Abstract
Abstract Purpose Neele DM (Diabetologia 1999) showed that insulin suppressed apolipoprotein(a) synthesis by primary cultures of cynomolgus monkey hepatocytes. Therefore, there is a possibility that inverse association exists between lipoprotein(a) [Lp(a)] and metabolic syndorome (Mets) with insulin resistance/hyperinsulinemia for coronary atherosclerosis. Sung KC (Nutr Metab Cardiovasc Dis 2013) described the inverse association between Lp(a) levels and Mets and its components on an asian occupational cohort. And high levels of Lp(a) were associated with preclinical atherosclerosis, as evaluated by coronary calcium score with cardiac computed tomography. There is no similar examination on coronary artery disease (CAD) patients. The purpose is to examine similar considerations on CAD patients. Method 610 subjects with angiographically demonstrated CAD were enrolled. The patients who receiving medication for dyslipidemia and Insulin administration were excluded. The blood samples for laboratory tests were collected after an over night fast. Subjects were divided into four groups according to quartiles of Lp(a) levels (mg/dL). Ranges of quartile groups of Lp(a) were Q1: <9.0, Q2: 9.0–<16.0, Q3: 16.0–<30.0, Q4: ≥30.0. Results The inverse association Lp(a) levels and Mets and its component. The comparison of Q1 (bottom quartile) versus Q4 (top quartile) was shown below; the comorbidity rate of Mets 19.5% versus 8.0% (p<0.01), BMI (kg/m2) 23.5 versus 22.7 (p<0.05), trigyceride (mg/dL) 144.0 versus 107.5 (p<0.0001), HDL cholesterol (mg/dL) 46.8 versus 50.7 (p<0.05), the comorbidity rate of hypertension 60.4% versus 50.7% (p=0.084), glucose (mg/dL) 107.1 versus 100.6 (p<0.05), insulin (μU/mL) 8.49 versus 5.85 (p<0.0001), HOMA-R 2.26 versus 1.44 (p<0.0001). The mean number of diseased coronary vessel was higher in the Q4 group (2.07) than in the Q1 group (1.87) (p<0.05). Conclusion There was the inverse association between Lp(a) levels and Mets and its components on CAD patients. The robust association was found between Lp(a) levels and severity of coronary atherosclerosis despite this inverse correlation. Funding Acknowledgement Type of funding source: None
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