Investigating the Atherogenic Risk of Lipoprotein(a) in Type 2 Diabetic Patients

Peela, Jagannadha Rao; Latiwesh, Omar B; Elshaari, Farag A.; Hussain, Azhar; Tabrez, Elsa; Viglianco, Emily; Edwards, Ajené; Ali, Farwa; Rawal, Avinash K

doi:10.7759/cureus.3030

Cited by 7 publications

(8 citation statements)

References 27 publications

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“…Some other stud-ies showed that CRP and IL-6 levels correlated with significance positively with Lp(a) levels in hemodialysis patients [16]. Lp(a) levels showed no significant correlations with glycemic control parameters nor insulin and triglyceride levels in study with diabetic patients [17]. Some authors suggest that levels of hsCRP are associated with a disorders of lipid profile such as an increase in total cholesterol, triglycerides and LDL cholesterol and lower HDL-but the mechanism is not entirely clear [18].…”

Section: Discussionmentioning

confidence: 83%

Chronic inflammation and lipid profile parameters in obese subjects with normal and disturbed glucose metabolism

et al. 2019

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Introduction/Objective In different states of increased chronic inflammation, like obesity and diabetes, early changes in lipid metabolism could represent an adaptive response aimed at diminishing the elevated inflammatory reaction. The aim of study was to investigate the impact of glucose tolerance status on relationship between chronic inflammation and lipid metabolism parameters. Methods The study consisted of four groups (n = 30 for each group): obese individuals with disturbed glucose metabolism (subjects with newly diagnosed type 2 diabetes (T2DM)) before and after metformin treatment initiation, obese subjects with normal glucose tolerance (NGT) and a control group of healthy normal weight subjects. Appropriate anthropometric measurements and laboratory tests were carried out in all participants. Results Among the subgroup of obese subjects, the association of highly sensitive C reactive protein (hsCRP) with triglycerides and lipoprotein (a) (Lp(a)) was especially pronounced in the group of T2DM subjects before treatment initiation. In this group, the level of inflammation was the highest and correlation coefficients of triglycerides and Lp(a) with hsCRP were significantly different compared with the group of obese without diabetes (r = 0.21 vs. r =-0.36; p = 0.0172) for triglycerides and (r =-0.17 vs. r = 0.36, p = 0.0324) for Lp(a). Correlations of hsCRP with triglycerides and Lp(a) in groups of NGT obese subjects and T2DM subjects after treatment initiation did not differ significantly. Treatment with metformin changed the relationship of hsCRP with triglycerides and Lp(a) to the one which is similar to the relationship observed in obese NGT subjects (r = 0.21 vs. r = 0.38; p = 0.2449) for triglycerides and (r =-0.17 vs. r =-0.27, p = 0.3562) for Lp(a). Conclusion In subjects with newly diagnosed T2DM, who have the highest level of inflammation, it is probable that the increase in triglycerides is a part of the anti-inflammatory response, whereas Lp(a) is probably produced and used in the reduction of elevated inflammation.

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Section: Discussionmentioning

confidence: 83%

Chronic inflammation and lipid profile parameters in obese subjects with normal and disturbed glucose metabolism

et al. 2019

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“…The first opinion was that there was a direct relationship between Lp(a) levels with TC and LDL-C and a reverse relationship between Lp(a) levels with HDL-C in healthy participants. The results from a research indicated that serum Lp(a) levels have a positive correlation with TC and LDL-C in patients with T2DM [ 16 ]. These results also revealed that serum Lp(a) levels had no significant associations with glycemic indices, HDL-C, BMI, and high blood pressure [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

“…The results from a research indicated that serum Lp(a) levels have a positive correlation with TC and LDL-C in patients with T2DM [ 16 ]. These results also revealed that serum Lp(a) levels had no significant associations with glycemic indices, HDL-C, BMI, and high blood pressure [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

“…The results indicated that serum Lp(a) levels in patients with T2DM are significantly higher. Serum Lp(a) levels have a positive correlation with total cholesterol (TC) and LDL-C in these patients [ 16 ]. Although raised serum Lp(a) is a strong predictor of premature CAD in patients with T2DM, among the individuals with premature CAD, patients with T2DM have lower Lp(a) levels than patients without T2DM [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

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Association of C-peptide and lipoprotein(a) as two predictors with cardiometabolic biomarkers in patients with type 2 diabetes in KERCADR population-based study

