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Lipoprotein(a), apolipoprotein(a) polymorphism and coronary atherosclerosis severity in type 2 diabetic patients

C Gazzaruso1, R Bruno, A Pujia

  • 1IRCCS Maugeri Foundation Hospital Scientific Institue of Pavia, Italy. c.azzaruso@tele2.it

International Journal of Cardiology
|June 18, 2005
PubMed

Insights

High lipoprotein(a) levels and specific apolipoprotein(a) gene variations are linked to more severe coronary artery disease in type 2 diabetes patients. These factors independently predict the extent of atherosclerosis in this population.

Area of Science:

  • Cardiology
  • Diabetology
  • Genetics

Background:

  • Limited data exist on the association between lipoprotein(a) [Lp(a)] levels and coronary artery disease (CAD) severity in diabetic patients.
  • Previous studies have not investigated the influence of apolipoprotein(a) [apo(a)] polymorphism on this relationship.
  • This study aims to analyze Lp(a) levels and apo(a) polymorphism in relation to coronary atherosclerosis severity in type 2 diabetes.

Purpose of the Study:

  • To investigate the association between Lp(a) levels and CAD severity in type 2 diabetic patients.
  • To examine the role of apo(a) polymorphism in predicting CAD severity in this cohort.
  • To determine if Lp(a) and apo(a) are independent predictors of coronary atherosclerosis in type 2 diabetes.

Main Methods:

  • A cohort of 227 type 2 diabetic patients undergoing coronary angiography was studied.
  • Patients were categorized based on the number of diseased coronary arteries: normal, single-vessel, double-vessel, and multi-vessel disease.
  • Lp(a) levels and apo(a) phenotypes were analyzed in relation to CAD severity.

Main Results:

  • Both Lp(a) levels and the prevalence of low molecular weight apo(a) isoforms significantly increased with the number of diseased coronary vessels (p<0.001).
  • Multiple logistic regression revealed that elevated Lp(a) levels (OR: 1.31) and apo(a) polymorphism (OR: 3.43) were independent predictors of CAD severity.
  • Specifically, patients with multi-vessel disease showed higher Lp(a) levels and a greater percentage of low molecular weight apo(a) isoforms.

Conclusions:

  • Elevated Lp(a) levels are significantly associated with increased coronary artery disease severity in type 2 diabetic patients.
  • Apo(a) polymorphism, particularly low molecular weight isoforms, is also a significant predictor of CAD severity in this population.
  • Lp(a) levels and apo(a) polymorphism are suggested as reliable predictors of coronary atherosclerosis severity in type 2 diabetes.
Abstract

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