The online version of this article (doi:10.1186/1475-2840-11-81) contains supplementary material, which is available to authorized users.
The authors declare that they have no competing interests.
M.B. conceived the study and wrote the manuscript, P.S. performed the statistical analyses, N.P.-M. M.J.L.-M. and C.R.-P. researched the data and helped to draft the manuscript, and F.J.N. reviewed the manuscript and contributed to the discussion. All authors read and approved the final manuscript.
Recent data suggest that concentrations of lipoprotein(a) [Lp(a)] may be inversely associated with the risk of diabetes. This study analyzed the relationships between Lp(a) and both diabetes and insulin resistance in an adult cohort from the island of Gran Canaria, Spain.
Lp(a), homeostasis model assessment for insulin resistance (HOMA-IR) and conventional risk factors for diabetes were assessed in a sample of 1,030 adult individuals participating in a cross-sectional population-based epidemiological survey in the city of Telde. Diabetes was defined according to the WHO 1999 criteria, or as a previous diagnosis of diabetes. To identify patients at risk for diabetes, an Lp(a) cutoff level of 46 mg/dl was selected previously using classification and regression tree analysis. A multivariate logistic regression model with L2-regularization was used to assess the independent effect of Lp(a) on diabetes and its interactions with variables traditionally linked to the disease. Additionally, to investigate the effect of Lp(a) on insulin resistance, a parametric model was developed to describe the relationship between age and HOMA-IR values in subjects with levels of Lp(a) ≤46 or >46 mg/dl.
Along with variables known to be associated with diabetes, including age, mean blood pressure, serum triglycerides, and an interaction term between age and low HDL cholesterol, the logistic model identified a significant inverse association for diabetes and the interaction term between age and Lp(a) levels >46 mg/dl. According to the proposed parametric model, HOMA-IR was significantly lower in subjects of all ages who had Lp(a) levels >46 mg/dl.
These results suggest that the age-related increase in the probability of having diabetes is significantly lower in subjects with Lp(a) levels >46 mg/dl. This could be explained in part by a lower insulin resistance in this subset of the population.
Nordestgaard BG, Chapman MJ, Ray K, Borén J, Andreotti F, Watts GF, Ginsberg H, Amarenco P, Catapano A, Descamps OS, Fisher E, Kovanen PT, Kuivenhoven JA, Lesnik P, Masana L, Reiner Z, Taskinen M-R, Tokgözoglu L, Tybjærg-Hansen A, for the European Atherosclerosis Society Consensus Panel: Lipoprotein(a) as a cardiovascular risk factor: current status. Eur Heart J. 2010, 31: 2844-2853. 10.1093/eurheartj/ehq386. PubMedCentralCrossRefPubMed
Li C, Ford ES, Tsai J, Zhao G, Balluz LS, Gidding SS: Serum non-high-density lipoprotein cholesterol concentration and risk of death from cardiovascular diseases among U.S. adults with diagnosed diabetes: the Third National Health and Nutrition Examination Survey linked mortality study. Cardiovasc Diabetol. 2011, 10: 46-57. 10.1186/1475-2840-10-46. PubMedCentralCrossRefPubMed
Habib SS, Aslam M, Shah SFA, Naveed AK: Lipoprotein (a) is associated with basal insulin levels in patients with type 2 diabetes mellitus. Arq Bras Cardiol. 2009, 93: 25-30. CrossRef
World Health Organization: Definition, diagnosis and classification of diabetes mellitus and its complications. Report of a WHO Consultation, Part 1: Diagnosis and classification of Diabetes Mellitus. 1999, World Health Organization, Geneva, 1-59.
Breiman L, Friedman JH, Olshen RA, Stone CJ: Classification and regression trees. 1984, Wadsworth International, Belmont, CA
Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, Gordon DJ, Krauss RM, Savage PJ, Smith SC, Spertus JA, Costa F: Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation. 2005, 112: 2735-2752. 10.1161/CIRCULATIONAHA.105.169404. CrossRefPubMed
- High levels of lipoprotein(a) are associated with a lower prevalence of diabetes with advancing age: Results of a cross-sectional epidemiological survey in Gran Canaria, Spain
María J López-Madrazo
Francisco J Nóvoa
- BioMed Central
Neu im Fachgebiet Innere Medizin
Meistgelesene Bücher aus der Inneren Medizin
Mail Icon II