Skip to main content
NCBI home page
The BMJ logoLink to The BMJ
. 1991 Sep 21;303(6804):675–678. doi: 10.1136/bmj.303.6804.675

Serum Lp(a) lipoprotein concentrations in insulin dependent diabetic patients with microalbuminuria.

H Kapelrud 1, H J Bangstad 1, K Dahl-Jørgensen 1, K Berg 1, K F Hanssen 1
PMCID: PMC1670918  PMID: 1833011

Abstract

OBJECTIVE--To compare the serum concentrations of lipoproteins and apolipoproteins in insulin dependent diabetic patients with and without microalbuminuria. DESIGN--Cross sectional study. SETTING--Paediatric and medical outpatient clinic at a university hospital. PATIENTS--76 insulin dependent diabetic patients: 41 with microalbuminuria (20 males, 21 females) and 35 controls without microalbuminuria (18 males, 17 females). The two groups were similar with respect to age, duration of disease, and haemoglobin A1c concentrations before the study. MAIN OUTCOME MEASURES--Serum concentrations of Lp(a) lipoprotein, total cholesterol, high density lipoprotein cholesterol, very low density lipoprotein cholesterol, low density lipoprotein cholesterol, triglycerides, and apolipoproteins A-I, A-II, and B. RESULTS--Median serum Lp(a) lipoprotein concentration was 10.0 mg/100 ml in the microalbuminuric group and 4.9 mg/100 ml in the control group (p = 0.007). 17 (41%) of the microalbuminuric patients and five (14%) of the control patients had Lp(a) lipoprotein values above the upper quartile of a normal population. Median serum triglycerides concentrations in the microalbuminuric and control groups were 1.15 mmol/l and 0.88 mmol/l respectively (p = 0.03). Median very low density lipoprotein cholesterol concentration was 0.52 mmol/l in the microalbuminuric group and 0.40 mmol/l in the control group (p = 0.03). No significant differences in serum concentrations of total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol, or apolipoproteins A-I, A-II, and B were found between the groups. CONCLUSIONS--Serum concentrations of Lp(a) lipoprotein are twice as high in insulin dependent diabetic patients with microalbuminuria as in those without microalbuminuria. Increased concentrations of Lp(a) lipoprotein might partly explain the increased morbidity and mortality from cardiovascular disease observed among patients with diabetic nephropathy.

