Lipoprotein(a) in Diabetic Patients with and Without Chronic Renal Failure

Abstract

Lp(a) may contribute to the increased prevalence of atherosclerotic disease in diabetic patients and patients with chronic renal failure, especially in IDDM patients whose lipoprotein pattern was not different from that of the control group.

Levels of lipoprotein(a), apolipoprotein B, and lipoprotein cholesterol distribution in IDDM. Results from follow-up in the Diabetes Control and Complications Trial

“…Conclusions as to the effect of improved glycemic control on Lp(a) levels have also varied [29,33,[35][36][37][38][39][40][41][42]. At follow-up in the DCCT, Caucasian subjects who received conventional treatment had significantly higher levels of Lp(a) than both the subjects who received intensive treatment and those in a nondiabetic control population.…”

“…Some investigators found elevated Lp(a) levels in subjects with IDDM compared with normoglycemic control subjects [29,30], white others have not [31][32][33][34]. Several studies of IDDM subjects have shown that Lp(a) levels increase with worsening glycemic control [35][36][37][38][39][40], although other studies have not [29,33,41,42]. Finally, earlier studies showed a direct correlation between the degree of proteinuria and increasing Lp(a) levels in subjects with IDDM [43][44][45][46], but more recent studies have not [31,42,47].…”

“…How Lp(a) levels might be affected by IDDM and its complications and whether Lp(a) contributes to CAD [27,28] in this population remain controversial. Some investigators found elevated Lp(a) levels in subjects with IDDM compared with normoglycemic control subjects [29,30], white others have not [31][32][33][34]. Several studies of IDDM subjects have shown that Lp(a) levels increase with worsening glycemic control [35][36][37][38][39][40], although other studies have not [29,33,41,42].…”

“…In subjects with IDDM and proteinuria, Lp(a) levels have been reported to be either increased or unchanged [31,[42][43][44][45][46][47]. Several studies of patients with nephrotic syndrome and/or renal failure from various causes have failed to demonstrate a difference in Lp(a) levels in subjects with IDDM compared with in subjects with other causes of renal dysfunction [20,29,65]. In the present study, most of the subjects had a normal creatinine clearance (greater than 1.17 ml [bullet] s sup-1 [bullet] 1.73 m sup-2) and level of albuminuria (less than 40 mg/24 h).…”

Microalbuminúria em pacientes diabéticos tipo 1: prevalência e fatores associados

“…Estes dados estão de acordo com o que já foi descrito na literatura em outros estudos transversais (44)(45)(46). A maioria dos estudos que descreve uma associação, esta é principalmente com os níveis de colesterol total e LDL-colesterol (47,48) e ainda é importante ressaltar que na maioria dos estudos clínicos, onde há alterações significativas do perfil lipídico nos pacientes diabéticos tipo 1, estes apresentam uma taxa de excreção de albumina já considerada como macroalbuminúria (28).…”