Lipoprotein(a) is an independent risk factor for coronary artery disease in NIDDM patients in South India

Abstract

O B J E C T I V E— Asian Indians have been re p o rted to have very high prevalence rates of coron a ry art e ry disease (CAD) in the absence of traditional risk factors. Recently, elevated levels of l i p o p rotein(a) [Lp(a)] have been re p o rted to be associated with pre m a t u re CAD in migrant Asian Indians. However, there are very little data re g a rding Lp(a) in CAD patients from the Indian subcontinent and virtually none in individuals with NIDDM. The objective of this study was to assess the role of Lp(a) as a marker for CAD in South Indian NIDDM patients. RESEARCH DESIGN AND METHODS— We estimated serum Lp(a) in 100 contro l subjects, 100 NIDDM patients without CAD, and 100 NIDDM patients with CAD. Lp(a) values were transformed into natural logarithms. Statistical analysis included Student’s t test, oneway analysis of variance, and 2 test. Multiple logistic re g ression analysis was used to identify associations with CAD. R E S U LT S— Lp(a) levels were significantly higher in NIDDM patients with CAD compare d with NIDDM patients without CAD and control subjects (geometric mean 24.6, 15.1, and 19.4 mg/dl, re s p e c t i v e l y, P 0.05). Results of logistic re g ression analysis showed that Lp(a), age, and HDL were associated with CAD. In NIDDM patients with CAD, there was no corre l a t i o n between Lp(a) and serum cholesterol, triglyceride, or HDL cholesterol levels, but there was a weak association with LDL cholesterol and systolic blood pre s s u re . C O N C L U S I O N S— The data suggests that serum Lp(a) is an independent risk factor for CAD in NIDDM patients in South India.