Levels of lipoprotein(a) [Lp(a)], apolipoprotein (apo) B, and lipoprotein cholesterol distribution using density-gradient ultracentrifugation were measured as part of a cross-sectional study at the final follow-up examination (mean 6.2 years) in the Diabetes Control and Complications Trial. Compared with the subjects in the conventionally treated group (n = 680), those subjects receiving intensive diabetes therapy (n = 667) had a lower level of Lp(a) (Caucasian subjects only, median 10.7 vs 12.5 mg/dl, respectively; P = 0.03), lower apo B (mean 83 vs. 86 mg/dl, respectively; P = 0.01), and a more favorable distribution of cholesterol in the lipoprotein fractions as measured by density-gradient ultracentrifugation with less cholesterol in the very-low-density lipoprotein and the dense low-density lipoprotein fractions and greater cholesterol content of the more buoyant low-density lipoprotein. Compared with a nondiabetic Caucasian control group (n = 2,158), Lp(a) levels were not different in the intensive treatment group (median 9.6 vs. 10.7 mg/dl, respectively; NS) and higher in the conventional treatment group (9.6 vs. 12.5 mg/dl, respectively; P < 0.01). No effect of renal dysfunction as measured by increasing albuminuria or reduced creatinine clearance on Lp(a) levels could be demonstrated in the diabetic subjects. Prospective follow-up of these subjects will determine whether these favorable lipoprotein differences in the intensive treatment group persist and whether they influence the onset of atherosclerosis in insulin-dependent diabetes.
Levels of Lipoprotein(a), Apolipoprotein B, and Lipoprotein Cholesterol Distribution in IDDM: Results From Follow-Up in the Diabetes Control and Complications Trial
apo, apolipoprotein; CAD, coronary artery disease; CI, confidence interval; CV, coefficient of variation; DCCT, Diabetes Control and Complications Trial; DGUC, density-gradient ultracentrifugation; ELISA, enzyme-linked immunosorbent assay; IDDM, insulin-dependent diabetes mellitus; IDL, intermediate-density lipoprotein; HDL, high-density lipoprotein; LDL, low-density lipoprotein; Lp(a), lipoprotein(a); VLDL, very-low-density lipoprotein.
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Jonathan Q Purnell, Santica M Marcovina, John E Hokanson, Hal Kennedy, Patricia A Cleary, Michael W Steffes, John D Brunzell; Levels of Lipoprotein(a), Apolipoprotein B, and Lipoprotein Cholesterol Distribution in IDDM: Results From Follow-Up in the Diabetes Control and Complications Trial. Diabetes 1 October 1995; 44 (10): 1218–1226. https://doi.org/10.2337/diab.44.10.1218
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