LEVELS OF LIPOPROTEIN(A), APOLIPOPROTEIN-B, AND LIPOPROTEIN CHOLESTEROL DISTRIBUTION IN IDDM - RESULTS FROM FOLLOW-UP IN THE DIABETES CONTROL AND COMPLICATIONS TRIAL

Levels of lipoprotein(a) [Lp(a)], apolipoprotein (ape) B, and Lipoprotein cholesterol distribution using density-gradient ultracentrifugation were measured as part of a cross-sectional study at the final follow-up examination (mean 6.2 years) in the Diabetes Control and Complications Trial, Compared with the subjects in the conventionally treated group (n = 680), those subjects receiving intensive diabetes therapy (n = 667) had a lower level of Lp(a) (Caucasian subjects only, median 10.7 vs, 12.5 mg/dl, respectively; P = 0.03), lower apo B (mean 83 vs, 86 mg/dl, respectively; P = 0.01), and a more favorable distribution of cholesterol in the lipoprotein fractions as measured by density-gradient ultracentrifugation with less cholesterol in the very-low-density lipoprotein and the dense low-density Lipoprotein fractions and greater cholesterol content of the more buoyant low-density lipoprotein, Compared with a nondiabetic Caucasian control group (n = 2,158), Lp(a) levels were not different in the intensive treatment group (median 9.6 vs, 10.7 mg/dl, respectively; NS) and higher in the conventional treatment group (9.6 vs, 12.5 mg/dl, respectively; P < 0.01), No effect of renal dysfunction as measured by increasing albuminuria or reduced creatinine clearance on Lp(a) levels could be demonstrated in the diabetic subjects. Prospective follow-up of these subjects will determine whether these favorable lipoprotein differences in the intensive treatment group persist and whether they influence the onset of atherosclerosis in insulin-dependent diabetes.