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Decrease of lipoprotein(a) with improved glycemic control in IDDM subjects.

S M Haffner1, K R Tuttle, D L Rainwater

  • 1Department of Medicine, University of Texas Health Science Center, San Antonio 78284.

Diabetes Care
|April 1, 1991
PubMed
Summary
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Improving metabolic control in insulin-dependent diabetes mellitus (IDDM) significantly lowered lipoprotein(a) [Lp(a)] levels. This suggests better diabetes management may reduce coronary heart disease risk associated with Lp(a) in IDDM patients.

Area of Science:

  • Cardiology
  • Endocrinology
  • Metabolic Syndrome

Background:

  • Lipoprotein(a) [Lp(a)] is a significant risk factor for coronary heart disease (CHD).
  • Individuals with insulin-dependent diabetes mellitus (IDDM) face elevated CHD risk.
  • Limited data exist on Lp(a) levels and metabolic control in IDDM.

Purpose of the Study:

  • To investigate the impact of improved metabolic control on plasma Lp(a) concentrations in IDDM patients.
  • To assess changes in plasma lipids and lipoproteins alongside Lp(a) levels.

Main Methods:

  • Studied 12 IDDM subjects over 21 days of tight metabolic control.
  • Measured plasma Lp(a), lipids, and lipoproteins before and after the intervention.
  • Analyzed apolipoprotein(a) isoform distribution.

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Main Results:

  • Glycosylated hemoglobin decreased significantly (8.4% to 6.9%, P < 0.001).
  • Plasma Lp(a) concentrations showed a significant decline (29.7 to 27.1 mg/dl, P = 0.022).
  • No significant changes were observed in total, LDL, or HDL cholesterol; triglyceride changes were borderline significant.

Conclusions:

  • Improved metabolic control in IDDM may reduce CHD risk by lowering Lp(a) levels.
  • Despite a small sample size and modest control improvement, findings suggest a potential therapeutic link.
  • Lp(a) concentrations in IDDM patients were higher compared to non-diabetic controls.