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A prospective study of lipoprotein(a) and risk of coronary heart disease among women with type 2 diabetes.
Diabetologia 2005; 48(8):1469-76D

Abstract

AIMS

We examined the association between lipoprotein (Lp)(a) and CHD among women with type 2 diabetes.

METHODS

Of 32,826 women from the Nurses' Health Study who provided blood at baseline, we followed 921 who had a confirmed diagnosis of type 2 diabetes.

RESULTS

During 10 years of follow-up (6,835 person-years), we documented 122 incident cases of CHD. After adjustment for age, smoking, BMI, glycosylated HbA(1)c, triglycerides (TGs), high-density lipoprotein cholesterol, low-density lipoprotein cholesterol and other cardiovascular risk factors, the relative risk (RR) comparing extreme quintiles of Lp(a) was 1.95 (95% CI 1.07-3.56). The association was not appreciably altered after further adjustment for apolipoprotein B(100) or several inflammatory biomarkers. Increasing levels of Lp(a) were associated with lower levels of TGs. The probability of developing CHD over 10 years was higher among diabetic women with substantially higher levels of both Lp(a) (>1.07 micromol/l) and TGs (>2.26 mmol/l) than among diabetic women with lower levels (22 vs 10%, p log-rank test=0.049). Diabetic women with a higher level of only Lp(a) or TGs had a similar (14%) risk. In a multivariate model, diabetic women with higher levels of Lp(a) and TGs had an RR of 2.46 (95% CI 1.21-5.01) for developing CHD, as compared with those with lower levels of both biomarkers (p for interaction=0.413). The RRs for women with a higher level of either Lp(a) (RR=1.22, 95% CI 0.77-1.92) or TGs (RR=1.39, 95% CI 0.78-2.42) were comparable.

CONCLUSIONS/INTERPRETATION

Increased levels of Lp(a) were independently associated with risk of CHD among diabetic women.

Authors+Show Affiliations

Department of Nutrition, Harvard School of Public Health, Boston, MA, USA. irish@bgu.ac.ilNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

15971061

Citation

Shai, I, et al. "A Prospective Study of Lipoprotein(a) and Risk of Coronary Heart Disease Among Women With Type 2 Diabetes." Diabetologia, vol. 48, no. 8, 2005, pp. 1469-76.
Shai I, Schulze MB, Manson JE, et al. A prospective study of lipoprotein(a) and risk of coronary heart disease among women with type 2 diabetes. Diabetologia. 2005;48(8):1469-76.
Shai, I., Schulze, M. B., Manson, J. E., Stampfer, M. J., Rifai, N., & Hu, F. B. (2005). A prospective study of lipoprotein(a) and risk of coronary heart disease among women with type 2 diabetes. Diabetologia, 48(8), pp. 1469-76.
Shai I, et al. A Prospective Study of Lipoprotein(a) and Risk of Coronary Heart Disease Among Women With Type 2 Diabetes. Diabetologia. 2005;48(8):1469-76. PubMed PMID: 15971061.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A prospective study of lipoprotein(a) and risk of coronary heart disease among women with type 2 diabetes. AU - Shai,I, AU - Schulze,M B, AU - Manson,J E, AU - Stampfer,M J, AU - Rifai,N, AU - Hu,F B, Y1 - 2005/06/22/ PY - 2004/10/11/received PY - 2005/03/09/accepted PY - 2005/6/23/pubmed PY - 2005/10/20/medline PY - 2005/6/23/entrez SP - 1469 EP - 76 JF - Diabetologia JO - Diabetologia VL - 48 IS - 8 N2 - AIMS: We examined the association between lipoprotein (Lp)(a) and CHD among women with type 2 diabetes. METHODS: Of 32,826 women from the Nurses' Health Study who provided blood at baseline, we followed 921 who had a confirmed diagnosis of type 2 diabetes. RESULTS: During 10 years of follow-up (6,835 person-years), we documented 122 incident cases of CHD. After adjustment for age, smoking, BMI, glycosylated HbA(1)c, triglycerides (TGs), high-density lipoprotein cholesterol, low-density lipoprotein cholesterol and other cardiovascular risk factors, the relative risk (RR) comparing extreme quintiles of Lp(a) was 1.95 (95% CI 1.07-3.56). The association was not appreciably altered after further adjustment for apolipoprotein B(100) or several inflammatory biomarkers. Increasing levels of Lp(a) were associated with lower levels of TGs. The probability of developing CHD over 10 years was higher among diabetic women with substantially higher levels of both Lp(a) (>1.07 micromol/l) and TGs (>2.26 mmol/l) than among diabetic women with lower levels (22 vs 10%, p log-rank test=0.049). Diabetic women with a higher level of only Lp(a) or TGs had a similar (14%) risk. In a multivariate model, diabetic women with higher levels of Lp(a) and TGs had an RR of 2.46 (95% CI 1.21-5.01) for developing CHD, as compared with those with lower levels of both biomarkers (p for interaction=0.413). The RRs for women with a higher level of either Lp(a) (RR=1.22, 95% CI 0.77-1.92) or TGs (RR=1.39, 95% CI 0.78-2.42) were comparable. CONCLUSIONS/INTERPRETATION: Increased levels of Lp(a) were independently associated with risk of CHD among diabetic women. SN - 0012-186X UR - https://www.unboundmedicine.com/medline/citation/15971061/A_prospective_study_of_lipoprotein_a__and_risk_of_coronary_heart_disease_among_women_with_type_2_diabetes_ L2 - https://dx.doi.org/10.1007/s00125-005-1814-3 DB - PRIME DP - Unbound Medicine ER -