Prospective Study of Lipoprotein(a) as a Risk Factor for Atherosclerotic Cardiovascular Disease in Patients With Diabetes

OBJECTIVE To assess whether lipoprotein(a) [Lp(a)] is a risk factor for atherosclerotic cardiovascular disease in diabetes. RESEARCH DESIGN AND METHODS We studied 221 patients with non-insulin-dependent diabetes mellitus (NIDDM) without diabetic complications who were followed for 2.2–3.1 years. Their serum Lp(a) levels were semiquantified by a rapid electrophoretic method that accurately discriminates high from low serum Lp(a) at the 20 mg/dl level. RESULTS Seven of 105 diabetic patients with a high serum Lp(a) experienced a clinical event related to atherosclerotic cardiovascular disease. This incidence was significantly higher than that of the 110 diabetic patients with a low serum Lp(a). The logistic regression analysis revealed that Lp(a) was an independent risk factor for the event. CONCLUSIONS Lp(a) is a significant risk factor for atherosclerotic cardiovascular disease in NIDDM.