Independent Correlation Between Plasma Lipoprotein(a) and Angiographie Coronary Artery Disease in NIDDM

Watts, GF; Gwilym, R. M. Ap; Mazurkiewicz, J; Coltart, J

doi:10.2337/diacare.18.2.234

Cited by 24 publications

(11 citation statements)

References 10 publications

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“…Several studies showed that Lp(a) levels were associated with CAD extent and progressions in the general population [28,29,30,31], and the group of type II diabetic patients [32, 33]. In addition, some studies showed that Lp(a) levels and apo(a) polymorphism are associated with CAD severity [32, 34].…”

Section: Discussionmentioning

confidence: 99%

Lipoprotein(a) and LDL Particle Size Are Related to the Severity of Coronary Artery Disease

Moon

Kwon

et al. 2007

Cardiology

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Background: The pathophysiological role and metabolic pathway of Lp(a) have not been clearly defined. An association between Lp(a) and oxidative low-density lipoprotein (LDL) were recently reported. And small dense LDL (sd-LDL) were associated with circulating malondialdehyde-modified LDL. We investigated the relationships between serum Lp(a) level and LDL particle size in coronary artery disease (CAD) patients. Further, we investigated the relationships of sd-LDL and Lp(a) with the extent and severity of CAD. Methods: A total of 490 patients (mean: 60.5 ± 11.5 years old) who underwent coronary angiography to evaluate chest pain were investigated. Patients were classified into two groups, a CAD group (n = 256), who had significant stenosis observed by coronary angiogram, and a control group (n = 234), who had normal, or minimal coronary arteries. CAD severity was measured by Gensini scores. The distribution of the LDL subfraction was analyzed using a Quantimetrix Lipoprint LDL System. Results: The serum Lp(a) concentration was correlated with the fraction of sd-LDL (r = 0.193, p < 0.001) and mean LDL size (r = 0.160, p = 0.003). The Lp(a) level and mean LDL particle size were significantly correlated with a high Gensini score. LDL particle size in the CAD group was smaller than in the control group (26.74 ± 0.64 vs. 26.43 ± 0.93 nm, p < 0.001). The Gensini score was significantly higher in small LDL with high Lp(a) level groups. Conclusion: The positive correlation of the level of Lp(a) and sd-LDL fraction were demonstrated. The mechanism of this association is not clearly defined; we can suggest that it may stem from the individual atherogenic condition that linked to increased oxidative stress. Both increased Lp(a) and sd-LDL fraction were correlated with the severity of CAD.

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Section: Discussionmentioning

confidence: 99%

Lipoprotein(a) and LDL Particle Size Are Related to the Severity of Coronary Artery Disease

Moon

Kwon

et al. 2007

Cardiology

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“…12,13,17 Data from Watts et al 12 group containing 36 diabetics with coronary angiography in 1995 and Gazzaruso et al 13 group enrolling 227 CAD patients with diabetes in 2006 suggested that Lp(a) might be a reliable predictor of CAD severity in type 2 diabetic patients, whereas the study performed by Pedreno et al 17 in 2000 suggested that there was lack of an association in CAD patients with diabetics (n = 355, 101 patients with diabetes and 254 patients without diabetes). In this study, we investigated the relationship between Lp(a) and the severity of new-onset CAD in patients with diabetes in a relatively large sample size and compared with those without diabetes.…”

Section: Discussionmentioning

confidence: 99%

“…7 However, although Lp(a), used as a unique cardiovascular risk factor, has been widely, intensively studied for many years, particularly in recent years, whether the level of Lp(a) is an independent risk factor for CVD remains controversial till now. [8][9][10][11][12][13] Several studies indicated that Lp(a) might initiate atherosclerosis 14,15 and possibly promote thrombosis at very high levels, 16 while other data did not support the notion that Lp(a) was an independent predictor for CVD risk. 17 At the same time, few studies have analysed the relationship between serum Lp(a) levels and the severity of coronary artery disease (CAD), in particular using the well-recognized quantitative coronary scores in a large sample size.…”

Section: Introductionmentioning

confidence: 99%

Role of lipoprotein(a) in predicting the severity of new on-set coronary artery disease in type 2 diabetics: A Gensini score evaluation

