Serum Lipoprotein(a) Levels are Greater in Female than Male Patients with Type‐2 Diabetes

Abstract

Women with diabetes are faced with a higher risk of dyslipidemia and cardiovascular disorders than men with diabetes. We aimed to study the role of gender and menopausal status in serum Lp(a) levels in patients with type 2 diabetes. We quantified serum Lp(a) levels in a group of 477 patients with type 2 diabetes (men, premenopausal and postmenopausal women with diabetes), as well as in 105 controls. We stratified the patients into two groups of low Lp(a) levels (Lp(a) <35 mg/dl) and elevated Lp(a) levels (Lp(a) >35 mg/dl). Patients with diabetes had higher serum Lp(a) levels than the controls. Serum Lp(a) levels was significantly higher in women with diabetes than men with diabetes. Lp(a) levels did not differ between male and females in the control group. Premenopausal and postmenopausal women with diabetes did not differ significantly in serum Lp(a) levels. The odds ratio of having a serum Lp(a) level higher than 35 was 5.85 in premenopausal women with diabetes, 5.08 in postmenopausal women with diabetes, 2.41 in men with diabetes and 1.9 in the women in the control group compared to the men in the control group, after adjustment for age and BMI. This observational study clearly indicated that serum Lp(a) levels were significantly higher in women and men with diabetes. The increase in women was independent of menopause. The level of serum Lp(a) had no correlation with lipid parameters in men or women.

Gender-dependent association of type 2 diabetes with the vasoactive intestinal peptide receptor 1

“…This is confirmed in our study since the cohort of diabetic woman show worse parameters that diabetic males except for the cholesterol-HDL as already reported (Wannamethee et al, 2011). It is indeed well established that post-menopausal women are more prone to dyslipidemia as well as to an increased risk of mortality for cardiovascular diseases (Kautzky-Willer et al, 2010;Nakhjavani et al, 2011). The reason for this is not clear but it is possible that diabetes has a greater adverse effect in cardiovascular risk factors (Wannamethee et al, 2011).…”

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.…”

Lipoprotein(a) in postmenopausal women: assessment of cardiovascular risk and therapeutic options

“…Interestingly, in cases of surgical menopause, a significant increase in Lp(a) concentrations is already noticed 3 months after oophorectomy . However, few studies have directly compared Lp(a) concentrations between pre‐ and postmenopausal women . In the majority of them, postmenopausal women had higher Lp(a) compared with premenopausal, as well as with perimenopausal women .…”

“…Moreover, oxidative compounds, such as oxidised phospholipid (OxPL), non‐covalently bound to apoB‐100, are also key mediators for the role of Lp(a) in the atherosclerotic process . However, despite the independent association of Lp(a) concentrations with increased prevalence of CVD, few studies have assessed its role in menopause‐related CVD risk, seeking for differences between pre‐ and postmenopausal women …”