Role of Lipoprotein (a) in the Pathogenesis of Diabetic Vascular Lesions. A 9-year Follow-Up Study.

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  • 糖尿病性血管合併症におけるＬｉｐｏｐｒｏｔｅｉｎ（ａ）の臨床的意義　　９年間の経過観察研究
  • A 9-year Follow-Up Study
  • 9年間の経過観察研究

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Abstract

To elucidate the role of lipoprotein (a)[Lp (a)] in the pathogenesis of vascular lesions in diabetic patients, ninety-four patients with type 2 diabetes mellitus (49 female and 45 male, mean age 57.4 years) were enrolled in this follow-up study. Lp (a) levels, serum lipids and glycemic status were evaluated over a 9-year period in all patients. Besides these biochemical parameters, the diabetic microangiopathies, such as neuropathy, retinopathy and nephropathy, and macroangiopathies, such as ischemic heart diseases, cerebrovascular diseases and arteriosclerosis obliterans (ASO), were monitored. Lp (a) levels were also measured in 100 control subjects without any detectable disease. Furthermore, phenotype classification of Lp (a) was performed by western blot analysis.<BR>Lp (a) levels in patients with type 2 diabetes mellitus were significantly higher than those of control subjects, though serum Lp (a) levels of diabetics without vascular lesions were not higher than those of control subjects. There was no significant relationship between Lp (a) levels at the beginning of the study and degrees of microangiopathies or macroangiopathies. After the 9-year follow-up period, the serum Lp (a) increment was significantly correlated with the occurrence of diabetic retinopathy. In addition, there was also a significant relationship between the Lp (a) increment and the occurrence of ASO. Among 57 patients, in whom the Lp (a) phenotype was determined by western blot analysis, 32 (56%) were judged to have phenotype IV. In these patients with Lp (a) phenotype IV, the serum Lp (a) increment was significantly correlated with the occurrence of ischemic heart diseases, cerebrovascular disorders, and ASO.

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