Diabetes Monit 2001;2(2):152-160.
제 2 형 당뇨병 환자에서 혈관합병증과 Lipoprotein ( a ) 와의 관계
김현각, 박지현, 류완희, 박태선, 백홍선
The Relation Between Lipoprotein ( a ) and Vascular Complications in Patients with Type 2 Diabetes Mellitus
Hyun Kag Kim, Ji Hyun Park, Wan Hee Yoo, Tae Sun Park, Hong Sun Baek
Abstract
Background
Lipoprotein(a) [Lp(a)] is a plasma particle, similar in size and lipid composition, to LDL, which, in addition to apo B1OO, contains a second glycoprotein, apo(a), which bears a strong resemblance to plasminogen. Many reports have indicated that Lp(a) is an independent risk factor for ischemic heart disease. Furthermore, recent studies have suggested an association between elevated Lp(a) levels and carotid atherosclerosis and chronic renal insufficiency in nondiabetic subjects. Thus we investigated the relationship between Lp (a) level and carotid intima-media thickness (IMT) and the other vascular complications in type 2 diabetes subjects. Method: A total of 150 diabetic patients with type 2 diabetes were examined. The carotid artery IMT and plaque formation were measured by high-resolution ultrasonography. The subjects were divided into tertiles according to IMT values. Serum Lp (a) level was measured by two-side sandwich enzyme-linked immunosorbent assay. Results: Serum Lp (a) increased with increasing IMT (24.5±17.6, 22.8±20.2, 40.2±37.0 ㎎/㎗, respectively; p=0.003) and was higher in subject with carotid artery plaques than without carotid artery plaques (35.4±26.5, 24.8±17.5 ㎎/㎗, p=0.019). Furthermore, serum LP(a) was increased with increasing proteinuria and was higher in subject with retinopathy than without retinopathy. Conclusions : From our study, we suggest that Lp(a) level is associated with carotid atherosclerosis and microvascular diabetic complications in subjects with type 2 diabetes mellitus. Prospective studies will be needed to confirm the effect of Lp(a) an the development of vascular complications in type 2 diabetes.
Key Words: Lp , a , Cerebrovascular disease , Carotid intima - media thickness , Diabetic retinopathy , Diabetic nephropathy


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