Determination and evaluation of the serum levels of Low Molecular Weight Apolipoprotein(a) Isoforms in Sudanese Diabetic Patients with Coronary Heart Disease

Abstract

A cross-sectional study conducted during the period from December 2007 to July 2010 to determine and to assess the serum levels of LMW apo(a) isforms in Sudanese diabetic patients with coronary heart disease in comparison with a healthy control group and a diabetic group without coronary heart disease. One hundred-fifty Sudanese diabetic patients with Coronary Heart Disease (CHD) were selected from different hospitals and diabetic medical centers in Khartoum states, Sudan, the test group, compared with two control groups, control group A included 150 diabetic patients without CHD, whereas control group B included 150 apparently healthy volunteers. Blood specimens were collected from all groups and serum Apolipoproteins (LMW apo(a) isoforms, lp(a) apo A1 and apo B) and lipid profiles (Total cholesterol, Triglyceride, LDL cholesterol and HDL cholesterol) were determined. Age and gender of the test group were matched with the control groups. The serum levels of apolipoprotein and lipid profiles were measured using Roche/Hitachi 902 full-automated analyzer and commercial kits from Biosystems, BioRad and Sigma Aldrich companies. Statistical analysis was done, using SPSS computer analysis programme for analysis of results. The serum levels of apo(a) LMW isoforms and lipoprotein(a), of the test group showed significantly raised when compared with control group A and control group B. The serum levels of apolipoprotein B, total cholesterol, LDL-cholesterol triglyceride and VLDL of the test group were not significantly different when compared with control group A, whereas they were significantly raised when compared with control group B. The serum levels of apolipoprotein A1 and HDL-cholesterol of the test group showed insignificant difference when compared with control group A, while they showed significant decrease when compared with control group B. The study indicated a strong positive correlations between the duration of diabetes mellitus and the serum levels of LMW apo(a) isoforms, and lipoprotein(a), and indicated moderate correlations between the duration of diabetes and apolipoprotein B, and showed a weak correlations between the duration of diabetes and Total cholesterol and LDL, and indicated a weak negative correalation between apolipoprotein A1 HDL cholesterol, and showed insignificant correlations between the duration of diabetes and Triglyceride and VLDL. The study indicated strong positive correlations between the age of patients and the serum levels of LMW apo(a) isoforms and lipoprotein(a). The study demonstrated a moderate correlation between apolipoprotein A1 and HDL. and a weak correlation between apolipoprotein B and LDL. In conclusion the study indicates that LMW apo(a) isoforms and lipoprotein(a) are important diagnostic markers because they are strongly correlated with the duration of the diabetes and the age of patients, so they can be used for early detection of atherosclerotic cardiovascular disease (CVD) and in follow up of diabetic patients.