Clinical investigation of lipoprotein (a) levels in type 2 diabetics for cardiovascular diseases prediction and prognosis
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Yasser Bustanji
, Noor Barham
Abstract
Objectives
We aimed to evaluate the levels of serum lipoprotein a, LP (a), in Jordanian patients with type 2 diabetes mellitus (DM); and to examine its relation to glycemic control, metabolic syndrome (MS) and duration of DM. The LP (a) is considered one of the independent risk factors for coronary artery disease (CAD) in the general population.
Methods
Fasting blood samples were drawn from 51 diabetic patients with type 2 DM and 31 non-diabetic age and sex control subjects. Serum LP (a) was measured along with other parameters, including triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-c), low-density lipoprotein cholesterol (LDL-c) and glycosylated haemoglobin (HbA1c). Correlation analyses were performed between LP (a) and the various variables measured.
Results
LP (a) measurement showed a skewed distribution towards the lower levels in both groups. Mean LP (a) levels showed a statistically insignificant difference between the two groups. No correlations of LP (a) were observed with age, sex or body mass index (BMI). No correlations of LP (a) with LDL-c, HDL-c, TG, TC, MS, DM duration or HbA1c were observed. The LP (a) serum levels were significantly higher in type 2 diabetic patients with retinopathy.
Conclusions
LP (a) serum levels are not increased in type 2 diabetic patients; so, LP (a) may not be a reliable marker for early therapeutic interventions in DM patients, even in high-risk for thrombosis groups.
Funding source: University of Jordan
Award Identifier / Grant number: Unassigned
Acknowledgments
The authors wish to thank the Deanship of Scientific Research for their generous funds.
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Research funding: This project was sponsored by the Deanship of Scientific Research at the University of Jordan.
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Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
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Competing interests: Authors state no conflict of interest.
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Informed consent: An informed consent form, written in lay Arabic language, was handed to and signed by each subject.
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Ethical approval: An institutional review board (IRB) approval was granted form research and graduate studies committee in the School of Pharmacy/The University of Jordan.
References
1. Mohamed, J, Nazratun Nafizah, AH, Zariyantey, AH, Budin, SB. Mechanisms of diabetes-induced liver damage: the role of oxidative stress and inflammation. Sultan Qaboos Univ Med J 2016;16:e132–41. https://doi.org/10.18295/squmj.2016.16.02.002.Search in Google Scholar PubMed PubMed Central
2. Berg, K. A new serum type system in man-the Lp system. Acta Pathol Microbiol Scand 2009;59:369–82. https://doi.org/10.1111/j.1699-0463.1963.tb01808.x.Search in Google Scholar PubMed
3. McCormick, SP. Lipoprotein(a): biology and clinical importance. Clin Biochem Rev 2004;25:69–80.Search in Google Scholar
4. Dugani, SB, Akinkuolie, AO, Paynter, N, Glynn, RJ, Ridker, PM, Mora, S. Association of lipoproteins, insulin resistance, and rosuvastatin with incident type 2 diabetes mellitus: secondary analysis of a randomized clinical trial. JAMA Cardiol 2016;1:136–45. https://doi.org/10.1001/jamacardio.2016.0096.Search in Google Scholar PubMed PubMed Central
5. Kronenberg, F. Human genetics and the causal role of lipoprotein(a) for various diseases. Cardiovasc Drugs Ther 2016;30:87–100. https://doi.org/10.1007/s10557-016-6648-3.Search in Google Scholar PubMed PubMed Central
6. Vaverková, H, Karásek, D, Halenka, M, Cibíčková, L, Kubíčková, V. Inverse association of lipoprotein (a) with markers of insulin resistance in dyslipidemic subjects. Physiol Res 2017:S113–20.10.33549/physiolres.933583Search in Google Scholar PubMed
