| Background and AimThere are about 50% disorder of serum lipids metabolism in patients with type 2 diabetes mellitus (DM), and the profile of its lipids and lipoproteins are different compared to that in patients without type 2 DM. After 7 years study by following 313 patients with type 2 DM, Laakso and his colleague pointed out that the reduced levels of high- density lipoprotein (HDL) cholesterol, elevated very-low-density lipoprotein (VLDL) and triglyceride, were independent risk factors for the development of coronary heart disease (CHD) in type 2 DM. Lipoprotein(a) (Lp(a)) is one of the members of lipoproteins which discovered by Berg K in 1963. Lp(a) contains apoB-100 and the Lp(a) protein (a) which is unque antigen component in lipoproteins. The high plasma Lp(a) level might play an important role in atherosclerosis and thrombosis. It can be moved from blood circulating to the wall of artery or vessel which improve atherosclerosis. Lp(a), a homolog of plasminogen , can conpetitive inhibit fibrinolysis; It can promote proliferation and cytodifferentiation because its structure is similar as hepatopoietin A; It also inhibits the acitivity of transforming growth factor P(TGF-P) to promote proliferation of human smooth muscle cells .Many studies suggested that the high Lp(a) level was of close relationship to the incidence of heart and cerebral macroangiopathy in the patients with type 2 DM. Xia's study suggested the level of serum Lp(a) was incresed in the early kindney injure in the patients with type 2 DM .Another study suggested that the high level of serum Lp(a) was discovered in the patients with diabetic macro vascular complications and it was independent factor for type 2 DM macroangiopathy. But they were not compared to the patients with non-diabetic macrovascular complications. In order to study therelationship between the variation of concentration of serum Lp(a) and macroangiopathy in type 2 DM patients, this study is designed to investigate the changes and to assess the significance of serum Lp(a) , apoA,, apoB, and apoA/apoB in the macroangiopathy patients with and without type 2 DM .Patients and metheds61 patients diagnosed with type 2 DM according to ADA criteria (45 with macrovascular complications and 16 without macrovascular complications) , 29 non-diabetic patients with macroangiopathy and 30 age and sex matched healthy controls were included in our study. The diabetic macrovascular complications group comprised 30 males and 15 females (average age 68.71 ?.38 years, average duration 3.44?.80 years), including 34 patients with cerebral thrombosis , 2 patients with myocardial infarction , 4 patients with angina pectoris and 5 patients with lower limb artery thrombosis. The non-diabetic macrovascular complications type 2 DM group comprised 10 males and 6 females (average age 66.38?3.49 years, average duration 3.88?.67 years ), while the macroangiopathy without type 2 DM group comprised 19 males and 10 females (average age 67.24?.61 years , including 22 patients with cerebral thrombosis , 1 patient with myocardial infarction ,4 patients with angina pectoris and 2 patients with lower limb artery thrombosis ). Hypertension was diagnosed according to 1999 WHO/ISH criteria. Fasting serum Lp(a) levels were determined in all subjects by nephelometry. Fasting blood glucose (FBG),serum triglyceride (TG), low-density lipoprotein cholesterol (LDL-C) , high- density lipoprotein cholesterol (HDL-C), apoAi, apoB levels were also measured in all subjects . The statistical ways were t test, x2 test ,and correlation test.ResultsThere were no difference in age, sex and hypertension between the three patients groups(pX).05). FBG levels in diabetic macrovascular complications group (12.26 + 6.26mmol/L) and diabetic patients without macrovascular complications group (11.345.64mmol/L) were higher than that in the cpntrol group(4.74 ?0.33mmol/L) and macroangiopathy without type 2 DM group (5.07 + 0.4 Immol/L) (p<0.01). There was no significant difference in FBG level between diabetic patients... |
PDF Full Text Request