title: Low-molecular-weight lipoprotein (a) and low relative lymphocyte concentration are significant and independent risk factors for coronary heart disease in patients with type 2 diabetes mellitus: Lp(a) phenotype, lymphocyte, and coronary heart disease.
abstract: BACKGROUND
  The aim of the present prospective study was to examine whether lipoprotein (a) [Lp(a)] phenotypes and/or low relative lymphocyte concentration (LRLC) are independently associated with coronary heart disease (CHD) in patients with type 2 diabetes mellitus (T2DM).
  
  
  METHODS
  Serum Lp(a) concentration, Lp(a) phenotypes, and RLC were analyzed in 214 subjects. Lp(a) phenotypes were classified into 7 subtypes according to sodium dodecyl sulfate-agarose gel electrophoresis by Western blotting. Subjects were assigned to the low-molecular-weight (LMW (number of KIV repeats: 11-22) ) and high-molecular-weight (HMW( number of KIV repeats: >22 )) Lp(a) groups according to Lp(a) phenotype and to the LRLC (RLC: <20.3%) and normal RLC (NRLC; RLC: ≥20.3%) groups according to RLC. A CHD event was defined as the occurrence of angina pectoris or myocardial infarction during the follow-up period.
  
  
  RESULTS
  During the follow-up period, 30 cases of CHD events were verified. Neutrophil count showed no correlation with CHD, while relative neutrophil concentration and RLC showed positive and negative correlations, respectively, with CHD. The Cox proportional hazard model analysis revealed the following hazard ratios adjusted for LMW Lp(a), LRLC, and LMW Lp(a) + LRLC: (4.31; 95% confidence interval [CI], 1.99-9.32; P < 0.01, 3.621; 95% CI, 1.50-8.75; P < 0.05, and 7.15; 95% CI, 2.17-23.56; P < 0.01, respectively).
  
  
  CONCLUSIONS
  Our results suggest that both LMW Lp(a) and LRLC are significant and independent risk factors for CHD and that the combination thereof more strongly predicts CHD in patients with T2DM.
authors.affiliation: Department of Internal Medicine (Divisions of Cardiology, Hepatology, Geriatric Medicine, and Integrated Medicine), Nippon Medical School, 1-1-5, Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan. t-suzuki@nms.ac.jp
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Suzuki
authors.forename: Shoko
authors.initials: S
authors.lastname: Futami-Suda
authors.forename: Yoshimasa
authors.initials: Y
authors.lastname: Igari
authors.forename: Kentaro
authors.initials: K
authors.lastname: Watanabe
authors.forename: Motoshi
authors.initials: M
authors.lastname: Ouchi
authors.forename: Kazunari
authors.initials: K
authors.lastname: Suzuki
authors.forename: Ken-Ichi
authors.initials: K
authors.lastname: Sekimizu
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Kigawa
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nakano
authors.forename: Kenzo
authors.initials: K
authors.lastname: Oba
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D003327:Coronary Disease / Q000097:blood* / Q000175:diagnosis / Q000209:etiology / Q000473:pathology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications / Q000175:diagnosis / Q000473:pathology; D004591:Electrophoresis, Polyacrylamide Gel; D005260:Female; D006801:Humans; D017270:Lipoprotein(a) / Q000097:blood* / Q000145:classification; D018655:Lymphocyte Count; D008214:Lymphocytes / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D008970:Molecular Weight; D009504:Neutrophils / Q000473:pathology; D010641:Phenotype; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D017270:Lipoprotein(a)