Karin Littmann, Sweden
Karolinska Institute Laboratory Medicine
Presenter of 2 Presentations
Live Q&A
Session Time
12:00 - 13:00
Lecture Time
12:20 - 12:35
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[session]
[presentation]
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High plasma lipoprotein(a) levels are associated with increased prevalence of cardiovascular disease and poorer metabolic control in patients with type 1 diabetes mellitus
Session Time
12:00 - 13:00
Lecture Time
12:15 - 12:20
Background and Aims
To investigate the association between Lipoprotein(a) [Lp (a)] plasma levels, vascular complications and metabolic control in patients with type 1 diabetes mellitus.
Methods
Patients with type 1 diabetes mellitus receiving regular care were recruited in this observational cross-sectional study. Patients were grouped by Lp(a) levels (nmol/L) into very Low <10; Low 10-30; Intermediate 30-120; High>120, and prevalence of vascular complications were compared between the groups. Lp(a) plasma levels in patients with good (HbA1c <52 mmol/mol) or poor (HbA1c >52 mmol/mol) metabolic control were studied.
Results
The patients (n=1860) had a median age 48 years, diabetes duration 25 years, and HbA1c 61 mmol/mol. The median Lp(a) (interquartile range) was 19 (10-71) nmol/L. No significant differences between males and females were observed, but Lp(a) levels increased with increasing age. Patients in the high Lp(a) group had higher prevalence of complications than patients in the very low Lp(a) group. The age- and smoking-status-adjusted relative risk ratio for any macrovascular disease was 1.51 (CI 1.01-2.28, p=0.048), coronary heart disease 1.70 (CI 0.97-3.00, p=0.063), albuminuria 1.68 (CI 1.12-2.50, p=0.01) and calcified aortic valve disease 2.03 (CI 1.03-4.03; p=0.042). Patients with good metabolic control had significantly lower 80th (p=0.031) and 90th (p<0.001) percentiles Lp(a) levels than patients with poorer metabolic control.
Conclusions
Lp(a) is a significant risk factor for macrovascular disease, albuminuria and calcified aortic valve disease in patients with type 1 diabetes mellitus. Poor metabolic control in these patients is associated with increased Lp(a) levels.
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