An International Journal for Biomedical Sciences - Biomedicine

Serum LP ‘a’ and TG in Diabetes Mellitus
contribute to the thrombotic phenomenon.
Further, LDL-like structure contributes to
atherogenicity leading to Ischemic heart disease
(6, 7). Studies regarding levels of Lp(a) in type
2 diabetics still remains controversial, some
reporting higher levels ( 8,9,10,11 ), some lower
(12, 13), while few have shown no significant
change (14, 15 ,16). Variations in Lp (a) levels
are mainly under genetic control (17). Various
other factors like ethnicity, diet, drugs and
hormones also affect serum Lp (a) levels (18,19,
20 , 21). There are very few studies showing the
influence of various serum lipids on Lp (a) levels
in diabetics. Although an inverse correlation
between serum Lp (a) and serum triglycerides
has been reported in non-diabetic subjects, there
is scanty literature on this relationship among
the diabetic population.
Materials and methods:
This study was conducted among the out patients
attending the General Medicine department
at Narayana General Hospital, Nellore over a
period of 6 months.
A total of 55 subjects were enrolled for the study
(type 2 diabetics
n= 21, non-diabetic first degree relatives
(FDRs) n=19 and healthy controls n=15).
Type 2 diabetic subjects were further subdivided
based on duration of diabetes into those with <
5 yrs duration and those with ≥5 yrs duration.
All of them were in the age group of 20-70
years and both sexes were included. Informed
oral consent was taken from all subjects.
Inclusion criteria:
Subjects should have been diabetic for at least
one year duration.
To avoid possible transient increase of Lp (a)
after starting insulin treatment, we excluded all
patients in whom insulin was initiated during
40
the first two months preceding the study.
Blood samples were collected after 12 hours
of overnight fasting. 5 ml of venous blood
was collected and part of the blood was
transferred into EDTA anticoagulant containing
tube and sodium fluoride containing tube for
estimation of HbA1c and glucose respectively.
Remaining blood was allowed to clot and the
serum separated was used to analyze lipids
immediately or stored at – 20°C and analyzed as
batch for Lp(a). Glucose and lipid profile were
estimated by Automated chemistry analyzer
[ Humastar 300 (Human Gm BH , Germany)]
using available commercial kits. VLDL was
calculated as triglycerides divided by 5.
Lipoprotein (a) (TULIP QUANTIA KIT) and
HbA1c were estimated by Immunoturbidimetry.
The reference value for Lp(a) is less than 30 mg/
dl. For adequate quality control, both normal
and abnormal reference control serum solutions
and calibrators were run before each testing.
Statistical analysis & Results:
Data were analyzed using statistical software
SPSS 12.0 version. Values were expressed
as mean ± standard error of mean (SEM) for
continuous variables. Correlations between the
different lipids and serum Lp (a) were done
using Spearman σ correlation. A non-parametric
test, Mann –Whitney test was used to compare
the means between the groups of subjects owing
to skewing of the data. A p value of < 0.05
was considered statistically significant. The
average age and standard deviation of type 2
diabetics, non-diabetic FDRs and controls were
52.7 yrs ± 9.15 , 32.4 yrs ± 9.91 and 31.2 yrs ±
7.35 respectively. Table 1 shows the values of
the biochemical parameters in type 2 diabetic
subjects and controls. Table 2 shows the values
of the biochemical parameters in type 2 diabetic
subjects and FDRs. Table 3 shows the values
of the biochemical parameters in FDRs and
www.biomedicineonline.org Biomedicine - Vol 31; No.1: 2011