Change of lipoprotein (a) and coagulative or fibrinolytic parameters in diabetic patients with nephropathy

Lipoprotein (a) (Lp(a)) is a plasma lipoprotein of high atherogenicity and competes with plasminogen at the site of plasminogen receptors. It is known that diabetic patients show a hypercoagulable state which might contribute to diabetic vascular complications. In the present study, mean levels of plasma Lp(a) and parameters of coagulation and fibrinolysis such as thrombin-antithrombin III complex (TAT) and alpha 2 plasmin inhibitor-plasmin complex (alpha 2PIC) were elevated in diabetic patients with nephropathy compared to healthy controls. A significant positive correlation was observed between the plasma levels of Lp(a) and alpha 2PIC (p < 0.05). Plasma levels of alpha 2PIC showed a significant positive correlation with those of TAT in the diabetic group, while there was no significant correlation observed in the non-diabetic group. The present results suggest that factors of Lp(a) and coagulation-fibrinolytic systems interacted, contributing to vascular complications in diabetic patients with nephropathy.