Biomarkers for intestinal failure in short bowel syndrome: A new era in GI rehabilitation? / Biomarcadores para la insuficiencia intestinal en síndrome de intestino corto: ¿Una nueva era en la rehabilitación gastrointestinal?

Damage control and gastrointestinal surgery have come a long way from the first reported case of an enterocutaneous fistula to advances in Intestinal transplant and vacuum assisted therapy. Everything we have known in between such as intestinal resections, enteral/parenteral nutrition, delayed abdominal wall closure and intestinal reconstruction have all lead to an exponential increase in our knowledge of gastrointestinal surgery. One area that still remains a significant challenge and clinical dilemma to the general surgeon is intestinal failure in short bowel syndrome. Not only does the anatomical complexity of short bowel syndrome offer difficulties in the definite reconstruction, but also the accompanying intestinal failure increases patient morbidity and mortality. There are no current algorithms or systematic approaches to these daunting clinical scenarios and although surgery has come a long way, there is still room for determining optimal approaches. Therefore, it is critical to keep researching new ways to treat these patients. A relatively new horizon in managing intestinal failure in short bowel syndrome is the use of biomarkers. Here we present a short review on the possible future treatment. The aim of this paper is to provide a pathway for future research into the treatment of this complex area of general surgery

La cirugía gastrointestinal y de control de daños ha tenido un recorrido amplio desde el primer caso reportado de fístula entero-cutánea, hasta llegar al uso de presión subatmosférica para el cierre asistido y el trasplante intestinal. Todos los avances propuestos en el intermedio, como las resecciones intestinales, los planes de nutrición entérica y parenteral, el cierre postergado de la pared abdominal y la reconstrucción intestinal, han llevado a un aumento exponencial del conocimiento de la cirugía gastrointestinal. A pesar de esto, hay un área que permanece como un reto significativo y un dilema clínico para el cirujano general: la falla intestinal en el síndrome de intestino corto. En esta, su complejidad anatómica presenta dificultades a la hora de su reconstrucción, y su alteración funcional aumenta la morbimortalidad del paciente. Así como sucede en la mayoría de las fallas específicas de órganos, esta se caracteriza por cambios en los marcadores séricos que ya han sido bien descritos en la literatura médica. En la falla cardiaca hay elevación del péptido natriurético auricular; en la falla renal, elevación de la creatinina sérica; en la falla hepática, elevación de las transaminasas, y así sucesivamente. Estos marcadores no solo indican la gravedad de la situación, sino que se relacionan con la suficiencia del órgano en cuanto a su función y su mejoría con la rehabilitación. Ahora, ¿cuáles son los marcadores del sistema gastrointestinal? Recientemente, la seriedad de la falla intestinal y su solución han sido objeto de la observación clínica y sintomática con el fin de determinar la orientación de la rehabilitación intestinal y el momento ideal para el inicio de la vía oral. En los últimos años han surgido biomarcadores pertinentes al estudio del sistema digestivo. En esta revisión se discuten los aspectos relacionados con el presente y el futuro de los marcadores serológicos intestinales en el síndrome de intestino corto

