DOI: https://dx.doi.org/10.18203/2320-6012.ijrms20222258
Published: 2022-08-29

Evaluation of serum lipoprotein(a) level in type 2 diabetic patients and non-diabetic people

Pijush Karmakar, Fatema Tuz Zohora, Taposhi Farzana

Abstract


Background: Type 2 diabetes mellitus has high morbidity and results in increased risk of mortality mainly due to cardiovascular diseases. Different factors have been found to be responsible for the increased prevalence of coronary artery disease in T2DM. One of these factors includes raised serum level of lipoprotein(a) (Lp(a)). The purpose of the present study is to assess the serum level of Lp(a) in type 2 diabetes mellitus patients and non-diabetic people with find the difference of serum Lp(a) between good and poor glycaemic control.

Methods: This cross-sectional study was carried out in the department of Biochemistry and Endocrinology, Chittagong Medical College Hospital, Chattogram from July 2017 to June 2018. We assess a total of 100 type 2 diabetic patients and a group of 50 non-diabetic people with the age range 31-60 years. Blood samples were collected in fasting state and analysed for FPG, HbA1c%, serum lipid profile (TC, TG, LDL & HDL) and Lp(a). Data were analysed by T-test and chi-square test.

Results: The serum Lp(a) levels were significantly elevated in type 2 diabetic patients compared to non-diabetic people (44.32±2.6 vs. 13.02±0.81). There were also significant difference of serum Lp(a) between good and poor glycaemic control.

Conclusions: Lp(a) is an independent risk factor for atherosclerosis and has elevated level in diabetic patients. So, selective screening with lowering its concentration would help prevention of coronary artery disease, a known cause of death in diabetic patients.


Keywords


Serum Lp(a), Type 2 DM, HbA1c%, Fasting lipid profile

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References


Diabetes Atlas. Available at: https://diabetesatlas.org. Accessed on 20 October 2021.

Forouhi NG, Wareham NJ. Epidemiology of diabetes. Medicine. 2014;42(12):698-702.

Wu Y, Ding Y, Tanaka Y, Zhang W. Risk factors contributing to type 2 diabetes and recent advances in the treatment and prevention. Int J Med Sci. 2014; 11(11):1185-200.

Olokoba AB, Obateru OA, Olokoba LB. Type 2 diabetes mellitus: a review of current trends. Oman Med J. 2012;27(4):269-73.

Gadi R, Samaha FF. Dyslipidemia in type 2 diabetes mellitus. Curr Diab Rep. 2007;7(3):228-34.

Mandal M, Kumari R., Mukherjee A. Prevalence of dyslipidemia in patients with type 2 diabetes mellitus: a hospital based study in Kishanganj, India. Int J Res Med Sci. 2015;3(12):3691-9.

Patil M, Kumar N, Nusrath A, Jayaram S, Rajeshwari A. Association of HbA1c with serum lipid profile and lipoprotein(a) in type 2 diabetes mellitus. Int J Cur Res Rev. 2014;06(06):20-5.

Er Oztas Y, Ozdol C, Karaca L. Plasma LDL subtype distribution in patients with or without coronary stenosis. Turk J Med Sci. 2011;41(6):959-64.

Peltier M, Iannetta Peltier MC, Sarano ME, Lesbre JP, Colas JL, Tribouilloy CM. Elevated serum lipoprotein(a) level is an independent marker of severity of thoracic aortic atherosclerosis. Chest. 2002;121(5):1589-94.

Kamstrup PR, Benn M, Tybjaerg-Hansen A, Nordestgaard BG. Extreme lipoprotein(a) levels and risk of myocardial infarction in the general population: the Copenhagen City Heart Study. Circulation. 2008;117(2):176-84.

Smolders B, Lemmens R, Thijs V. Lipoprotein(a) and stroke: a meta-analysis of observational studies. Stroke. 2007;38(6):1959-66.

Berg K. A new serum type system in man: The LP system. Acta Pathol Microbiol Scand. 1963;59:369-82.

Manocha A, Srivastava LM. Lipoprotein(a): a unique independent risk factor for coronary artery disease. Indian J Clin Biochem. 2016;31(1):13-20.

Hancock MA, Boffa MB, Marcovina SM, Nesheim ME, Koschinsky ML. Inhibition of plasminogen activation by lipoprotein(a): critical domains in apolipoprotein(a) and mechanism of inhibition on fibrin and degraded fibrin surfaces. J Biol Chem. 2003;278(26):23260-9.

