الفهرس 
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Abstract
In the present work we study lipoprotein patterns in insulin dependent
diabetic patients with and without microalbuminuria in a trial to find out the
relation between lipoproteins including Lp(a) and diabetic nephropathy.
This study included 40 subjects they were cartegorized into three main
groups:
Group I: 10 Healthy normal controls
Group II: 15 IDDM patients without microalbuminuria
Group III: 15 IDDM patients with microalbuminuria
Patients and controls were of the same age group and were subjected to
the following:-
- Careful history and clinical examination .
• Fundus examination to exclude diabetic retinopathy .
• The following laboratory investigations
1. Complete urine analysis.
2. Detection of microalbuminuria
3. Fasting and postprandial serum glucose.
4. Serum total cholesterol
S. Serum triglycerides.
6. Serum HDLc.
7. Serum LDLc.
8. Serum VLDLc.
9. Serum Lp(a).
Tile results of tilis work revealed:-
1. The mean plasma triglycerides levels in diabetics with microalbuminuria is
significantly higher than that of both the control group and diabetics without
microalbuminuria.
2. The mean plasma VLDLc levels in diabetics with microalbuminuria is
significantly higher than that of both the controls and diabetics without
microalbuminuria.
3. The mean plasma Lp(a) levels in diabetics without microalbuminuria is
significantly higher than that of the control group. Moreover, the mean plasma
Lp(a) levels in diabetics with microalbuminuria is significantly higher than
that of both the controls and diabetics without microalbuminuria.
4. Significant positive correlation between serum Lp(a) and fasting serum
glucose, postprandial glucose, total cholesterol, and LDLc, in diabetics with
and without microalbuminuria.
As an increased plasma concentration of Lp(a) is strongly correlated with
the risk ofCHD, finding of higher level ofLp(a) in microalbuminuric patients
may be important in understanding the increased prevalence of CHD in
diabetic patients with nephropathy.
So elevated levels of Lp(a) independent of other plasma lipoproteins can
be used as an early marker for the development of diabetic nephropathy as it
increases in patients with IDDM without microalbuminuria more than the
control and higher levels were detected in microalbuminuric patients inspite
of good control of the diabetic state and non significant changes in the other
lipoprotein patterns.