Changes of serum TOS and TAS levels and their association with apolipoprotein(a) in patients with polycystic ovary syndrome and infertility / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate changes of serum total oxidation status (TOS) and total antioxidant status (TAS) and their association with apolipoprotein (a) [Apo(a)] in patients with polycystic ovary syndrome (PCOS) combined with infertility.</p><p><b>MWTHODS</b>Ninety patients with PCOS and infertility were selected as the study group, including 45 patients treated with antioxidants combined with Diane-35(group A) and 45 with Diane-35 therapy only (group B), with 45 healthy volunteers with normal menstruation and normal dual phase basic body temperatures as the control group. Serum TOS of the participants was determined by dual xylenol orange method, and serum TAS was determined with ABTS method; plasma Apo(a) level was determined by dual wavelength immune transmission turbidity method.</p><p><b>RESULTS</b>Before treatment, serum TOS, OSI, and Apo(a) levels were significantly higher and TAS level was significantly lower in the study group than in the control group (P<0.05). Serum TOS, OSI, and Apo (a) were significantly lowered and TAS was significantly increased in group A after the therapy as compared with the levels before therapy and the levels in group B. The rate of natural recovery of menstruation was significantly higher and the incidence of cardiovascular disease was significantly lower in group A than in group B (P<0.05). Pearson correlation analysis showed that serum TOS and OSI were positively correlated with plasma Apo(a) (r=0.524 and 0.531, P<0.05), and serum TAS was negatively correlated with plasma Apo(a) (r=-0.519, P<0.05).</p><p><b>CONCLUSION</b>Antioxidant therapy can lower TOS, OSI and Apo(a) levels and increase TAS level to lessen oxidative stress, improve the prognosis, and reduce the risks of cardiovascular disease in patients with PCOS and infertility.</p>

Advances in the Association between Apolipoprotein (a) Gene Polymorphisms and Coronary Heart Disease / 中国医学科学院学报

Human apolipoprotein (a) (LPA) gene is highly polymorphic, and the polymorphic loci on this gene include the Kringle 4 subtype 2(KIV-2) repeat polymorphism, the pentanucleotide repeat (TTTTA)n polymorphism, and a number of single nucleotide polymorphisms. KIV-2 repeat polymorphism was found to be significantly associated with coronary heart disease(CHD), and the reducing number of KIV-2 repeats is a risk factor for CHD. Both the increase and decrease of the pentanucleotide repeat(TTTTA)n polymorphism repeats are possibly associated with CHD risk. In single nucleotide polymorphisms loci, the rs10455872 and rs3798220 loci were widely reported to be associated with CHD, while other loci were less reported. The association between LPA polymorphisms and CHD may be mediated by either the elevation of plasma LPA level or the change of LPA subtypes. This article reviews the association between the LPA polymorphisms and CHD and the underlying mechanisms.

Association between lipoprotein [A] and small apo [A] phenotypes and coronary heart disease in Sudanese diabetic patients

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

Variabilidade interensaios de dislipidemias em pacientes hipertensos / Inter-assays variability of dislipidemias in hypertensive patients

INTRODUÇÃO E OBJETIVOS: Ensaios de diferentes procedências para avaliação das dislipidemia podem resultar em variações significativas nos resultados obtidos e consequente conduta inadequada pelo clínico. O estudo objetivou comparar resultados laboratoriais de colesterol total (CT), triglicérides (TG), colesterol da lipoproteína de alta densidade (HDL-C), colesterol da lipoproteína de baixa densidade (LDL-C), apolipoproteína A-1 (Apo A-1), apolipoproteína B (Apo B) e lipoproteína (a) (Lp[a]) e índices lipídicos (não-HDL-C, CT/HDL-C, LDL-C/HDL-C, TG/HDL-C e Apo B/HDL-C) de pacientes hipertensos e/ou diabéticos diagnosticados. MÉTODOS: Foram utilizados conjuntos reativos, e os respectivos analisadores Gold Analisa, Dia Sys (CCX - Abbott), Dade Behring (Nefelômetro BN 100) e Roche (COBAS Integra 400), para verificar a reprodutibilidade dos resultados obtidos. Participaram 99 pacientes (36 do sexo masculino e 63 do feminino). Comparando os resultados, verificamos que: todas as médias obtidas dos constituintes lipídicos apresentaram diferença significativa; número semelhante de pacientes apresentou níveis séricos elevados de CT, TG, Lp(a) e Apo A-1. O HDL-C, o LDL-C e a Apo B apresentaram discordância, assim como os índices de CT/LDL-C, LDL-C/HDL-C e TG/HDL-C. Para não-HDL-C e ApoB/HDL, houve semelhança no número de pacientes com valores não recomendados. Em consequência da diferença, em relação ao LDL-C, a decisão da conduta terapêutica poderá ser inadequada, enquanto o não-HDL-C, além de evidenciar partículas aterogênicas, apresentou número de hipertensos com valores séricos não referendados semelhantes, independente da metodologia e do equipamento utilizado. CONCLUSÃO: No grupo de hipertensos analisados, o não-HDL-C se caracterizou um importante fator de correção interensaios de parâmetros lipídicos. E sua associação à relação Apo B/HDL-C pode ser um fator adicional em relação às condutas hipolipemiantes a serem adotadas.

