Lipoprotein (a) Level Among Patients with Type 2 Diabetes Mellitus and Prediabetes in Comparison with Healthy Controls


  • Barhav Issa Abdullah Dept. of Medical Laboratory, College of Health and Science, Duhok University, Kurdistan Region Iraq.
  • Sherwan Ferman Salih Clinical biochemistry, Duhok University, College of Medicine



lipoprotein (a), diabetes mellitus type 2, prediabetes


Objective: Diabetes mellitus type 2 is a chronic endocrine condition defined as high blood glucose concentration and produced by either insulin resistance or relative lack of insulin, Prediabetes is a metabolic disorder defined by high blood glucose levels that are below the diagnostic threshold for diabetes mellitus. This study aimed to measure lipoprotein (a) levels in individuals with type 2 diabetes mellitus and prediabetic individuals.

Methods: A cross-sectional research was performed at Diabetes Unit at Azadi Teaching Hospital, Kurdistan region, Iraq. The study group consist of 235 participants, 85 type 2 diabetic patients, 60 prediabetic individuals and 90 individuals as control group.

Results: Mean levels of Lipoprotein (a) were higher in patients with type 2 diabetes mellitus (60.43±13.19 mg/dl) and prediabetic individuals (42.53±11.65 mg/dl) in comparison with healthy control (27.3±11.16 mg/dl). Moreover, there was higher prevalent rate of abnormal high lipoprotein (a) among type 2 diabetic patients (69 ,81.1%) and prediabetic individuals (10, 16.7%).

Conclusion: High mean level of lipoprotein (a) and high prevalence rate of abnormal high lipoprotein (a) were observed in type 2 diabetic patients and prediabetic individuals.

Author Biographies

Barhav Issa Abdullah, Dept. of Medical Laboratory, College of Health and Science, Duhok University, Kurdistan Region Iraq.

Dept. of Medical Laboratory, College of Health and Science, Duhok University, Kurdistan Region Iraq (

Sherwan Ferman Salih, Clinical biochemistry, Duhok University, College of Medicine

Clinical biochemistry, Duhok University, College of Medicine (


Al-Shaer, M. H., Elzaky, M. M., Farag, E. S. M., & Saad, M. O. M. (2021). In Type 2 Diabetes Mellitus Patients, the Atherogenic Index of Plasma as a Marker of Coronary Artery Diseases. Indian Journal of Clinical Cardiology, 2(4), 217-221.

Arnold, S. V., Bhatt, D. L., Barsness, G. W., Beatty, A. L., Deedwania, P. C., Inzucchi, S. E., ... & Welty, F. K. (2020). American Heart Association Council on Lifestyle and Cardiometabolic Health and Council on Clinical Cardiology. Clinical management of stable coronary artery disease in patients with type 2 diabetes mellitus: a scientific statement from the American Heart Association. Circulation, 141(19), e779-806.

Care, D. (2019). Care in Diabetes 2019. Diabetes Care, 42(1), S13-S28.

Bansal, N. (2015). Prediabetes diagnosis and treatment: A review. World journal of diabetes, 6(2), 296.

Bener, A., Zirie, M., Daghash, M. H., Al-Hamaq, A. O., Daradkeh, G., & Rikabi, A. (2007). Lipids, lipoprotein (a) profile and HbA1c among Arabian Type 2 diabetic patients. Biomedical research, 18(2), 97-102.

Bhowmik, B., Siddiquee, T., Mujumder, A., Afsana, F., Ahmed, T., Mdala, I. A., ... & Omsland, T. K. (2018). Serum lipid profile and its association with diabetes and prediabetes in a rural Bangladeshi population. International journal of environmental research and public health, 15(9), 1944.

Bo, M. S., Cheah, W. L., Lwin, S., Moe Nwe, T., Win, T. T., & Aung, M. (2018). Understanding the relationship between atherogenic index of plasma and cardiovascular disease risk factors among staff of a University in Malaysia. Journal of Nutrition and Metabolism, 2018.