Full text

PDF
675

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Andersen A. R., Christiansen J. S., Andersen J. K., Kreiner S., Deckert T. Diabetic nephropathy in Type 1 (insulin-dependent) diabetes: an epidemiological study. Diabetologia. 1983 Dec;25(6):496–501. doi: 10.1007/BF00284458. [DOI] [PubMed] [Google Scholar]
  2. BERG K. A NEW SERUM TYPE SYSTEM IN MAN--THE LP SYSTEM. Acta Pathol Microbiol Scand. 1963;59:369–382. doi: 10.1111/j.1699-0463.1963.tb01808.x. [DOI] [PubMed] [Google Scholar]
  3. Berg K., Dahlén G., Frick M. H. Lp(a) lipoprotein and pre-beta1-lipoprotein in patients with coronary heart disease. Clin Genet. 1974;6(3):230–235. doi: 10.1111/j.1399-0004.1974.tb00657.x. [DOI] [PubMed] [Google Scholar]
  4. Borch-Johnsen K., Andersen P. K., Deckert T. The effect of proteinuria on relative mortality in type 1 (insulin-dependent) diabetes mellitus. Diabetologia. 1985 Aug;28(8):590–596. doi: 10.1007/BF00281993. [DOI] [PubMed] [Google Scholar]
  5. Borch-Johnsen K., Kreiner S. Proteinuria: value as predictor of cardiovascular mortality in insulin dependent diabetes mellitus. Br Med J (Clin Res Ed) 1987 Jun 27;294(6588):1651–1654. doi: 10.1136/bmj.294.6588.1651. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Brown M. S., Goldstein J. L. Plasma lipoproteins: teaching old dogmas new tricks. Nature. 1987 Nov 12;330(6144):113–114. doi: 10.1038/330113a0. [DOI] [PubMed] [Google Scholar]
  7. Cooper M. E., Frauman A., O'Brien R. C., Seeman E., Murray R. M., Jerums G. Progression of proteinuria in type 1 and type 2 diabetes. Diabet Med. 1988 May-Jun;5(4):361–368. doi: 10.1111/j.1464-5491.1988.tb01006.x. [DOI] [PubMed] [Google Scholar]
  8. Cushing G. L., Gaubatz J. W., Nava M. L., Burdick B. J., Bocan T. M., Guyton J. R., Weilbaecher D., DeBakey M. E., Lawrie G. M., Morrisett J. D. Quantitation and localization of apolipoproteins [a] and B in coronary artery bypass vein grafts resected at re-operation. Arteriosclerosis. 1989 Sep-Oct;9(5):593–603. doi: 10.1161/01.atv.9.5.593. [DOI] [PubMed] [Google Scholar]
  9. Dahl-Jørgensen K., Hanssen K. F., Kierulf P., Bjøro T., Sandvik L., Aagenaes O. Reduction of urinary albumin excretion after 4 years of continuous subcutaneous insulin infusion in insulin-dependent diabetes mellitus. The Oslo Study. Acta Endocrinol (Copenh) 1988 Jan;117(1):19–25. doi: 10.1530/acta.0.1170019. [DOI] [PubMed] [Google Scholar]
  10. Deckert T., Feldt-Rasmussen B., Borch-Johnsen K., Jensen T., Kofoed-Enevoldsen A. Albuminuria reflects widespread vascular damage. The Steno hypothesis. Diabetologia. 1989 Apr;32(4):219–226. doi: 10.1007/BF00285287. [DOI] [PubMed] [Google Scholar]
  11. Feldt-Rasmussen B., Mathiesen E. R., Deckert T. Effect of two years of strict metabolic control on progression of incipient nephropathy in insulin-dependent diabetes. Lancet. 1986 Dec 6;2(8519):1300–1304. doi: 10.1016/s0140-6736(86)91433-9. [DOI] [PubMed] [Google Scholar]
  12. Frick M. H., Dahlén G., Berg K., Valle M., Hekali P. Serum lipids in angiographically assessed coronary atherosclerosis. Chest. 1978 Jan;73(1):62–65. doi: 10.1378/chest.73.1.62. [DOI] [PubMed] [Google Scholar]
  13. Friedewald W. T., Levy R. I., Fredrickson D. S. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem. 1972 Jun;18(6):499–502. [PubMed] [Google Scholar]
  14. Guyton J. R., Dahlen G. H., Patsch W., Kautz J. A., Gotto A. M., Jr Relationship of plasma lipoprotein Lp(a) levels to race and to apolipoprotein B. Arteriosclerosis. 1985 May-Jun;5(3):265–272. doi: 10.1161/01.atv.5.3.265. [DOI] [PubMed] [Google Scholar]
  15. Jensen T., Bjerre-Knudsen J., Feldt-Rasmussen B., Deckert T. Features of endothelial dysfunction in early diabetic nephropathy. Lancet. 1989 Mar 4;1(8636):461–463. doi: 10.1016/s0140-6736(89)91365-2. [DOI] [PubMed] [Google Scholar]