INTRODUCTION AND OBJECTIVES: Different assays to evaluate dyslipidemia may show significant variations in the obtained results and a consequent inappropriate clinical approach may be adopted. This study aimed to compare the results of total cholesterol (CT), triglycerides (TG), HDL-C, Apo A1, Apo B, lipoprotein (a) and lipidic indexes (not-HDL-C, CT/HDL-C, LDL-C/HDL-C, TG/HDL-C and Apo B/HDL-C) of hypertensive and/or diabetic patients. METHODS: The following reactive kits and respective analyzers were applied to verify the reproducibility of results: Gold Analisa, DiaSys (CCX-ABBOTT), Dade Behring (Nephelometer BN 100) and Roche (COBAS Integra 400). Ninety nine patients (36 male and 63 female gender) were investigated. Comparing the results, we observed that all mean numbers of lipid constituents showed a significant difference. A similar number of patients had high CT, TG, Lp (a) and Apo A-1 serum levels. There was also disagreement in HDL-C, LDL-C, ApoB, CT/LDL-C, LDL-C/HDL-C and TG/HDL-C indexes. For not-HDL-C and ApoB/HDL, there was similarity in the number of patients with not recommended values. As a consequence of this difference, the choice of therapeutic approach may be inappropriate as to LDL-C levels, whereas Not-HDL-C not only showed atherogenic particles but also a number of hypertensive patients with similar not recommended serum values, regardless of the methodology and the equipment used. CONCLUSION: In the analyzed group of hypertensive patients, not-HDL-C was an important inter assay correction factor of lipidic parameters. The association with Apo B/HDL-C relation may be an additional factor as to the choice of hypolipemiant treatments.

Lipoprotein(a) as a risk factor for diabetic retinopathy in patients with type 2 diabetes mellitus.

AIMS: To estimate serum lipoprotein(a) [Lp(a)] levels in patients with type 2 diabetes mellitus with and without diabetic retinopathy and to determine the correlation, if any, between serum Lp(a) levels and severity of diabetic retinopathy. MATERIALS AND METHODS: The study included a total of 200 patients of type 2 diabetes mellitus out of which 100 patients who had no retinopathy served as the control group and 100 patients with diabetic retinopathy formed the study group. A detailed fundus examination was done with dilated pupil. The Lp(a) levels were measured quantitatively in fasting venous samples by an immunoturbidimetric method using commercially available kits (Clonital). STATISTICAL ANALYSIS USED: Group comparisons involving qualitative measures were carried out using Chi square test. ANOVA procedure was applied for comparing group means. Logistic regression analysis was performed for independent factors associated with diabetic retinopathy. RESULTS: The average Lp(a) levels in the study group (68.5 mg/dl) were significantly higher than in the control group (25.1 mg/dl) (P 0.001). The Lp(a) levels were found to increase with increasing severity of diabetic retinopathy. CONCLUSIONS: Serum Lp(a) levels are significantly raised in patients with diabetic retinopathy as compared to those with no retinopathy.