Mahmoodi

Najafipour

2022

PLoS ONE

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We sought association between serum Lipoprotein(a) and C-Peptide levels as two predictors with cardiometabolic biomarkers in patients with type 2 diabetes mellitus. This nested case-control study was conducted on 253 participants with type 2 diabetes mellitus and control from the second phase of the KERCADR cohort study. The participants were randomly allocated into case and control groups. The quantitative levels of Lipoprotein(a) and C-Peptide were measured by ELISA. Atherogenic indices of plasma were measured. The plasma Atherogenic Index of Plasma significantly decreased (P = 0.002) in case-male participants, and plasma Castelli Risk Index II level significantly increased (P = 0.008) in control-male participants with the highest dichotomy of Lipoprotein(a). The plasma Atherogenic Index of Plasma level in case-female participants significantly increased (P = 0.023) with the highest dichotomy of C-Peptide. Serum C-Peptide level significantly increased (P = 0.010 and P = 0.002, respectively) in control-male participants with the highest dichotomies of Atherogenic Index of Plasma and Castelli Risk Index I. There was a significant association between the highest quartile of C-Peptide and higher anthropometric values in case participants; and higher atherogenic indices of plasma and anthropometric values in control participants. Raised serum C-peptide than raised Lipoprotein(a) can be a prior predictor for cardiometabolic disease risk in healthy participants and patients with type 2 diabetes mellitus with increased cardiometabolic biomarkers. Case and control males with general and visceral obesity and case and control females with visceral obesity are exposure to increased C-peptide, respectively. Lipoprotein(a) may be risk independent biomarker for type 2 diabetes mellitus. Reducing raised Lipoprotein(a) levels to less than 30ng/ml with strict control of low density lipoprotein cholesterol would be the best approach to prevent coronary artery disease consequences. It is suggested that a screening system be set up to measure the Lp(a) levels in the community for seemingly healthy people or individuals with one or more cardiometabolic biomarkers.

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“…Moreover, it has been reported that lipoprotein (a) {Lp (a)} levels were elevated in patients with T2D. Lipoprotein (a) is a modified LDL particle that is considered an important risk factor for cardiovascular diseases (CVDs) in diabetic patients via its proatherogenic, prothrombotic, and inflammatory properties [5].…”

Section: Introductionmentioning

confidence: 99%

The vascular impact of dapagliflozin, liraglutide, and atorvastatin alone or in combinations in type 2 diabetic rat model

Medany

Hammadi

Khalifa

et al. 2022

Fundamemntal Clinical Pharma

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Diabetic dyslipidemia is a significant contributor in the pathogenesis of type 2 diabetes (T2D). The study aimed at comparing the effect of dapagliflozin, liraglutide, and atorvastatin alone or their combinations on lipids and inflammatory markers and their vascular impact in T2D rats. There were 56 male albino rats included in the study and divided into two main groups. Group A (8 rats) served as normal control. Group B (48 rats) were streptozotocin-nicotinamide-induced diabetic rats. Subgroups (B-1, B-2, B-3, B-4, B-5, and B-6) received (no medications, dapagliflozin, liraglutide, atorvastatin, dapagliflozin + atorvastatin, and liraglutide + atorvastatin), respectively. Urine albumin/creatinine ratio (UACR), glycosylated hemoglobin (HBA1c), fasting serum glucose (FSG), serum low-density lipoproteincholesterol (LDL-C), high-density lipoprotein-cholesterol (HDL-C), TGs, lipoprotein(a) Lp (a), serum thyrotropin (TSH), highly sensitive C-reactive protein (hs-CRP) and advanced glycation end products (AGEs), were assessed. Qualitative and quantitative histological examination of kidneys focused on renal corpuscles. Dapagliflozin improved the studied parameters but with statistically insignificant increase in LDL-C, Lp (a) and significant increase in UACR. Atorvastatin improved the studied parameters but with statistically insignificant increase in FSG and HbA1C. Liraglutide and the combination groups significantly improved all studied parameters. Histologically, liraglutide and atorvastatin produced therapeutic effect, while dapagliflozin depicted nephrotoxic effect. Combination groups resulted in better effects with normalization of most of renal corpuscles. There were positive correlations between LDL-C and hs-CRP, AGEs, TSH and mesangial expansion. Combination of atorvastatin with liraglutide can improve its vasculoprotective effect. Moreover, combination of atorvastatin with dapagliflozin can ameliorate its possible nephrotoxic effect.

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Investigating the Atherogenic Risk of Lipoprotein(a) in Type 2 Diabetic Patients

Cited by 7 publications

References 27 publications

Chronic inflammation and lipid profile parameters in obese subjects with normal and disturbed glucose metabolism

Chronic inflammation and lipid profile parameters in obese subjects with normal and disturbed glucose metabolism

Association of C-peptide and lipoprotein(a) as two predictors with cardiometabolic biomarkers in patients with type 2 diabetes in KERCADR population-based study

The vascular impact of dapagliflozin, liraglutide, and atorvastatin alone or in combinations in type 2 diabetic rat model

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