ABSTRACT
Recent studies indicate an independent association of apolipoprotein [a] small phenotypes with the diabetes and the onset of coronary heart disease. Apolipoprotein [a] small phenotypes when used together with Lipoprotein [a] levels make powerful markers in assessing the actual risk of developing coronary heart disease in diabetic patients. Evaluation of clinical and diagnostic significant of Lipoprotein [a] levels and apolipoprotein [a] small phenotypes and its relation to coronary heart disease in Sudanese diabetic patients. Diabetic patients attending hospitals and medical centers from May 2011-December 2012, in Khartoum, Sudan. This was a case control, hospital based study done on 138 Sudanese diabetic patients attending hospitals and medical centers in Khartoum. Patients were divided into 2 groups. One group had diabetic cases with coronary heart disease and the other were diabetic patients without coronary heart disease. Controls were age and gender matched. Blood samples were collected from both groups [patients and controls] and were run for apolipoproteins, lipoproteins and apolipoprotein [a] small phenotype, low-density lipoprotein, high-density lipoprotein and trigeminal ganglia. The levels of Lipoprotein [a] of patients were significantly higher than controls [p<0.05]. Apolipoprotein[a] small phenotype distribution showed a significant difference when compared between patients of both groups [diabetics with and without coronary heart disease] and controls [p<0.05]. Both low-density lipoprotein and high-density lipoprotein cholesterol showed significant difference in both patient groups and controls [p<0.05]. Total cholesterol and triglyceride levels showed no significant difference between patients and controls. Apolipoprotein[a] small phenotypes showed significant distribution in diabetic patients when compared with coronary heart disease patients [more than one low molecular weight isoform] and [low molecular weight isoforms more than 600 kd]. There were significant association between apolipoprotein [a] low molecular weight isoforms and coronary heart disease in diabetes specially diabetes with history of coronary heart disease. Apolipoprotein [a] low molecular weight isoforms and Lipoprotein [a] levels are useful markers in assessing the risk of developing coronary heart disease in diabetic patients