For patients with type 1 diabetes, lipoprotein(a) [Lp(a)] is a significant risk factor for macrovascular disease, albuminuria, and calcified aortic valve disease, according to a study published online December in Diabetes Care.

Karin Littmann, from Karolinska Institutet in Stockholm, and colleagues recruited 1,860 patients with type 1 diabetes mellitus receiving regular care and divided them into four groups based on their Lp(a) levels (very low, low, intermediate, and high). Vascular complications were compared between the groups.

The researchers found that compared with patients in the very low Lp(a) group, those in the high Lp(a) group had a higher prevalence of complications, with age- and smoking status-adjusted relative risk ratios of 1.51 (95 percent confidence interval [CI], 1.01 to 2.28; P = 0.048), 1.70 (95 percent CI, 0.97 to 3.00; P = 0.063), 1.68 (95 percent CI, 1.12 to 2.50; P = 0.01), and 2.03 (95 percent CI, 1.03 to 4.03; P = 0.042) for having any macrovascular disease, coronary heart disease, albuminuria, and calcified aortic valve disease, respectively. Significantly lower Lp(a) levels were seen for patients with good metabolic control (hemoglobin A1c <6.9 percent) versus those with poorer metabolic control (hemoglobin A1c >6.9 percent).

"Introducing measurement of plasma Lp(a) levels in the routine management of these patients could potentially improve their risk factor assessment and provide the basis for intensified conventional treatment," the authors write.

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