ADA: Lipoprotein(a) Associated
with Cardiovascular Mortality in Type 2 Diabetes
First ever research to provide evidence
for this association.
There appears to be an independent association
between lipoprotein a and cardiovascular mortality
in patients with type 2 diabetes, researchers
reported at the American Diabetes Association
63rd Annual Meeting.
"This is the first research to provide initial
evidence for this independent association,"
said investigator Cristina Hernandez, MD, of the
diabetes unit, division of endocrinology, Hospital
General Universitari Vall d'Hebron, in Barcelona,
Spain.
Between April and May of 1993, Dr. Hernandez
and colleagues enrolled and tracked data on 122
consecutive patients with type 2 diabetes attending
an outpatient diabetic unit in Barcelona. These
patients were participating in a larger 9-year
prospective study.
Besides lipoprotein a, the investigators followed
changes in age, gender, body mass index (BMI),
cigarette smoking, blood pressure, hemoglobin
A1c (HbA1c), serum cholesterol concentration,
albumin excretion rate, and serum creatinine levels.
At end point the investigators analyzed data
from 99 remaining subjects, using stepwise multiple
logistic regression to determine cardiovascular
mortality as an dependent variable from other
variables.
They measured lipoprotein a by enzyme-linked
immunosorbent assay (ELISA) and log-transformed
the data before their statistical analysis, in
order to achieve a normal distribution.
They reported that during follow-up, 29.3% of
subjects died, with 21.2% of deaths due to cardiovascular
causes.
"The [lipoprotein(a)] concentration was
higher in patients who died from cardiovascular
disease [15.5 mg/dL] in comparison with those
who remain alive [7 mg/dL] or those who died from
non-cardiovascular disease [3.7 mg/dL],"
the researchers stated.
The stepwise multivariate logistic regression
analysis indicated that lipoprotein a is an independent
risk factor for cardiovascular mortality (RR 3.57,
95% CI: 1.01 to 12.6; P=0.04).
"This represents a beginning -- a powerful
one -- in the study of this independent connection
and of its clinical implications," Dr. Hernandez
added.
[Study title: Lipoprotein as a Risk Factor for
Cardiovascular Mortality in Type 2 Diabetic Patients:
A 9-year Follow- up Study. Abstract 667]
