Lipoprotein (a) in type 2 diabetes mellitus: Relation to LDL:HDL ratio and glycemic control

Abstract

BACKGROUND:Increased lipoprotein (a) [Lp (a)] concentrations are predictive of coronary artery disease (CAD). Type 2 diabetes mellitus also leads to dyslipidemia, like elevated triglyceride levels and low HDL levels, which are known risk factors for CAD. This study was designed to investigate the levels of Lp (a) in type 2 diabetic patients and their association with LDL: HDL ratio and glycemic control.MATERIALS AND METHODS:The study included 60 patients of type 2 diabetes and 50 age and sex matched controls. The Lp(a) levels in the diabetic group were compared with the control group and the relationship between the Lp(a) levels and LDL: HDL ratio was evaluated. Diabetic group was further divided into three subgroups according to levels of glycated hemoglobin. Lp(a) levels and glycated hemoglobin in controlled and uncontrolled diabetes mellitus were also compared to find out any correlation between them. Statistical analysis was done using the students ‘t’ test and Chi square test.RESULTS:Lp(a) levels were found to be significantly increased in the diabetic group as compared to the control group (P< 0.001). LDL: HDL ratio was also increased in the diabetic group as compared to the control group. Lp(a) levels showed no association with LDL: HDL ratio and degree of glycemic control in these patients.CONCLUSIONS:The results of the present study suggest that Lp(a) levels are increased in type 2 diabetic patients. The elevated Lp(a) levels do not reflect the glycemic status and are also independent of increase in LDL:HDL ratio suggesting different metabolic pathways and the genetic connection for LDL and Lp(a).

Lipoprotein ( a ) and Atherogenic Indices in Sudanese Patients with Type 2 Diabetes

“…However, as shown in Figure (1) nearly half of the patients (51.4%) had Lp (a) greater than 30 mg/dl which is considered as a cut-off value of a higher risk for CVD. (38) In agreement with our finding, Singla et al (37) reported that the Lp(a) levels was significantly increased in in the patients of type 2 diabetes mellitus as compared to the control group (P< 0.001). Moreover, Singla et al reported that Lp(a) levels in the patients of type 2 diabetes mellitus were associated with the LDL:HDL ratio and HbA1c which conflicted with our finding that no association between Lp (a) and LDL-C:HDL-C ratio was noticed as shown in table 3.…”

“…(36) However, studies regarding association of the mean Lp (a) levels with diabetes is contradictory. (37) In this report the mean concentration of Lp (a) in Sudanese type 2 diabetics was significantly higher than healthy controls (28.49±5.5 vs. 23.06±4.2 mg/dl, p< .001). However, as shown in Figure (1) nearly half of the patients (51.4%) had Lp (a) greater than 30 mg/dl which is considered as a cut-off value of a higher risk for CVD.…”

Role of glycated hemoglobin (HBA1c) as a dual marker to predict glycemic status and dyslipidemia in type II diabetes mellitus

“…30 Type 2 diabetes mellitus is commonly associated with an abnormal lipoprotein phenotype which is characterised by increased TAG, decreased HDLc and an accumulation of small dense LDLc particles (The so called atherogenic dyslipidemic phenotype). 31 Our study also showed a significant increase in TC/HDLc and LDLc/HDLc ratios between control and patient groups and also in between controlled and uncontrolled diabetic group. An increased CAD risk was suggested due to the increase in total cholesterol/ HDLc ratio.…”

Lipoprotein (a): impact by ethnicity and environmental and medical conditions

“…Early studies re ported elevated Lp(a) concentrations in patients with type 1 diabetes mellitus (IDDM) (225)(226)(227)(228)(229)(230), as well as in pa tients with type 2 diabetes mellitus (NIDDM) (231,232). Furthermore, some recent studies in Asian populations report an association between an elevated Lp(a) concen tration and incident NIDDM (233)(234)(235). Rainwater et al (236) reported significantly lower Lp(a) concentrations in NIDDM patients compared with matched nondiabetic controls in the San Antonio Heart Study.…”