Abstract
Lipoprotein (a) [Lp(a)] has been reported to be an independent risk factor for coronary heart disease. Elevated levels of Lp(a) in diabetic subjects have also been reported, especially in subjects with nephropathy. However, the mechanism and the clinical implication of Lp(a) elevation in diabetics remain obscure. In the present study, to verify the change in Lp(a) concentration with the progression of nephropathy, serum Lp(a) levels were measured in 546 NIDDM patients, 33 hemodialysis NIDDM patients, and 145 non-diabetic controls. 1) The serum Lp(a) levels in diabetics were significantly higher than those in the non-diabetic controls. 2) Serum Lp(a) concentrations in microalbuminuric subjects were significantly higher than those in normoalbuminuric subjects, and were further increased in macroalbuminuric subjects. 3) In macroalbuminuric subjects, serum Lp(a) concentrations were inversely correlated with serum protein concentrations, but not with serum creatinine. 4) Once hemodialysis was started, the decrement of both serum Lp (a) and LDL-C concentrations were associated with the increment of serum protein concentrations. These data indicate that elevation of serum Lp (a) concentration in overt nephropathy could be, at least in part, due to hypoproteinemia.
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