2 diabetes compared with glimepiride

Park

Kwak

Cho

et al. 2016

J of Diabetes Invest

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Aims/IntroductionDipeptidyl peptidase‐4 inhibitors might have pleiotropic protective effects on cardiovascular disease (CVD), in contrast to sulfonylureas. Therefore, we compared various CVD risk factors between vildagliptin and glimepiride.Materials and MethodsWe carried out a randomized, prospective and crossover trial. A total of 16 patients with type 2 diabetes whose glycated hemoglobin was >7% were randomized to add vildagliptin or glimepiride. After 12‐week treatment, each drug was replaced with the other for another 12 weeks. Before and after each treatment, glucose homeostasis and CVD risk factors were assessed, and the continuous glucose monitoring system was applied to calculate glycemic variability.ResultsThe mean age of the participants was 60 years, 31% were men, body mass index 25.5 kg/m2 and HbA1c 8.41%. Both vildagliptin and glimepiride significantly decreased glycated hemoglobin and glycemic variability indices. Despite the improved glucose homeostasis, favorable change of CVD markers was not prominent in both the arms, along with significant weight gain. Only plasma stromal cell‐derived factor (SDF)‐1α decreased by 30% in the vildagliptin arm. According to regression analyses, the reduction of SDF‐1α was independently associated with vildagliptin usage and serum interleukin‐6 changes, but white blood cells were not related with the SDF‐1α changes.ConclusionCompared with glimepiride, vildagliptin arrestingly decreased plasma SDF‐1α, and its clinical implications should be further investigated.

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“…Several meta-analyses have provided support for an association between Lp(a) and CVD [41–44]. It remains unclear as to whether Lp(a) causally affects increased CVD risk in patients with diabetes [45]. To our knowledge, this is the first study which has assessed information on Lp(a) in exclusively children with either type of diabetes who are also overweight or obese.…”

Section: 0 Discussionmentioning

confidence: 99%

Overweight adolescents with type 2 diabetes have significantly higher lipoprotein abnormalities than those with type 1 diabetes

Hanks

Pelham

Vaid

et al. 2016

Diabetes Research and Clinical Practice

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Aim Diabetes-associated glucoregulatory derangements may precipitate atherogenesis in childhood and CVD risk, particularly with obesity. We aimed to delineate lipoprotein profile differences between children with type 1 and 2 diabetes who are overweight/obese. Methods Data were obtained from electronic medical records of patients ≥85th BMI percentile with type 1 (n=159) and type 2 (n=77) diabetes, ages 12–19y. Group differences were evaluated by correlations and general linear modeling analysis, adjusting for BMI, HbA1c, and diabetes duration. Results There were no group differences in TC, LDL, or non-HDL. Fewer subjects with type 1 diabetes had low HDL (17 vs. 30%; P<0.05). While no difference in HbA1c level was observed between groups, HbA1c was positively correlated with TC (P≤0.0001), LDL (P≤0.0001), non-HDL (P≤0.0001), ApoB100 (P≤0.0001), and LDL pattern B (P≤0.0001). In adjusted models, apoB100 (85.4 vs. 91.3mg/dl; P<0.05) and incidence of LDL pattern B (21 vs. 42%; P<0.01) were lower in subjects with type 1 diabetes. BMI was inversely correlated with HDL, HDL-2 and HDL-3 (all P≤0.0001). The correlation of BMI with HDL-2 and HDL-3 were attenuated when evaluating subjects by diabetes type. Conclusions Despite having no difference in absolute LDL levels, children with type 2 diabetes were more likely to have small, dense LDL particle pattern, higher apo B100 and lower total HDL, HDL-2, and HDL-3 fractions. Furthermore, poor glycemic control was associated with abnormal lipoprotein profiles in patients with both type 1 and 2 diabetes.

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Lipoprotein(a) and cardiovascular disease in diabetic patients

Cited by 22 publications

References 92 publications

The mixed benefit of low lipoprotein(a) in type 2 diabetes

The mixed benefit of low lipoprotein(a) in type 2 diabetes

Vildagliptin reduces plasma stromal cell‐derived factor‐1α in patients with type 2 diabetes compared with glimepiride

Overweight adolescents with type 2 diabetes have significantly higher lipoprotein abnormalities than those with type 1 diabetes

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