Chen

Zhang

et al. 2015

Diabetes and Vascular Disease Research

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The objective of the study was to investigate the usefulness of serum lipoprotein(a) level in predicting the severity of new on-set coronary artery disease in type 2 diabetics. A total of 1254 new on-set, consecutive coronary artery disease patients were classified into two groups: diabetes group (n = 380) and non-diabetes group (n = 874). The relationship between serum lipoprotein(a) levels and the severity of coronary artery disease assessed by Gensini score was analysed. Data showed that the diabetes group had higher serum triglyceride and high sensitivity C-reactive protein levels but lower high-density lipoprotein cholesterol levels (all p < 0.05). The multivariate logistic regression analysis suggested that lipoprotein(a) was an independent predictor for high Gensini score (odds ratio = 1.82, 95% confidence interval: 1.10-3.12, p = 0.029) after adjusting for traditional cardiovascular risk factors. Additionally, lipoprotein(a) levels were positively correlated with Gensini score (rho = 0.15, p = 0.014) and significantly elevated according to the tertiles of Gensini score (p = 0.008) in diabetics. However, no such results were observed in non-diabetics. Our data indicate that lipoprotein(a) is an independent predictor for the severity of new on-set coronary artery disease patients accompanied by type 2 diabetes, suggesting that these patients may benefit from lipoprotein(a) management in clinical assessment.

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“…There is also evidence that Lp(a) lipoprotein, which is associated with coronary heart disease in Type II diabetes [26,27], is an acutephase protein [9,28]. 2 A model for the role of cytokines and the innate immune system in the aetiology of Type II diabetes.…”

Section: Evidence For An Acute-phase Response In Type II Diabetesmentioning

confidence: 99%

Is Type II diabetes mellitus a disease of the innate immune system?

1998

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The cause of the common type of Type II (non-insulin-dependent) diabetes mellitus, which affects at least 100 million people throughout the world, is not known. One of the foremost challenges we face is to account mechanistically for not only the defining hyperglycaemia but also for the myriad of other biochemical and physiological abnormalities which are characteristic of this disease. For example, it is now clear that Type II diabetes and lesser degrees of glucose intolerance commonly occur together with a collection of clinical and biochemical features which have been called metabolic syndrome X [1, 2].These features include central obesity, hypertension, accelerated atherosclerosis, hypertriglyceridaemia and low serum concentrations of high-density lipoprotein (HDL) cholesterol. Though insulin resistance seems to be a central abnormality, the origin of the impaired insulin action and how it explains the many other abnormalities of Type II diabetes is not known.In recent years, we have been gathering evidence that in Type II diabetes there is a cytokine-associated acute-phase reaction, part of the innate immune response. As an alternative direction for research into the aetiology of Type II diabetes, we propose that it may be helpful to consider whether the mechanisms involved in the acute-phase response can be major contributors to the pathophysiology of many of the features of Type II diabetes and syndrome X, including glucose intolerance, insulin resistance, impair- Diabetologia (1998) Summary Type II (non-insulin-dependent) diabetes mellitus is associated with increased blood concentrations of markers of the acute-phase response, including sialic acid, a-1 acid glycoprotein, serum amyloid A, C-reactive protein and cortisol, and the main cytokine mediator of the response, interleukin-6. The dyslipidaemia common in Type II diabetes (hypertriglyceridaemia and low serum levels of HDL cholesterol) is also a feature of natural and experimental acutephase reactions. We review evidence that a long-term cytokine-mediated acute-phase reaction occurs in Type II diabetes and is part of a wide-ranging innate immune response. Through the action of cytokines on the brain, liver, endothelium, adipose tissue and elsewhere, this process could be a major contributor to the biochemical and clinical features of metabolic syndrome X (glucose intolerance, dyslipidaemia, insulin resistance, hypertension, central obesity, accelerated atherosclerosis) but also provides a mechanism for many other abnormalities seen in Type II diabetes, including those in blood clotting, the reproductive system, metal ion metabolism, psychological behaviour and capillary permeability. In the short-term, the innate immune system restores homeostasis after environmental threats; we suggest that in Type II diabetes and impaired glucose tolerance long-term lifestyle and environmental stimulants, probably in those with an innately hypersensitive acute-phase response, produce disease instead of repair. [Diabetologia (1998

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Independent Correlation Between Plasma Lipoprotein(a) and Angiographie Coronary Artery Disease in NIDDM

Abstract: Plasma Lp(a) is a strong and independent correlate of the extent of angiographic CAD in symptomatic patients with NIDDM.

Cited by 24 publications

References 10 publications

Lipoprotein(a) and LDL Particle Size Are Related to the Severity of Coronary Artery Disease

Lipoprotein(a) and LDL Particle Size Are Related to the Severity of Coronary Artery Disease

Role of lipoprotein(a) in predicting the severity of new on-set coronary artery disease in type 2 diabetics: A Gensini score evaluation

Is Type II diabetes mellitus a disease of the innate immune system?

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