당뇨병성 신병증환자에서 Lipoprotein ( a ) 농도

• Published in: The Korean journal of medicine Vol. 53; no. 5; pp. 605 - 611
• Main Authors: 은연기, Yeon Ki Eun, 류미숙, Mee Sook Ryu, 홍성표, Sung Pyo Hong, 이태원, Tae Won Lee, 임천규, Chun Gyoo Ihm, 김명재, Myung Jae Kim
• Format: Journal Article
• Language: Korean
• Published: 대한내과학회 01.11.1997
• Subjects: Diabetic Nephropathy; Lipoprotein; Proteinuria
• ISSN: 1738-9364

Background: Lipoprotein(a)[Lp(a)] is a subspecies of low-density lipoprotein and has been shown to be associated with pathogenesis of thrombosis-related disease. It is already known that patients with diabetic nephropathy are usually complicated by vascular complications such as coronary artery diseases and cerebrovascular accidents. According to the recent data, Lp(a) level tends to be increased as the proteinuria is increased and renal function are decreased. We evaluated the Lp(a) level to know whether its level is correlated to the severity of diabetic nephropathy. Methods: We investigated Lp(a) levels in eighty-one patients with Type 2 (non-insulin-dependent) diabetic patients. They were divided into four groups according to the level of urinary albumin excretion and serum creatinine level: Group 1 (n=30): normal renal function + urine microalbumin ≤20㎍/min, Group 2 (n=20): normal renal function + protein on urinalysis + urine microalbumin 20-200㎍/min, Group 3 (n=14): urine protein (+) on urinalysis + normal renal function, Group 4 (n=15): urine protein (+) on urinalysis + serum creatinine leve1≥1.5㎎/dL. Blood samples were obtained during the morning in the fasting state and separated serum from the it and reserved at -70℃. Lp(a) concentration was checked by one-step sandwich ELISA test. All grouped data were expressed as mean±SD. ANOVA and unpaired t-test was used to assess the statistical difference between any two means. Results: Lp(a) levels were 30.2±4.6㎎/dL in Group 1, 42.7±8.2㎎/dL in group 2, 73.4±19.7㎎/dL in group 3, and 80.7±14.8㎎/dL in group 4. The level of Lp(a) in group4, group 3, and group 2 was significantly higher than that of group 1 respectively (P=0.009, 0.001, 0.038). However, no significant correlation was observed between the level of Lp(a) and that of total cholesterol, triglyceride and total lipid in all groups. Conclusions: these results indicate that Lp(a) concentrations are increased in the patients with diabetic nephropathy with microalbuminuria or overt proteinuria. So, the presence of albuminuria may be the important determinant for the elevated Lp(a) level in diabetic nephropathy.