Bonora, E., Kiechl, S., Willeit, J., Oberhollenzer, F., Egger, G., Bonadonna, R. C., & Muggeo, M. (2003). Carotid atherosclerosis and coronary heart disease in the metabolic syndrome: prospective data from the Bruneck study. Diabetes care, 26(4), 1251-1257.

Boronat, M., Saavedra, P., Pérez-Martín, N., López-Madrazo, M. J., Rodríguez-Pérez, C., & Nóvoa, F. J. (2012). High levels of lipoprotein (a) are associated with a lower prevalence of diabetes with advancing age: results of a cross-sectional epidemiological survey in Gran Canaria, Spain. Cardiovascular diabetology, 11(1), 1-6.

Cândido, A. P. C., Ferreira, S., Lima, A. A., de Carvalho Nicolato, R. L., de Freitas, S. N., Brandão, P., ... & Machado-Coelho, G. L. L. (2007). Lipoprotein (a) as a risk factor associated with ischemic heart disease: Ouro Preto Study. Atherosclerosis, 191(2), 454-459.

Cerf, M. E. (2013). Beta cell dysfunction and insulin resistance. Frontiers in endocrinology, 4, 37.

Chamberlain, J. J., Rhinehart, A. S., Shaefer Jr, C. F., & Neuman, A. (2016). Diagnosis and management of diabetes: synopsis of the 2016 American Diabetes Association Standards of Medical Care in Diabetes. Annals of internal medicine, 164(8), 542-552.

Daghash, M. H., Bener, A., Zirie, M., Dabdoob, W., Al-Hamaq, A. O., & Al-Arabi, Z. A. (2007). Lipoprotein profile in Arabian type 2 diabetic patients. Relationship to coronary artery diseases. International journal of cardiology, 121(1), 91-92.

Dai, W., Long, J., Cheng, Y., Chen, Y., & Zhao, S. (2018). Elevated plasma lipoprotein (a) levels were associated with increased risk of cardiovascular events in Chinese patients with stable coronary artery disease. Scientific reports, 8(1), 1-9.

Daniel, M. J. (2011). Lipid management in patients with type 2 diabetes. American health & drug benefits, 4(5), 312.

Ding, L., Song, A., Dai, M., Xu, M., Sun, W., Xu, B., ... & Ning, G. (2015). Serum lipoprotein (a) concentrations are inversely associated with T2D, prediabetes, and insulin resistance in a middle-aged and elderly Chinese population [S]. Journal of lipid research, 56(4), 920-926.

Draznin, B., Aroda, V. R., Bakris, G., Benson, G., Brown, F. M., Freeman, R., ... & Kosiborod, M. (2022). 16. Diabetes Care in the Hospital: Standards of Medical Care in Diabetes-2022. Diabetes Care, 45(Supplement_1), S244-S253.

Fan, W. (2017). Epidemiology in diabetes mellitus and cardiovascular disease. Cardiovascular endocrinology, 6(1), 8.

Gao, L., Zhang, Y., Wang, X., & Dong, H. (2021). Association of apolipoproteins A1 and B with type 2 diabetes and fasting blood glucose: a cross-sectional study. BMC endocrine disorders, 21(1), 1-11.

Habib, S. S. (2013). Serum lipoprotein (a) and high sensitivity C reactive protein levels in Saudi patients with type 2 diabetes mellitus and their relationship with glycemic control. Turkish Journal of Medical Sciences, 43(2), 333-338.

Haghighatdoost, F., Amini, M., Feizi, A., & Iraj, B. (2017). Are body mass index and waist circumference significant predictors of diabetes and prediabetes risk: Results from a population based cohort study. World journal of diabetes, 8(7), 365.

Hussain, A., Ballantyne, C. M., Saeed, A., & Virani, S. S. (2020). Triglycerides and ASCVD risk reduction: recent insights and future directions. Current Atherosclerosis Reports, 22(7), 1-10.

