[Lipoprotein (a) and diabetes: relationship based on 224 cases].
Recent studies have suggested that Lp(a) is implicated in the high incidence of coronary heart disease in diabetic subjects, but data are still controversial. We therefore studied the distribution of plasma Lp(a), assayed by radial immunodiffusion, in a group of 224 diabetics and compared them to 92 non diabetic controls. Besides plasma Lp(a), TG and glucose were evaluated in 16 insulin-requiring diabetic patients before and after 10 days of normoglycaemia. The distribution of plasma Lp(a), as usually skewed to the left, was not different either between diabetic subjects and controls or between Type 1 and Type 2 diabetic subjects. No significant correlation was observed between Lp(a) and glycaemic control expressed by HbA1c. The sequence of normoglycaemia did not affect plasma Lp(a), no significant correlation between the variations of glycaemia and Lp(a) levels and the variations of triglyceridaemia and Lp(a) levels were found. Thus our group of diabetic subjects has a similar distribution of Lp(a) to controls. Lp(a) concentrations do not seem to be affected by chronic hyperglycaemia or rapid normalisation of glycaemic levels. However there is a strong need of standardization of Lp(a) assay before any definitive conclusion. As we have so far no efficient treatment for lowering Lp(a) in daily clinical practice, the energetic care of other associated vascular risk factors is needed.