[Lipoprotein (a) and diabetes mellitus]

Area of Science:

• Cardiovascular Science
• Endocrinology
• Metabolic Disorders

Context:

• Lipoprotein(a) [Lp(a)] possesses atherogenic and thrombotic properties, establishing it as a significant risk factor for atherosclerotic disease.
• Diabetic patients, both with insulin-dependent (IDDM) and non-insulin-dependent diabetes mellitus (NIDDM), exhibit an increased risk of cardiovascular disease.
• Lp(a) has garnered attention as a potential risk factor specifically within the diabetic population.

Purpose:

• To investigate the role of Lipoprotein(a) [Lp(a)] as a risk factor in diabetic patients.
• To explore the association between Lp(a) levels and diabetic complications, including retinopathy and nephropathy.
• To clarify the conflicting literature regarding Lp(a) levels in IDDM and NIDDM and their relationship with metabolic control and vascular complications.

Summary:

• Lp(a) levels are possibly elevated in IDDM, potentially linked to metabolic control and microangiopathy, though findings are debated.
• Evidence suggests Lp(a) is not consistently elevated in NIDDM, with no strong correlation to blood glucose control or microalbuminuria.
• Elevated Lp(a) in some diabetic patients with coronary heart disease appears linked to genetic factors rather than diabetes itself.

Impact:

• Plasma Lp(a) measurement is advised for both IDDM and NIDDM patients to identify elevated levels.
• Identification of elevated Lp(a) warrants screening for other major vascular risk factors.
• Understanding Lp(a)'s role in diabetes can refine cardiovascular risk assessment and management strategies for diabetic patients.