Lipoprotein(a) in South Indian Type 2 Diabetic Subjects in Relation to Diabetic Vascular Complications
R Deepa, Anjana Mohan, M Rema, SP Haranath, G Saravanan, V Mohan
MV Diabetes Specialities Centre, Madras Diabetes Research Foundation, Gopalapuram, Chennai, India.
Received : 2.3.2001; Revised : 14.8.2001; Accepted : 16.9.2001
Objectives : Lipoprotein(a) [LP(a)] has been reported to be an independent risk factor for coronary artery disease (CAD). However, its relationship with other vascular complications is not clear. The aim of the study was to determine the relation of lipoprotein(a) with micro- and macrovascular complications seen in type 2 diabetic patients.
Methods : We studied 725 type 2 diabetic patients with and without diabetic complications at the MV Diabetes Specialities Centre, Chennai. The mean age of the study group was 54 ± 10 years and 70% were males. Diabetic complications viz retinopathy, proteinuria, peripheral vascular disease and coronary artery disease were diagnosed using standardized definitions. Lipoprotein(a) levels were measured using enzyme linked immunosorbant assay (ELISA). Since the frequency distribution of Lp(a) was skewed Lp(a) values were log transformed and geometric mean was used for statistical analysis.
Results : The mean Lp(a) level of patients with any vascular complication was significantly higher compared to the subjects without any complications. Multiple logistic regression analysis revealed that lipoprotein(a) had as independent association with CAD (Odds Ratio - 1.16, p=0.04) and proteinuria (Odds Ratio - 1.69, p < 0.001). The association of Lp(a) with retinopathy and PVD turned out to be non-significant when CAD and proteinuria was introduced as cofactors in the regression model.
Conclusion : Lp(a) concentrations are found to be higher in those with CAD and proteinuria. There appears to be no association between Lp(a) and retinopathy or PVD in South Indian type 2 diabetic patients. (J Assoc Physicians India 2002;50:657-661)