Effects of wild-type (Trp72) and mutant (Arg72) apolipoprotein(a) kringle IV-10 on the proliferation of human arterial smooth muscle cells / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To assess the atherogenicity of lipoprotein(a), the effect of the heterogeneity of lysine binding of apolipoprotein(a) [apo(a)], a plasminogen-like glycoprotein component on the proliferation of human arterial smooth muscle cells (SMCs).</p><p><b>METHODS</b>Both wild type (wt) Trp72 and mutant (mut) Trp72-->Arg forms of apo(a) kringle IV-10 were expressed by employing a GST-gene fusion system into E. coli. The proliferation of SMCs was determined by flow cytometry and MTT colorimetry. Enzyme-linked immunosorbent assay (ELISA) assay was used to detect the active form of transforming growth factor beta(1) (TGF-beta(1)).</p><p><b>RESULTS</b>Apo(a) wt-kringle IV-10 that has lysine binding properties possessed a growth-stimulating activity to SMCs on a dose-dependence manner by stimulating cells in the G(1)/G(0) phase of cell cycle to S and G(2)/M phase, and reduced significantly the amounts of endogenous active TGF-beta(1) in culture when compared with the control medium and the GST group (2.4 +/- 0.5 vs 8.6 +/- 1.6 and 9.1 +/- 1.7 ng/ml, P < 0.01). The growth-stimulating effect of apo(a) mut-kringle IV-10 deficient in lysine binding was negligible.</p><p><b>CONCLUSIONS</b>Apo(a) induces SMCs growth by inhibiting the activation of latent TGF-beta(1), an activity that may involve the ability of apo(a) kringle IV-10 to bind lysine. The mitogenic effect of apo(a) wt-kringle IV-10 on SMCs might play an active role in the atherogenic function of lipoprotein(a).</p>

Correlations among Serum Lipoprotein (a), LDL cholesterol, and Apolipoprotein (a) Concentrations in Liver Cirrhosis / 대한임상병리학회지

BACKGROUND: The structure of lipoprotein(a) [Lp(a)] includes a low-density lipoprotein cholesterol (LDL-C) component and apolipoprotein(a) [apo(a)] linked to apolipoprotein B-100 of LDL-C with a disulfide bond. Liver cirrhosis is the only disease in which the decrease of serum Lp(a) concentra-tion is observed as a secondary effect. In this study, we tried to investigate the mechanisms for the Lp(a) decrease in cirrhotic patients. METHODS: Forty Child 's class A cirrhotic patients, 40 Child 's class C patients from Asan Medical Center, and 80 healthy controls were recruited. Serum concentrations of interleukin-6 (IL-6), LDL-C, Lp(a), and free apo(a) were measured. RESULTS: The serum concentrations of Lp(a) in the Child 's class C patients were significantly lower than those in class A and the control group (P < 0.05). The apo(a) concentrations in the Child 's class C patients were significantly lower than those in class A and the control group (P < 0.05). The LDL-C concentrations of Child 's class C patients were significantly lower than those in class A and the con-trol group (P < 0.01). The IL-6 concentrations of Child 's class C patients were significantly higher than those in class A and the control group (P < 0.005). Serum concentrations of Lp(a) showed positive correlations with those of LDL-C (r=0.42, P < 0.0001) and with those of the free apo(a) (r=0.68, P < 0.0001). But serum concentrations of IL-6 had no correlation to those of the Lp(a) or the free apo(a). CONCLUSIONS: Considering the positive correlation between Lp(a) and LDL-C, the decrease in the serum Lp(a) in cirrhotic patients could be due mainly to the decrease in the LDL component, although we could not suggest the mechanism for the LDL decrease.

