Endocrine Abstracts

Background/aim: Lipoprotein a (Lpa) is a major atherogenic factor associated with increased cardiovascular risk among patients with type 1 diabetes (t1D). This study investigated the possible relationship of Lpa levels to the metabolic profile, bone status and kidney function of patients with T1D.

Materials and methods: 122 adult patients with T1D (70 males and 52 females), were studied in an observational cross-sectional study. Demographic, clinical and laboratory data regarding glycemic regulation (HbA1c, Time in range 70-180 mg/dl [TIR])), lipid status (Tchol; Total cholesterol; HLD, LDL, triglycerides, Lpa) bone metabolism (BMD [bone mass density] and T-Score in FN [femoral neck] and LS [lumbar spine]) and renal function (eGFR [estimated glomelural filration rate] were recorded. Patients were divided in 2 groups based on their Lpa levels (low<30 mg/dl and high ≥ 30 mg/dl.) and on their HbA1c status (good, < 7%; bad ≥7%).

Results: Mean age and body mass index of the patients were 44.2 years and 26.6 kg/m² respectively. Mean HbA1c and Lp(a) values were 7.5% and 37 mg/dl respectively. Men exhibited notably higher HbA1c, Tchol, LDL and Lpa values (HbA1c: 7.67 vs 7.3%, P=0.011; Tchol: 221 vs 204 mg/dl, P=0.06; LDL: 112 vs 86 mg/dl, P=0.043; and Lpa:48 vs 24 mg/dl, P=0.031 respectively). Interestingly, patients with higher Lp(a) values had deteriorated metabolic profile (HbA1c: 7.7% vs 7.2%, P=0.002) and worse glycemic regulation (TIR: 64 vs 77%, P=0.011) than those with lower Lpa values. Furthermore, eGFR values were remarkably lower among the high Lpa group patients versus the low Lpa group ones (55 vs 62 mL/min/1.73m², P=0.03). Finally, patient with T1D and increased Lpa values exhibited decreased BMD and T-Score in the FN (BMD: 0.711 vs 0.784, P=0.034; T-Score: -1.1 vs -0.9, P=0.04) and the LS (BMD: 0.884 vs 0.901, P=0.012; T-Score: -0.95 vs -0.7, P=0.033) compared to those with increased Lpa values. Interestingly, patients with good metabolic control were found to have significantly lower Lp(a) levels than those with worse metabolic control (49 vs 28 mg/dl, P=0.041).

Conclusions: The results of our study indicate that Lpa could potentially be a major risk factor for worse metabolic, bone and renal profile among patients with T1D. Conversely, deteriorated glycemic regulation in patients with T1D is linked to markedly higher Lp(a) levels.