Plasma Lipoprotein(a) Levels Are Not Influenced by Glycemic Control in Type 1 Diabetes

Antonio Pérez; Gemma Carreras; Assumpta Caixàs; Agustina Castellví; Agueda Caballero; Rosa Bonet; Jordi Ordóñez-Llanos; Alberto de Leiva

doi:10.2337/diacare.21.9.1517

Original Articles

Plasma Lipoprotein(a) Levels Are Not Influenced by Glycemic Control in Type 1 Diabetes

Antonio Pérez, MD, PHD,
Gemma Carreras, MD,
Assumpta Caixàs, MD, PHD,
Agustina Castellví, RN,
Agueda Caballero, MD,
Rosa Bonet, MSC,
Jordi Ordóñez-Llanos, MD, PHD and
Alberto de Leiva, MD, PHD

Department of Endocrinology, Hospital Sant Pau, Autonomous University of Barcelona Barcelona, Spain
Department of Biochemistry, Hospital Sant Pau, Autonomous University of Barcelona Barcelona, Spain

Address correspondence and reprint requests to Antonio Pérez Pérez, MD, PhD, Department of Endocrinology, Hospital Sant Pau, Sant Antoni M^a Claret 167, 08025 Barcelona, Spain.

Diabetes Care 1998 Sep; 21(9): 1517-1520. https://doi.org/10.2337/diacare.21.9.1517

Abstract

OBJECTIVE To determine the influence of glycemic control improvement with intensive therapy on lipoprotein(a) [Lp(a)] concentrations in type 1 diabetic patients.

RESEARCH DESIGN AND METHODS A total of 105 poorly controlled type 1 diabetic patients (60 men, 45 women) without diabetic complications participated in a longitudinal study performed in a tertiary referral center, to compare lipid, lipoprotein, and Lp(a) levels before and after 3 months of intensive therapy with multiple insulin doses. Lp(a) levels were measured by the Terumo method. Differences between the two periods were assessed by the paired t test and Wilcoxon's test.

RESULTS After 3 months of intensive therapy, all patients exhibited improved glycemic control. HbA_1c decreased from 8.9 ± 2.4 to 6.5 ± 1.6% (P < 0.0001), being ≤6% in 47% of patients. However, although a more favorable lipoprotein profile was obtained, no changes in Lp(a) concentrations were observed in the whole group of patients (16.7 ± 17.3 vs. 17.2 ± 17.7 mg/dl) or in patients with baseline Lp(a) levels above 30 mg/dl (47.1 ± 14.8 vs. 47.4 ± 18.9 mg/dl) or below 30 mg/dl (9.6 ± 7.3 vs. 10.2 ± 6.7 mg/dl). In addition, patients reaching HbA_1c ≤6 or >6% presented similar Lp(a) levels (19.7 ± 18.0 vs. 15.0 ± 17.4 mg/dl), and changes in Lp(a) did not correlate with those observed in HbA_1c.

CONCLUSIONS These data demonstrate that the improvement of glycemic control does not influence plasma Lp(a) concentrations in type 1 diabetic patients independently of baseline Lp(a) levels and the degree of glycemic control.