A preliminary study of pentanucleotide repeat polymorphism of apolipoprotein(a) gene in coronary atherosclerotic heart disease / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>This study inquired into the relationship between a pentanucleotide repeats(PNR) polymorphism of the apolipoprotein(a)[apo(a)] gene and coronary atherosclerotic heart disease(CHD) in Chinese Han nationality.</p><p><b>METHODS</b>PNR polymorphism of the apo(a) gene from 165 cases of CHD and 153 normal individuals were analyzed by polymerase chain reaction(PCR)-denature polyacrylamide gel electrophoresis-silver stain.</p><p><b>RESULTS</b>The frequencies of (TTTTA)(5/8) genotype (0.188) and (TTTTA)(5) allele (0.115) in CHD group were remarkably higher than those in control group (0.039, 0.026)(P<0.01, P<0.05).</p><p><b>CONCLUSION</b>These findings indicate that the PNR polymorphism of apo(a) is associated with the susceptibility to CHD, which may be involved in the development of CHD.</p>

The Effects of Lipoprotein(a) on Coronary Stent Restenosis

BACKGROUND: Lipoprotein (a) [Lp(a)] contains apolipoprotein(a), which is a structural homologue of plasminogen and competes with it for binding sites. It also acts by increasing plasminogen activator inhibitor-1 expression. The objective of this study was to evaluate the relationship between Lp(a) levels and restenosis rate after successful coronary stent placement. METHODS: The study included 306 patients who underwent coronary stent placement and follow-up coronary angiogram at Chonnam National University Hospital from August 1996 to June 2000. Restenosis rate was analyzed according to the level of Lp(a); Group I with high Lp(a) (n=7, Lp(a) 36 mg/dL, 58.98.8 years, female: 35.1%) and Group II with low Lp(a) (n=29, Lp(a) < 36 mg/dL, 57.79.8 years, female: 18.8%). RESULTS: 1) There was no significant differences in risk factors of atherosclerosis, clinical diagnosis, the number of involved coronary artery, left ventricular function, angiographic lesion characteristics by American College of Cardiology/American Heart Association clasification and Thrombolysis In Myocardial Infarction flow in two groups. 2) Angiographic restenosis rates were not different between two groups (group I : 33.8%, group II : 35.4%). CONCLUSION: Plasma Lp(a) levels are not related with the angiographic restenosis rate after coronary stent placement.

Allele Frequencies of Apo(a) Pentanucleotide(TTTTA) Repeat Polymorphism / 대한임상병리학회지

BACKGROUND: Lipoprotein(a) [Lp(a)] is an atherogenic lipoprotein that is assembled from a low density lipoprotein(LDL) and apolipoprotein(a) [apo(a)]. The variations in Lp(a) concentration tend to be inversely related to the number of kringle IV in apo(a) gene, but other polymorphisms [pentanucleotide(TTTTA) repeats, +93 C/T polymorphism, and Met/Thr polymorphism] of the apo(a) gene are also seems to be related to Lp(a) concentrations. The purpose of this study was to investigate the association of the pentanucleotide repeat polymorphism(PNRP) and Met/Thr polymorphism with the Lp(a) concentrations. METHODS: We studied 197 healthy adults. For genotype analysis of the PNRP and the Met/Thr polymorphism, PCR was performed. Apo(a) phenotyping was performed by SDS-PAGE and immunoblotting. The Lp(a) concentrations were measured by ELISA method. More than two groups were compared using the Kruskal Wallis one-way analysis test. To establish a relationship between gene polymorphisms and Lp(a) concentrations, The linear regression test was performed. RESULTS: Mean Lp(a) concentration was 25.3+/-21.5 mg/dL. Allele frequencies for PNRP, subjects with 8/8 genotype were 114(57.9%) and most frequently observed. The Lp(a) concentrations showed the tendency to decrease as the sum of alleles of PNR increased. Subjects with Met/Thr genotype were 119(60.4%), Met/Met genotype were 71(36.0%) and Thr/Thr genotype were 7(3.6%). CONCLUSIONS: For PNRP, subjects with 8/8 genotype were 114(57.9%) and 8/8 genotype was the most frequently observed. Met/Thr genotype was most frequently observed.

