Elevated lipoprotein(a) levels predict cardiovascular disease in type 2 diabetes mellitus: a 10-year prospective cohort study
Korean Journal of Internal Medicine 2016³â 31±Ç 6È£ p.1110 ~ p.1119
(Lim Tae-Seok) - Catholic University College of Medicine Department of Internal Medicine Division of Endocrinology and Metabolism
À±Àç½Â(Yun Jae-Seung) - Catholic University College of Medicine Department of Internal Medicine Division of Endocrinology and Metabolism
Â÷¼±¾Æ(Cha Seon-Ah) - Catholic University College of Medicine Department of Internal Medicine Division of Endocrinology and Metabolism
¼Û±âÈ£(Song Ki-Ho) - Catholic University College of Medicine Department of Internal Medicine Division of Endocrinology and Metabolism
À¯±âµ¿(Yoo Ki-Dong) - Catholic University College of Medicine Department of Internal Medicine Divisions of Cardiology
¾ÈÀ¯¹è(Ahn Yu-Bae) - Catholic University College of Medicine Department of Internal Medicine Division of Endocrinology and Metabolism
¹Ú¿ë¹®(Park Yong-Moon) - University of South Carolina Arnold School of Public Health Department of Epidemiology and Biostatistics
°í½ÂÇö(Ko Seung-Hyun) - Catholic University College of Medicine Department of Internal Medicine Division of Endocrinology and Metabolism
Abstract
Background/Aims: Elevated lipoprotein(a) (Lp[a]) level is known to be a risk factor for cardiovascular disease (CVD). However, the data that has been reported on the association between the Lp(a) level and CVD in type 2 diabetes has been limited and incoherent. The aim of this study was to investigate the relationship between the Lp(a) concentration and new onset CVD in type 2 diabetes.
Methods: From March 2003 to December 2004, patients with type 2 diabetes without a prior history of CVD were consecutively enrolled. CVD was defined as the occurrence of coronary artery disease or ischemic stroke. Cox proportional hazards models were used to identify the associations between the Lp(a) and CVD after adjusting for confounding variables.
Results: Of the 1,183 patients who were enrolled, 833 participants were evaluated with a median follow-up time of 11.1 years. A total of 202 participants were diagnosed with CVD (24.2%). The median Lp(a) level for 1st and 4th quartile group was 5.4 (3.5 to 7.1) and 55.7 mg/dL (43.1 to 75.3). Compared with patients without CVD, those with CVD were older, had a longer duration of diabetes and hypertension, and used more insulin and angiotensin converting enzyme inhibitors/angiotensin receptor blockers at baseline. A Cox hazard regression analysis revealed that the development of CVD was significantly associated with serum Lp(a) level (hazard ratio, 1.92; 95% confidence interval [CI], 1.26 to 2.92; p < 0.001, comparing the 4th vs. 1st quartile of Lp[a]).
Conclusions: Elevated Lp(a) level was an independent predictable risk factor for CVD in type 2 diabetes. Other cardiovascular risk factors should be treated more intensively in type 2 diabetic patients with high Lp(a) levels.
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Lipoprotein(a), Cardiovascular diseases, Diabetes mellitus, type 2
KMID :
0338420160310061110
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À¯È¿¼º°á°ú(Recomendation)
Elevated Lp(a) level was an independent predictable risk factor for CVD in type 2 diabetes; Lipoprotein(a) (Lp[a]) level was an independent predictive risk factor for cardiovascular disease (CVD) in type 2 diabetes.