Pujar S, Hiremath K, Pujar LL, Prasad S, Bhuthal M. Estimation of serum lipoprotein(a), lipid profile and HbA1c in patients with type 2 diabetes mellitus - a case control study. Int J Cur Res Rev. 2014;6(19):54-8.

Premkumar KS. A study on lipoprotein(a) in healthy and type 2 Diabetes Mellitus. Int J Res Med Sci. 2017;5(2):639-45.

Selvam A, Prabhakar. Comparative study of lipoprotein(a) in type 2 diabetics and nondiabetics with acute coronary syndrome. IOSR-JDMS. 2016; 15(8):55-60.

Bilen O, Kamal A, Virani SS. Lipoprotein abnormalities in South Asians and its association with cardiovascular disease: Current state and future directions. World J Cardiol. 2016;8(3):247-57.

Stamler J, Vaccaro O, Neaton JD, Wentworth D. Diabetes, other risk factors and 12-yr cardiovascular mortality for men screened in the multiple risk factor intervention trial. Diab Care. 1993;16(2):434-44.

Kostner KM, Kostner GM. Lipoprotein(a): a historical appraisal. J Lipid Res. 2017;58(1):1-14.

Singla S, Kaur K, Kaur G, Kaur H, Kaur J, Jaswal S. Lipoprotein (a) in type 2 diabetes mellitus: Relation to LDL:HDL ratio and glycemic control. Int J Diabetes Dev Ctries. 2009;29(2):80-4.

Ogbera AO, Azenabor AO. Lipoprotein(a), C-reactive protein and some metabolic cardiovascular risk factors in type 2 DM. Diabetol Metab Syndr. 2010;2: 51.

Joseph J, Ganjifrockwala F, George G. Serum Lipoprotein(a) Levels in Black South African type 2 diabetes mellitus patients. South Africa: Hindawi Publishing; 2016.

Ziaee A, Sarreshtedari M, Abrishamchian N, Karimzadeh T, Oveisi S, Ghorbani A. Lipoprotein(a) in patients with type 2 diabetes compared with non-diabetic patients. IJDO. 2011;3(1):19-24.

Månsson M, Kalies I, Bergström G, Schmidt C, Legnehed A, Hultén LM, et al. Lp(a) is not associated with diabetes but affects fibrinolysis and clot structure ex vivo. Sci Rep. 2014;4:5318.

Liu C, Xu MX, He YM, Zhao X, Du XJ, Yang XJ. Lipoprotein(a) is not significantly associated with type 2 diabetes mellitus: cross-sectional study of 1604 cases and 7983 controls. Acta Diabetol. 2017;54(5): 443-53.

Structure and reference value of Lp(a). Available at: https://Wikipedia.org/wiki/Lipoprotein. Accessed on 06 February 2018.

Tsimikas S. Lp(a) as a new target for reduction of risk of cardiovascular disease and emergence of novel therapies to lower Lp(a). Curr Opin Endocrinol Diabetes Obes. 2016;23(2):157-64.

Nicholls SJ, Tang WH, Scoffone H, Brennan DM, Hartiala J, Allayee H, et al. Lipoprotein(a) levels and long-term cardiovascular risk in the contemporary era of statin therapy. J Lipid Res. 2010;51(10):3055-61.

Morita Y, Himeno H, Yakuwa H, Usui T. Serum lipoprotein(a) level and clinical coronary stenosis progression in patients with myocardial infarction: re-revascularization rate is high in patients with high-Lp(a). Circ J. 2006;70(2):156-62.

Ramirez LC, Arauz-Pacheco C, Lackner C, Albright G, Adams BV, Raskin P. Lipoprotein(a) levels in diabetes mellitus: relationship to metabolic control. Ann Intern Med. 1992;117(1):42-7.

Martín-Timón I, Sevillano-Collantes C, Segura-Galindo A, Del Cañizo-Gómez FJ. Type 2 diabetes and cardiovascular disease: Have all risk factors the same strength?. World J Diab. 2014;5(4):444-70.

Qi Q, Qi L. Lipoprotein(a) and cardiovascular disease in diabetic patients. Clin Lipidol. 2012;7(4):397-407.

Lim TS, Yun JS, Cha SA, Song KH, Yoo KD, Ahn YB, et al. Elevated lipoprotein(a) levels predict cardiovascular disease in type 2 diabetes mellitus: a 10-year prospective cohort study. Korean J Intern Med. 2016;31(6):1110-9.