7. Aleidi, SM, Shayeb, E, Bzour, J, Abu-Rish, EY, Hudaib, M, Al Alawi, S, et al.. Serum level of insulin-like growth factor-I in type 2 diabetic patients: impact of obesity. Horm Mol Biol Clin Invest 2019;39:1–8. https://doi.org/10.1515/hmbci-2019-0015.Search in Google Scholar PubMed
8. Muhanhali, D, Zhai, T, Cai, Z, Ling, Y. Lipoprotein(a) concentration is associated with risk of type 2 diabetes and cardiovascular events in a Chinese population with very high cardiovascular risk. Endocrine 2020;69:63–72. https://doi.org/10.1007/s12020-020-02286-5.Search in Google Scholar PubMed
9. Kaya, A, Onat, A, Yüksel, H, Can, G, Yüksel, M, Ademoğlu, E. Lipoprotein(a)-activated immunity, insulin resistance and new-onset diabetes. PGM (Postgrad Med) 2017;129:611–8. https://doi.org/10.1080/00325481.2017.1342508.Search in Google Scholar PubMed
10 Saeed, A, Sun, W, Agarwala, A, Virani, SS, Nambi, V, Coresh, J, et al.. Lipoprotein(a) levels and risk of cardiovascular disease events in individuals with diabetes mellitus or prediabetes: the atherosclerosis risk in communities study. Atherosclerosis 2019;282:52–6. https://doi.org/10.1016/j.atherosclerosis.2018.12.022.Search in Google Scholar PubMed PubMed Central
11. Roy, V, Biswas, J, Saraf, A. Comparative evaluation on lipid profile between diabetic and nondiabetic patients, signalizing some common physiological complications intended towards diabetes: a case study from Raipur, C.G., India. Ambient Sci 2019;06 & 06h.10.21276/ambi.2018.05.sp1.ra03Search in Google Scholar
12 Aleidi, SM, Shayeb, E, Bzour, J, Abu-Rish, EY, Hudaib, M, Al Alawi, S, et al.. Serum level of insulin-like growth factor-I in type 2 diabetic patients: impact of obesity. Horm Mol Biol Clin Invest 2019;39. article # 2019-0015.10.1515/hmbci-2019-0015Search in Google Scholar
13. Fonseca, L, Paredes, S, Vilaverde, J, Alves, M, Oliveira, JC, Palma, I. Type 2 diabetes and lipid profile: is low-density lipoprotein - cholesterol enough? Atherosclerosis 2018;275:e200.10.1016/j.atherosclerosis.2018.06.620Search in Google Scholar
14. Liu, C, Xu, M-X, He, Y-M, Zhao, X, Du, X-J, Yang, X-J. Lipoprotein (a) is not significantly associated with type 2 diabetes mellitus: cross-sectional study of 1604 cases and 7983 controls. Acta Diabetol 2017;54:443–53.10.1007/s00592-017-0965-2Search in Google Scholar
15. Paige, E, Masconi, KL, Tsimikas, S, Kronenberg, F, Santer, P, Weger, S, et al.. Lipoprotein(a) and incident type-2 diabetes: results from the prospective Bruneck study and a meta-analysis of published literature. Cardiovasc Diabetol 2017;16:38.10.1186/s12933-017-0520-zSearch in Google Scholar
16. Aleidi, S, Issa, A, Bustanji, H, Khalil, M, Bustanji, Y. Adiponectin serum levels correlate with insulin resistance in type 2 diabetic patients. Saudi Pharmaceut J 2015;23:250–6.10.1016/j.jsps.2014.11.011Search in Google Scholar
17. Rajappa, M, Sridhar, MG, Balachander, J, Sethuraman, KR. Lipoprotein (a) and comprehensive lipid tetrad index as a marker for coronary artery disease in NIDDM patients in South India. Clin Chim Acta 2006;372:70–5.10.1016/j.cca.2006.03.019Search in Google Scholar
18. Levitsky, LL, Scanu, AM, Gould, SH. Lipoprotein(a) levels in black and white children and adolescents with IDDM. Diabetes Care 1991;14:283–7.10.2337/diacare.14.4.283Search in Google Scholar
19. Haffner, SM, Tuttle, KR, Rainwater, DL. Decrease of lipoprotein(a) with improved glycemic control in IDDM subjects. Diabetes Care 1991;14:302–7.10.2337/diacare.14.4.302Search in Google Scholar
20. Selvin, E, Coresh, J, Golden, SH, Boland, LL, Brancati, FL, Steffes, MW. Glycemic control, atherosclerosis, and risk factors for cardiovascular disease in individuals with diabetes: the atherosclerosis risk in communities study. Diabetes Care 2005;28:1965–73.10.2337/diacare.28.8.1965Search in Google Scholar
21. Smaoui, M, Hammami, S, Chaaba, R, Attia, N, Hamda, KB, Masmoudi, AS, et al.. Lipids and lipoprotein(a) concentrations in Tunisian type 2 diabetic patients. J Diabetes Complicat 2004;18:258–63.10.1016/S1056-8727(03)00075-8Search in Google Scholar
