Abstract
Troglitazone is a new oral hypoglycemic agent that reduces insulin resistance in non-insulin-dependent diabetes mellitus (NIDDM). However, this agent increases serum lipoprotein(a) [Lp(a)], which is known as an atherogenic lipoprotein. The relationships between the response of Lp(a) to troglitazone and the apolipoprotein(a) [apo(a)] phenotype were investigated in this study. Nineteen NIDDM patients were treated with troglitazone for 4 weeks. Lp(a) increased significantly from 20.1 ± 16.5 mg/dL to 44.1 ± 31.9 mg/dL ( P < .001) in all study patients. Lp(a) increased from 25.7 ± 34.2 mg/dL to 50.1 ± 38.7 mg/dL ( P = .03) in patients with smaller apo(a) phenotypes (S1S4 to S2S4). Lp(a) also increased from 17.5 ± 12.0 mg/dL to 41.3 ± 29.6 mg/dL ( P < .01) in patients with larger apo(a) phenotypes (S3 to S4). Therefore, the increase of Lp(a) by troglitazone may be independent of the apo(a) phenotype.
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