  16. Jensen T., Borch-Johnsen K., Kofoed-Enevoldsen A., Deckert T. Coronary heart disease in young type 1 (insulin-dependent) diabetic patients with and without diabetic nephropathy: incidence and risk factors. Diabetologia. 1987 Mar;30(3):144–148. doi: 10.1007/BF00274218. [DOI] [PubMed] [Google Scholar]
  17. Jensen T., Stender S., Deckert T. Abnormalities in plasmas concentrations of lipoproteins and fibrinogen in type 1 (insulin-dependent) diabetic patients with increased urinary albumin excretion. Diabetologia. 1988 Mar;31(3):142–145. doi: 10.1007/BF00276846. [DOI] [PubMed] [Google Scholar]
  18. Jones S. L., Close C. F., Mattock M. B., Jarrett R. J., Keen H., Viberti G. C. Plasma lipid and coagulation factor concentrations in insulin dependent diabetics with microalbuminuria. BMJ. 1989 Feb 25;298(6672):487–490. doi: 10.1136/bmj.298.6672.487. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Katz J. B., Middle L. A. Evaluation of thymidine kinase and neomycin phosphotransferase II positive selection systems for recovery of genetically atypical and recombinant DNA vaccine viruses. Biologicals. 1990 Oct;18(4):301–304. doi: 10.1016/1045-1056(90)90033-v. [DOI] [PubMed] [Google Scholar]
  20. Masarei J. R., Rouse I. L., Lynch W. J., Robertson K., Vandongen R., Beilin L. J. Effects of a lacto-ovo vegetarian diet on serum concentrations of cholesterol, triglyceride, HDL-C, HDL2-C, HDL3-C, apoprotein-B, and Lp(a). Am J Clin Nutr. 1984 Sep;40(3):468–478. doi: 10.1093/ajcn/40.3.468. [DOI] [PubMed] [Google Scholar]
  21. McLean J. W., Tomlinson J. E., Kuang W. J., Eaton D. L., Chen E. Y., Fless G. M., Scanu A. M., Lawn R. M. cDNA sequence of human apolipoprotein(a) is homologous to plasminogen. Nature. 1987 Nov 12;330(6144):132–137. doi: 10.1038/330132a0. [DOI] [PubMed] [Google Scholar]
  22. Miles L. A., Fless G. M., Levin E. G., Scanu A. M., Plow E. F. A potential basis for the thrombotic risks associated with lipoprotein(a). Nature. 1989 May 25;339(6222):301–303. doi: 10.1038/339301a0. [DOI] [PubMed] [Google Scholar]
  23. Mogensen C. E., Christensen C. K. Predicting diabetic nephropathy in insulin-dependent patients. N Engl J Med. 1984 Jul 12;311(2):89–93. doi: 10.1056/NEJM198407123110204. [DOI] [PubMed] [Google Scholar]
  24. Morton N. E., Berg K., Dahlen G., Ferrell R. E., Rhoads G. G. Genetics of the Lp lipoprotein in Japanese-Americans. Genet Epidemiol. 1985;2(2):113–121. doi: 10.1002/gepi.1370020202. [DOI] [PubMed] [Google Scholar]
  25. Rath M., Niendorf A., Reblin T., Dietel M., Krebber H. J., Beisiegel U. Detection and quantification of lipoprotein(a) in the arterial wall of 107 coronary bypass patients. Arteriosclerosis. 1989 Sep-Oct;9(5):579–592. doi: 10.1161/01.atv.9.5.579. [DOI] [PubMed] [Google Scholar]
  26. Rhoads G. G., Dahlen G., Berg K., Morton N. E., Dannenberg A. L. Lp(a) lipoprotein as a risk factor for myocardial infarction. JAMA. 1986 Nov 14;256(18):2540–2544. [PubMed] [Google Scholar]
  27. Rosengren A., Wilhelmsen L., Eriksson E., Risberg B., Wedel H. Lipoprotein (a) and coronary heart disease: a prospective case-control study in a general population sample of middle aged men. BMJ. 1990 Dec 1;301(6763):1248–1251. doi: 10.1136/bmj.301.6763.1248. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Röschlau P., Bernt E., Gruber W. Enzymatische Bestimmung des Gesamt-Cholesterins im Serum. Z Klin Chem Klin Biochem. 1974 Sep;12(9):403–407. [PubMed] [Google Scholar]
  29. Seaquist E. R., Goetz F. C., Rich S., Barbosa J. Familial clustering of diabetic kidney disease. Evidence for genetic susceptibility to diabetic nephropathy. N Engl J Med. 1989 May 4;320(18):1161–1165. doi: 10.1056/NEJM198905043201801. [DOI] [PubMed] [Google Scholar]
  30. Vannini P., Ciavarella A., Flammini M., Bargossi A. M., Forlani G., Borgnino L. C., Orsoni G. Lipid abnormalities in insulin-dependent diabetic patients with albuminuria. Diabetes Care. 1984 Mar-Apr;7(2):151–154. doi: 10.2337/diacare.7.2.151. [DOI] [PubMed] [Google Scholar]

Articles from BMJ : British Medical Journal are provided here courtesy of BMJ Publishing Group

RESOURCES