Jacobson, T. A., Ito, M. K., Maki, K. C., Orringer, C. E., Bays, H. E., Jones, P. H., ... & Brown, W. V. (2015). National lipid association recommendations for patient-centered management of dyslipidemia: part 1—full report. Journal of clinical lipidology, 9(2), 129-169.

Jin, J. L., Cao, Y. X., Zhang, H. W., Sun, D., Hua, Q., Li, Y. F., ... & Li, J. J. (2019). Lipoprotein (a) and cardiovascular outcomes in patients with coronary artery disease and prediabetes or diabetes. Diabetes Care, 42(7), 1312-1318.

Joseph, J., Ganjifrockwala, F., & George, G. (2016). Serum Lipoprotein (a) Levels in Black South African Type 2 Diabetes Mellitus Patients. Oxidative Medicine and Cellular Longevity, 2016.

Karmakar, P. H. (2020). Association of Serum Lipoprotein(a) with Fasting Lipid Profile in Type 2 Diabetic Patients. Eastern Medical College Journal, 5, 18-22.

Klesareva, E. A., Afanas’eva, O. I., Donskikh, V. V., Adamova, I. Y., & Pokrovskii, S. N. (2016). Characteristics of lipoprotein (a)-containing circulating immune complexes as markers of coronary heart disease. Bulletin of experimental biology and medicine, 162(2), 231-236.

Lamina, C., & Ward, N. C. (2022). Lipoprotein (a) and diabetes mellitus. Atherosclerosis, 349, 63-71.

Li, C. L., Chen, S. Y., Lan, C., Pan, W. H., Chou, H. C., Bai, Y. B., ... & Lai, J. S. (2011). The effects of physical activity, body mass index (BMI) and waist circumference (WC) on glucose intolerance in older people: a nationwide study from Taiwan. Archives of Gerontology and Geriatrics, 52(1), 54-59.

Li, Y. W., Kao, T. W., Chang, P. K., Chen, W. L., & Wu, L. W. (2021). Atherogenic index of plasma as predictors for metabolic syndrome, hypertension and diabetes mellitus in Taiwan citizens: a 9-year longitudinal study. Scientific reports, 11(1), 1-8.

Lotfy, M., Adeghate, J., Kalasz, H., Singh, J., & Adeghate, E. (2017). Chronic complications of diabetes mellitus: a mini review. Current diabetes reviews, 13(1), 3-10.

Ma, X., Sun, Y., Cheng, Y., Shen, H., Gao, F., Qi, J., ... & Zhou, Y. (2020). Prognostic impact of the atherogenic index of plasma in type 2 diabetes mellitus patients with acute coronary syndrome undergoing percutaneous coronary intervention. Lipids in Health and Disease, 19(1), 1-13.

Mach, F., Baigent, C., Catapano, A. L., Koskinas, K. C., Casula, M., Badimon, L., ... & Wiklund, O. (2020). 2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk: the Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and European Atherosclerosis Society (EAS). European heart journal, 41(1), 111-188.

Málek, F., Dvořák, J., Skalníková, V., Mates, M., Kmoníček, P., Vávrová, Z., & Neužil, P. (2015). Correlation of lipoprotein (a) with the extent of coronary artery disease in patients with established coronary atherosclerosis: gender differences. European Journal of Preventive Cardiology, 22(5), 603-605.

Maranhão, R. C., Carvalho, P. O., Strunz, C. C., & Pileggi, F. (2014). Lipoprotein (a): structure, pathophysiology and clinical implications. Arquivos brasileiros de cardiologia, 103, 76-84.

Mirhosseini, N., Vatanparast, H., Mazidi, M., & Kimball, S. M. (2018). Vitamin D supplementation, glycemic control, and insulin resistance in prediabetics: a meta-analysis. Journal of the Endocrine Society, 2(7), 687-709.

Mohieldein, A. H., Abdalla, K. E., & Hasan, M. (2014). Lipoprotein (a) and atherogenic indices in Sudanese patients with type 2 diabetes. International journal of health sciences, 8(3), 237.

Nuttall, F. Q. (2015). Body mass index: obesity, BMI, and health: a critical review. Nutrition today, 50(3), 117.

