Relationship Between Increased Serum Lipoprotein (a) Levels and Urinary Albumin Excretion in NIDDM Patients

Authors: Miyase BAYRAKTAR, Sabri SAYINALP, Alper GÜRLEK, Olcay GEDİK

Abstract: Lipoprotein (a) is an independent risk for coronary heart disease in NIDDM patients. Increasing urinary albumin excretion also predicts the development of coronary heart disease in NIDDM patients. We investigated whether there is a potential relationship between plasma lipoprotein (a) levels and the degree of urinary albumin excretion rate in a population of NIDDM patients. The subjects were divided according to urinary albumin excretion rate as normoalbuminuric (n=79) microalbuminuric (n=31) and macroalbuminuric (n=15). Age, body mass index sex, and per cent smoking were similar in the three groups, the duration of diabetes and glycosylated hemoglobin level were different in the macroalbuminuric group (p<0.05). Subjects with macroalbuminuria had significantly higher lipoprotein (a) levels then the subjects with normoalbuminuria and microalbuminuria (p<0.05 [median levels with range; 153 (5-158) mg/dl, and 9 (4 -160) mg/dl respectively]. There was no difference in the lipoprotein (a) levels between normoand microalbuminuric subjects (p=NS). The frequency of lipoprotein (a) levels elevation above the threshold for increased cardiovascular risk (>30 mg/l) was significanly greater in subjects with macroalbuminuria compared to the subjects with normoalbuminuria and microalbuminuria (66.6%, 35.5%, 32.2% respectively p<0.05). The prevalence of coronary heart disease was similar in the subjects with macroalbuminuria have elevated Lp (a) levels, possibly as a result of altered Lp (a) metabolism by the kidney.

Keywords: Lipoprotein (a), microalbuminuria, macroalbuminuria, NIDDM