22. Erem, C, Hacıhasanoğlu, A, Çelik, Ş, Ovalı, E, Ersöz, HÖ, Ukinç, K, et al.. Coagulation and fibrinolysis parameters in type 2 diabetic patients with and without diabetic vascular complications. Med Princ Pract 2004;14:22–30.10.1159/000081919Search in Google Scholar
23. Ramirez, LC. Lipoprotein (a) levels in diabetes mellitus: relationship to metabolic control. Ann Intern Med 1992;117:42.10.7326/0003-4819-117-1-42Search in Google Scholar
24. Chandni, R, Ramamoorthy, KP. Lipoprotein(a) in type 2 diabetic subjects and its relationship to diabetic microvascular complications. World J Diabetes 2012;3:105–9.10.4239/wjd.v3.i5.105Search in Google Scholar
25. Lim, T-S, Yun, J-S, Cha, S-A, Song, K-H, Yoo, K-D, Ahn, Y-B, et al.. Elevated lipoprotein(a) levels predict cardiovascular disease in type 2 diabetes mellitus: a 10-year prospective cohort study. Korean J Intern Med 2016;31:1110–9.10.3904/kjim.2016.030Search in Google Scholar
26. Nasri, H. Association of serum lipoprotein (a) with hypertension in diabetic patients. Saudi J Kidney Dis Transpl 2008;19:420–7.Search in Google Scholar
27. Habib, SS, Aslam, M. Lipids and lipoprotein(a) concentrations in Pakistani patients with type 2 diabetes mellitus. Diabetes Obes Metabol 2004;6:338–43.10.1111/j.1462-8902.2004.00352.xSearch in Google Scholar
28. Albahrani, A, Alkindi, M, Marks, E, Alyahyaee, S, Shenkin, A. Lipoprotein(a): an independent risk factor for ischemic heart disease that is dependent on triglycerides in subjects with type 2 diabetes mellitus. Lipids Health Dis 2007;6:26.10.1186/1476-511X-6-26Search in Google Scholar
29. Abdella, NA, Mojiminiyi, OA, Akanji, AO, Al Mohammadi, H, Moussa, MAA. Serum lipoprotein(a) concentration as a cardiovascular risk factor in Kuwaiti Type 2 diabetic patients. J Diabetes Complicat 2001;15:270–6.10.1016/S1056-8727(01)00162-3Search in Google Scholar
30. Sunayama, S, Daida, H, Mokuno, H, Miyano, H, Yokoi, H, Lee, YJ, et al.. Lack of increased coronary atherosclerotic risk due to elevated lipoprotein(a) in women ≥55 years of age. Circulation 1996;94:1263–8.10.1161/01.CIR.94.6.1263Search in Google Scholar PubMed
31. Bayrak, A, Aldemir, D, Bayrak, T, Çorakçı, A, Dursun, P. The effect of hormone replacement therapy on the levels of serum lipids, apolipoprotein AI, apolipoprotein B and lipoprotein (a) in Turkish postmenopausal women. Arch Gynecol Obstet 2006;274:289–96.10.1007/s00404-006-0187-2Search in Google Scholar PubMed
32. Ushioda, M, Makita, K, Takamatsu, K, Horiguchi, F, Aoki, D. Serum lipoprotein(a) dynamics before/after menopause and long-term effects of hormone replacement therapy on lipoprotein(a) levels in middle-aged and older Japanese women. Horm Metab Res 2006;38:581–6.10.1055/s-2006-950504Search in Google Scholar PubMed
33. Imperatore, G, Rivellese, A, Galasso, R, Celentano, E, Iovine, C, Ferrara, A, et al.. Lipoprotein(a) concentrations in non-insulin-dependent diabetes mellitus and borderline hyperglycemia: a population-based study. Metabolism 1995;44:1293–7.10.1016/0026-0495(95)90032-2Search in Google Scholar
34. Poznyak, A, Grechko, AV, Poggio, P, Myasoedova, VA, Alfieri, V, Orekhov, AN. The diabetes mellitus-atherosclerosis connection: the role of lipid and glucose metabolism and chronic inflammation. Int J Mol Sci 2020;21:1835.10.3390/ijms21051835Search in Google Scholar PubMed PubMed Central
35. Ergün, UG, Oztüzün, S, Seydaoglu, G. Lipoprotein (A) levels in type 2 diabetic patients with diabetic retinopathy. Med J Malaysia 2004;59:406–10.Search in Google Scholar
36. Haffner, SM, Klein, BEK, Moss, SE, Klein, R. LP (a) is not related to retinopathy in diabetic subjects. Eur J Ophthalmol 1995;5:119–23.10.1177/112067219500500209Search in Google Scholar
37. Kim, CH, Park, HJ, Park, JY, Hong, SK, Yoon, YH, Lee, KU. High serum lipoprotein(a) levels in Korean type 2 diabetic patients with proliferative diabetic retinopathy. Diabetes Care 1998;21:2149–51.10.2337/diacare.21.12.2149Search in Google Scholar PubMed
