The Correlation Of Lipoprotein (a) To The Extent,Severity Of Coronary Artery Lesion In Patients With Coronary Artery Disease Complicated 2 Type Diabetes Mellitus

Objective To study the correlation of lipoprotein (a) [Lp (a) ] levels to the extent, severity of coronary artery lesion in coronary artery disease patients with 2 type diabetes mellitus. Methods One hundred and fifty-two patients with 2 type DM who were admitted to our hospital were recruited from January 2002 to December 2003. A total of 114 CAD patients angiographically documented were divided into two groups according to severity of coronary artery lesion, Group A (moderate stenosis) : 9 subjects (4 men and 5 women) , Group B (severe stenosis) : 105 subjects (61 men and 44 women) . The mean age was 62.9+8.7, 59.3+9.7 years old respectively. According to the extent of coronary artery lesion, divided into three groups, Group A (mo no vessel disease ) : 22 subjects (11 men and 11 women) , Group B (bivessel disease) : 36 subjects (23 men and 13 women) , Group C (multivessel disease) : 56 subjects (30 men and 26 women) . The mean age was 62.1+7.3, 60.0+9.5, 65.0+7.9 years old respectively. 38 subjects without CAD as control group (20 men and 18 women) . The mean age was 62.2+7.5 years old. 2 type diabetes mellitus was diagnosed according to World Health Organization (WHO) criteria (1997) . Serum lipid levels (total cholesterol: TC; triglycerides: TG; high-density lipoprotein cholesterol: HDL-C; low-density lipoprotein cholesterol: LDL-C; ApoA I and ApoB) were measured. Results 1. The mean concentration of Lp (a) was 115.21+54.37mg/L, 158.89+64.70 and 183.21+98.48 mg/L in control group, Group A (moderate stenosis) , and Group B (severe stenosis) respectively. The Lp (a) levels was significantly higher in Group A and Group B as compared to the controls (p <0.05) and the Lp (a) levels was significantly higher in Group B as compared to Group A (p < 0.05 ) . 2. The mean concentration of Lp (a) was 128.77+68.19mg/L, 186.42+93.05 mg/L and 261.39+108.78mg/L in Group A (monovessel disease ), Group B(bivessel disease ) and Group C (multivessel disease) respectively. The Lp (a) levels was significantly higher in Group B and Group C as compared to the controls (p < 0.05) , the Lp (a) levels was significantly higher in Group B and Group C as compared to Group A (p < 0.05) and there is a difference in the mean Lp( a) concentration between Group B and Group A (p < 0.05) .But no significant difference was observed in the levels of Lp (a) levels when Group A was compared with Group B (p>0.05) .The mean concentration of Lp (a) was 181.29+96.26mg/L in the coronary artery disease patients with 2 type DM,it was higher compared to the controls. 3. Lp (a) concentration was not significantly correlated with the levels of total cholesterol, low-density lipoprotein cholesterol ( LDL-C ) , triglyceride, high-density lipoprotein cholesterol (HDL-C) , apolipoprotein A-I, apolipoprotein B, age and duration of DM. Multiple logistic regression analysis showed that Lp (a) significantly and independently predicted the severity and extent of coronary artery lesion. Conclusion Our data suggest that Lp (a) levels are independently associated with CAD in Type 2 diabetic patients, elevated Lp (a) levels may predispose to the extent, severity of coronary artery lesion. Thus, the parameter may be helpful in selecting diabetic subjects at high genetic cardiovascular risk.