title: Relationship between lipoprotein (a) and micro/macro complications in type 2 diabetes mellitus: a forgotten target.
abstract: OBJECTIVE
  Increased lipoprotein (a) serum concentrations seems to be a cardiovascular risk factor; this has not been confirmed in extracoronary atherosclerosis complications. We therefore wished to gain a deeper insight into relationship between the plasma concentrations of lipoprotein (a) and the micro- and macro-vascular complications of type 2 diabetes mellitus and to identify possible differences in this association.
  
  
  METHODS
  This is a descriptive observational cross-sectional study. Two-hundred and seventeen elderly patients with type 2 diabetes mellitus were included from the internal medicine outclinic. Anthropometric data, analytical data (insulin reserve, basal and postprandial peptide C, glycosylated hemoglobin, renal parameters, lipid profile and clinical data as hypertension, obesity, micro- and macrovascular complications were collected.
  
  
  RESULTS
  Patients were grouped according to the type 2 diabetes mellitus time of evolution. The mean plasma concentration of lipoprotein (a) was 22.2 ± 17.3 mg/dL (22.1 ± 15.9 mg/dL for males, and 22.1 ± 18.4 mg/dL for females). Patients with hypertension, coronary heart disease, cerebrovascular accident, microalbuminuria and proteinuria presented a statistically significant increased level of lipoprotein (a). Similarly, the patients with hyperlipoprotein (a) (≥ 30 mg/dL) presented significantly increased levels of urea and total cholesterol. In the multivariate regression model, the level of lipoprotein (a) is positively correlated with coronary heart disease and diabetic nephropathy (P < 0.01 and P < 0.005, respectively).
  
  
  CONCLUSIONS
  The elevation of plasma levels of lipoprotein (a) are associated with the development of coronary heart disease and diabe tic nephropathy. Therefore, we consider that the determination of lipoprotein (a) may be a prognostic marker of vascular complications in patients with type 2 diabetes mellitus.
authors: Department of Medicine, Cádiz University, School of Medicine, Cádiz 11002, C/ Dr Marañon S/N, Cádiz, Spain.
authors: Rocio
authors: R
authors: Toro
authors: Department of Medicine, Cádiz University, School of Medicine, Cádiz 11002, C/ Dr Marañon S/N, Cádiz, Spain ; Department of Internal Medicine, University Hospital Puerta del Mar, Cádiz 11002, Ana de Viya S/N, Cádiz, Spain.
authors: Eduardo
authors: E
authors: Segura
authors: Department of Internal Medicine, University Hospital Gregorio Marañon, Madrid 28007, C/ Doctor Esquerdo, 46 Madrid, Spain.
authors: Jesús Millan
authors: JM
authors: Nuñez-Cortes
authors: Department of Internal Medicine, University Hospital del Mar Barcelona 08003, Passeig Marítim, 25-29, Barcelona, Spain.
authors: Juan Carlos
authors: JC
authors: Pedro-Botet
authors: Department of Cardiology, Cruz Roja Hospital,Madrid 28003, Av. de la Reina Victoria, 22-26 Madrid, Spain.
authors: Maribel
authors: M
authors: Quezada-Feijoo
authors: Department of Medicine, Cádiz University, School of Medicine, Cádiz 11002, C/ Dr Marañon S/N, Cádiz, Spain ; Department of Internal Medicine, University Hospital Puerta del Mar, Cádiz 11002, Ana de Viya S/N, Cádiz, Spain.
authors: Alipio
authors: A
authors: Mangas
keywords: Lipoprotein (a); Macrovascular complications; Risk factors; Type 2 diabetes