Relationship of progressively increasing albuminuria to apoprotein(a) and blood pressure in type 2 (non-insulin-dependent) and type 1 (insulin-dependent) diabetic patients.

Abstract

This study has explored the temporal relationship between apoprotein(a), blood pressure and albuminuria over a mean interval of 11 years in a cohort of 107 diabetic patients of whom 26 (14 Type 2 (non-insulin-dependent), 12 Type 1 (insulin-dependent) had progressively increasing albuminuria ('progressors'). In Type 2 diabetic patients, no significant differences were noted for HbA1, blood pressure, creatinine clearance or serum lipids between progressors and non-progressors. In Type 1 diabetic patients, final systolic and diastolic blood pressures were higher in progressors compared with non-progressors and progressors showed impairment of renal function in association with a rise in blood pressure at the macroalbuminuric stage. Initial apoprotein(a) levels were similar in progressors and non-progressors of either diabetes type. Apoprotein(a) levels increased exponentially with time in 12 of 14 Type 2 progressors but only in 5 of 12 Type 1 progressors (p < 0.01). In Type 2 diabetic patients, the annual increase in apoprotein(a) levels was 9.1 +/- 2.4%, which was significantly greater than in non-progressors, 2.0 +/- 1.2% (p < 0.01) and also exceeded the rates of increase of apoprotein(a) in progressors with Type 1 diabetes, 4.0 +/- 1.4%, (p < 0.05). Apoprotein(a) levels correlated significantly with albuminuria in 8 of 14 Type 2 progressors but only in 3 of 12 Type 1 progressors (p < 0.05). The rate of increase of apoprotein(a) levels was not related to mean HbA1, creatinine or creatinine clearance levels, or to albuminuria.(ABSTRACT TRUNCATED AT 250 WORDS)

• Authors: G Jerums, T J Allen, C Tsalamandris, A Akdeniz, A Sinha, R Gilbert, M E Cooper
• Journal: Diabetologia (Diabetologia) Vol. 36 Issue 10 Pg. 1037-44 (Oct 1993) ISSN: 0012-186X [Print] Germany
• PMID: 8243852 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Apolipoproteins
• Lipoprotein(a)
• Triglycerides
• Cholesterol
• Creatinine
• Apoprotein(a)

Topics

• Adult
• Albuminuria
• Apolipoproteins (analysis)
• Apoprotein(a)
• Blood Pressure
• Cholesterol (blood)
• Cohort Studies
• Creatinine (metabolism)
• Diabetes Mellitus, Type 1 (blood, physiopathology, urine)
• Diabetes Mellitus, Type 2 (blood, physiopathology, urine)
• Diastole
• Female
• Follow-Up Studies
• Humans
• Lipoprotein(a)
• Male
• Middle Aged
• Reference Values
• Systole
• Time Factors
• Triglycerides (blood)