engleski

Lipoprotein(a) predicts progression of carotid artery intima-media thickning in patients with type 2 diabetes : A four-year follow-up

The aim was to establish whether increased serum lipoprotein (a) (Lp(a)) significantly contributed to an increase in intima-media thickness (IMT) and the number of carotid artery plaques, and consequently cardiovascular risk in patients with type 2 diabetes mellitus. The levels of Lp(a), IMT and the number of carotid artery plaques were determined at the beginning of the study in 146 type 2 diabetic patients. IMT and the number of plaques were again determined after four years of follow-up. Subjects were divided into two groups according to serum Lp(a) levels (> or 30 mg/dL). IMT was assessed by high-resolution B-mode ultrasound. The studied groups revealed no significant differences in baseline IMT (p=0.112) according to Lp(a) level. After follow-up IMT was significantly greater in patients with higher Lp(a) level than in those with lower Lp(a) level (1.24 + 0.22 mm vs. 1.15+0.17 mm, respectively ; p=0.05). Mean increase in IMT over four years was 0.12 mm (0.030 mm/yr.) in the group with low Lp(a) level and 0.17 mm (0.043 mm/yr.) in the group with high Lp(a) level. Multivariate analysis indicated that IMT value depended on Lp(a), and not on triglyceride and HDL-cholesterol levels. No significant difference in baseline and follow-up number of plaques was observed between the groups (p=0.276 vs p=0.355, respectively). These results point to Lp(a) as an independent, genetically determined risk factor associated with IMT progression in type 2 diabetes.

lipoprotein(a); intima-media thickness; diabetes mellitus; carotid artery plaques; cardiovascular risk

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