Multivariate Analysis of Factors Associated with Serum Lipoprotein(a) Level in Continuous Ambulatory Peritoneal Dialysis Patients / 대한신장학회잡지

Lp(a) is an independent risk factor of atherosclerotic cardiovascular diseases. Marked increase in plasma lipoprotein(a)[Lp(a)] was reported in conti- nuous ambulatory peritoneal dialysis(CAPD) patients. Serum albumin, parameters of nutritional status and parameters of dialysis have been reported to be related with Lp(a) concentration. Eighty nine patients(age 52 +/- 13, M: F 61: 28) undergoing CAPD were included in this study. We measured Lp(a) concentration, apolipoprotein(a) [apo(a)] phenotype, serum albumin, parathyroid hormone (PTH), Creactive protein(CRP), fibrinogen, 24 hour peritosol protein ancl albumin, 24 hour urine protein and albumin, total albumin clearance, residual renal function(RRF), and parameters of nutritional status such as prealbumin, triceps skin fold(TSF), mid-arm muscle area(MAMA), and normalized protein cata- bolic rate(nPCR). Peritoneal equilibration test(PET) and weekly Kt/V,. were also measured to evaluate relationship of Lp(a) and the adequacy of dialysis. The median serum Lp(a) was 48.9mg/dl(29.1-73.5 mg/dl) (quartiles). Higher Lp(a) level was observed in the low molecular weight apo(a) subgroup. There was no significant difference in serum Lp(a) levels between male and female, diabetic and non-diabetic patients, smokers and non-smokers. Serum albumin was negatively correlated(r=-0.28, p<0.01), while total albumin clearance was positively correlated with Lp (a)(r=0.20, p<0.05). 4)gLp(a) was not correlated with age, duration of dialysis, prealbumin, fibrinogen, RRF, weekly Kt/V, PET, PTH, CRP, TSF, MAMA, nPCR, 24hour peritosol protein and albumin and 24hour urine protein and albumin. Multivariate analysis using apo(a) phenotype, serurn albumin, total albumin clearance as independent variables revealed that serum albumin and apo(a) phenotype were significantly related with logLp(a)(p<0.05). Apo(a) phenotype and serum albumin were the factors that were independently associated with se- rum Lp(a) concentration in CAPD patients.

Changes of Plasma Lipoprotein(a) Levels as a Acute Phase Reactantfrom Antepartum to Postpartum Period / 대한산부인과학회잡지

Lipoprotein(a)[Lp(a)] represents a class of lipoprotein particles defined by the presence of apolipoprotein(a), a unique glycoprotein linked by a disulfide bond to apolipoprotein B-100 to form a single macromolecule. It was known that Lp(a) levels were associated with risk factor for cardiovascular disease and were fluctuated during pregnancy and postpartum. In the present study, plasma Lp(a) levels were estimated in two groups of women comprising 48 normal spontaneous vaginal delivery group and 52 Cesarean section delivery group. The changes of plasma Lp(a) concentrations were serially estimated before delivery, postpartum 1 weeks and postpartum 6 weeks. The result can be summarized as follows.1. Mean ploasma Lp(a) levels were changed from 43.9 +/- 28.4 mg/dl at delivery to 68.5 +/- 35.5 mg/dl at postpartum 1 weeks 73.1 +/- 35.7 mg/dl versus 63.7 +/- 35.1 mg/dl. And after postpartum 6 weeks, mean plasma Lp(a) levels were returned to near initial levels 48.4 +/- 21.1 mg/dl versus 42.2 +/- 16.7 mg/dl.3. Lp(a) levels were significantly rised postpartum 1 weeks compared with before delivery(p < 0.05) and after postpatum 6 weeks(p < 0.05). In conclusion, serum Lp(a) levels were increased postpartum 1 weeks with significant value, and returned to initial levels after postpartum 6 weeks. Our findings suggests that Lp(a) has the characteristics of an acute phase reactant rather modulated by endogenous hormone.