38. Moosaie, F, Davatgari, RM, Firouzabadi, FD, Esteghamati, S, Deravi, N, Meysamie, A, et al.. Lipoprotein(a) and apolipoproteins as predictors for diabetic retinopathy and its severity in adults with type 2 diabetes: a case-cohort study. Can J Diabetes 2020;44:414–21.10.1016/j.jcjd.2020.01.007Search in Google Scholar PubMed
39. Zarich, SW. Treating the diabetic patient: appropriate care for glycemic control and cardiovascular disease risk factors. Rev Cardiovasc Med 2003;4(6 Suppl):S19–28.Search in Google Scholar
© 2022 Walter de Gruyter GmbH, Berlin/Boston
Articles in the same Issue
- Frontmatter
- Letter to the Editor
- Continuing medical education in Covid-19 pandemic
- Original Articles
- Reduced irisin levels in patients with acromegaly
- Clinical investigation of lipoprotein (a) levels in type 2 diabetics for cardiovascular diseases prediction and prognosis
- Exploring the relationship between vitamin D and leptin hormones in type 2 diabetes mellitus patients from Kuwait
- Serum 25(OH) vitamin D level in Relapsing-Remitting Multiple Sclerosis and clinically isolated syndrome groups
- Hypoglycemic, hypolipidemic and hepatoprotective effects of Alpinia officinarum on nicotinamide/streptozotocin induced type II diabetic rats
- Association of obesity in T2DM with differential polymorphism of ghrelin, growth hormone secretagogue receptor-1 and telomeres maintenance genes
- Effect of different dietary fats on inflammation and glucose intolerance in high fructose and high fat fed experimental animals
- Biological reference interval of nitric oxide in health and disease
- Maternal hypothyroidism prolongs gestation period and impairs glucose tolerance in offspring of Wistar rats
- A study on serum homocysteine and oxidized LDL as markers of cardiovascular risk in patients with overt hypothyroidism
- The study of serum hsCRP, ferritin, IL-6 and plasma D-dimer in COVID-19: a retrospective study
- Swimming exercise improves SIRT1, NF-κB, and IL–1β protein levels and pancreatic tissue injury in ovariectomized diabetic rats
- Short Communications
- The second wave of COVID-19 results in outbreak of mucormycosis: diabetes and immunological perspective
- A study on lipoprotein-a and PAI-1 in women with polycystic ovary syndrome
- Review Articles
- Oxytocin, the panacea for long-COVID? a review
- COVID-19 infection in pregnancy: a review of existing knowledge
Articles in the same Issue
- Frontmatter
- Letter to the Editor
- Continuing medical education in Covid-19 pandemic
- Original Articles
- Reduced irisin levels in patients with acromegaly
- Clinical investigation of lipoprotein (a) levels in type 2 diabetics for cardiovascular diseases prediction and prognosis
- Exploring the relationship between vitamin D and leptin hormones in type 2 diabetes mellitus patients from Kuwait
- Serum 25(OH) vitamin D level in Relapsing-Remitting Multiple Sclerosis and clinically isolated syndrome groups
- Hypoglycemic, hypolipidemic and hepatoprotective effects of Alpinia officinarum on nicotinamide/streptozotocin induced type II diabetic rats
- Association of obesity in T2DM with differential polymorphism of ghrelin, growth hormone secretagogue receptor-1 and telomeres maintenance genes
- Effect of different dietary fats on inflammation and glucose intolerance in high fructose and high fat fed experimental animals
- Biological reference interval of nitric oxide in health and disease
- Maternal hypothyroidism prolongs gestation period and impairs glucose tolerance in offspring of Wistar rats
- A study on serum homocysteine and oxidized LDL as markers of cardiovascular risk in patients with overt hypothyroidism
- The study of serum hsCRP, ferritin, IL-6 and plasma D-dimer in COVID-19: a retrospective study
- Swimming exercise improves SIRT1, NF-κB, and IL–1β protein levels and pancreatic tissue injury in ovariectomized diabetic rats
- Short Communications
- The second wave of COVID-19 results in outbreak of mucormycosis: diabetes and immunological perspective
- A study on lipoprotein-a and PAI-1 in women with polycystic ovary syndrome
- Review Articles
- Oxytocin, the panacea for long-COVID? a review
- COVID-19 infection in pregnancy: a review of existing knowledge