Serum Lipoprotein(a) in Diabetic Retinopathy Patients

Lipoprotein(a), a complex formed by apolipoprotein(a), apo B-100 and lipids, is considered an independent, genetically determined, predictor of cardiovascular disease. It may have antifibrinolytic properties in view of its similarity to plasmmogen. To evaluate whether lipoprotein(a) may be a risk factors in patients with diabetic retinopathy or not, we measured the circulating serum level of lipoprotein(a) in each group classified by the severity of diabetic retinopathy and control group. The serum lipoprotein(a) level was higher in the diabetic patients than in the control group, and diabetic retinopathy, which was expressed by the grade of retinopathy in the worse eye, was correlated significantly with the duration of disease, and the serum level of lipoprotein(a) independently(P<0.05). There was no correlation between the diabetic retinopathy and the age at the time of diagnosis, systolic or diastolic blood pressure, or the serum levels of HbA(IC), cholesterol, triglyceride, and total lipid. We concluded that the lipoprotein(a) may play a role as one of the independent risk factors in diabetic retinopathy.

The Association of the Lipoprotein(a) Levels with Age and Sex

BACKGROUND: Lipoprotein(a)[Lp(a)], an independent risk factor for athrosclerosis, consist of low density lipoprotein like particle and specific glycoprotein, apolipoprotein(a). The levels of Lp(a) are mainly determined by the genetic pleomorphism of apolipoprotein(a) and has been though not to be influenced by age, sex and other biochemical parameters. Recent reports have shown that the concentrations of Lp(a) are correlated with age in women. The purpose of this study was to invastigate the association of Lp(a) concentration with sex and age. METHODS: The concentrations of Lp(a) were measured in 3,707 women and 389 men, free of diseases and medications known to affect the lipid levels. Plasma Lp(a) concentration were measured by commercial radioimmunoassay kit and other lipid profiles by conventional method. RESULTS: In female, median Lp(a) concentration increased with age till the early sixth decade (P=.0000) and then decreased. If peri- and postmenopausal women were excluded in the fifth decades, the relation between age and Lp(a) disappeared. In male, Lp(a) concentration were not associated with age. Median Lp(a) concentrations were higher in females than in males in the fifth(p=.0039) and the sixth decades(p=.0007), The difference became negligible after the exclusion of peri- and postmenopausal woman in the fifth decade. CONCLUSION: The concentrations of Lp(a) were corrected with age only in female. Females had higher levels than males in the fifth and the sixth decades. The relations are thought to be nither due to aging process nor sex but due to postmenopausal increase of Lp(a).

The Association of the Lipoprotein(a) Levels with Age and Sex

BACKGROUND: Lipoprotein(a)[Lp(a)], an independent risk factor for athrosclerosis, consist of low density lipoprotein like particle and specific glycoprotein, apolipoprotein(a). The levels of Lp(a) are mainly determined by the genetic pleomorphism of apolipoprotein(a) and has been though not to be influenced by age, sex and other biochemical parameters. Recent reports have shown that the concentrations of Lp(a) are correlated with age in women. The purpose of this study was to invastigate the association of Lp(a) concentration with sex and age. METHODS: The concentrations of Lp(a) were measured in 3,707 women and 389 men, free of diseases and medications known to affect the lipid levels. Plasma Lp(a) concentration were measured by commercial radioimmunoassay kit and other lipid profiles by conventional method. RESULTS: In female, median Lp(a) concentration increased with age till the early sixth decade (P=.0000) and then decreased. If peri- and postmenopausal women were excluded in the fifth decades, the relation between age and Lp(a) disappeared. In male, Lp(a) concentration were not associated with age. Median Lp(a) concentrations were higher in females than in males in the fifth(p=.0039) and the sixth decades(p=.0007), The difference became negligible after the exclusion of peri- and postmenopausal woman in the fifth decade. CONCLUSION: The concentrations of Lp(a) were corrected with age only in female. Females had higher levels than males in the fifth and the sixth decades. The relations are thought to be nither due to aging process nor sex but due to postmenopausal increase of Lp(a).