Ogbera, A. O., & Azenabor, A. O. (2010). Lipoprotein (a), C-reactive protein and some metabolic cardiovascular risk factors in type 2 DM. Diabetology & metabolic syndrome, 2(1), 1-5.

Ormazabal, V., Nair, S., Elfeky, O., Aguayo, C., Salomon, C., & Zuñiga, F. A. (2018). Association between insulin resistance and the development of cardiovascular disease. Cardiovascular diabetology, 17(1), 1-14.

Ozder, A. (2014). Lipid profile abnormalities seen in T2DM patients in primary healthcare in Turkey: a cross-sectional study. Lipids in health and disease, 13(1), 1-6.

Peela, J. R., Latiwesh, O. B., Elshaari, F., Hussain, A., Tabrez, E., Viglianco, E., ... & Rawal, A. K. (2018). Investigating the atherogenic risk of lipoprotein (a) in type 2 diabetic patients. Cureus, 10(7).

Ponti, F., Santoro, A., Mercatelli, D., Gasperini, C., Conte, M., Martucci, M., ... & Bazzocchi, A. (2020). Aging and imaging assessment of body composition: from fat to facts. Frontiers in endocrinology, 10, 861.

Premkumar, K. S. (2006). A Study on Lipoprotein (A) in Health and Type-2 Diabetes Mellitus (Doctoral dissertation, Madras Medical College, Chennai).

Ren, X., Zhang, Z., & Yan, Z. (2021). Association between lipoprotein (a) and diabetic nephropathy in patients with type 2 diabetes mellitus: a meta-analysis. Frontiers in Endocrinology, 12, 633529.

Riches, K., & Porter, K. E. (2012). Lipoprotein (a): cellular effects and molecular mechanisms. Cholesterol, 2012.

Saeed, A., Sun, W., Agarwala, A., Virani, S. S., Nambi, V., Coresh, J., ... & Hoogeveen, R. C. (2019). Lipoprotein (a) levels and risk of cardiovascular disease events in individuals with diabetes mellitus or prediabetes: The Atherosclerosis Risk in Communities study. Atherosclerosis, 282, 52-56.

Shah, N. P., Pajidipati, N. J., McGarrah, R. W., Navar, A. M., Vemulapalli, S., Blazing, M. A., ... & Patel, M. R. (2020). Lipoprotein (a): an update on a marker of residual risk and associated clinical manifestations. The American journal of cardiology, 126, 94-102.

Stacey, R. B., Leaverton, P. E., Schocken, D. D., Peregoy, J. A., & Bertoni, A. G. (2015). Prediabetes and the association with unrecognized myocardial infarction in the multi-ethnic study of atherosclerosis. American heart journal, 170(5), 923-928.

Stepanek, L., Horakova, D., Nakladalova, M., Cibickova, L., Karasek, D., & Zadrazil, J. (2018). Significance of prediabetes as a nosological entity. Biomedical Papers of the Medical Faculty of Palacky University in Olomouc, 162(4).

Su, W., Cao, R., He, Y. C., Guan, Y. F., & Ruan, X. Z. (2017). Crosstalk of hyperglycemia and dyslipidemia in diabetic kidney disease. kidney diseases, 3(4), 171-180.

Sudesna, C., Khunti, K., & Davies, M. J. (2017). Type 2 diabetes. The Lancet, 389(10085), 2239-2251.

Vaverková, H., Karásek, D., Halenka, M., Cibickova, L., & Kubickova, V. (2017). Inverse association of lipoprotein (a) with markers of insulin resistance in dyslipidemic subjects. Physiological Research, 66, S113.

Viigimaa, M., Sachinidis, A., Toumpourleka, M., Koutsampasopoulos, K., Alliksoo, S., & Titma, T. (2020). Macrovascular complications of type 2 diabetes mellitus. Current vascular pharmacology, 18(2), 110-116.

Weitzman, S. (2016). The link between diabetes and cardiovascular disease: The epidemiological perspective. The Israel Medical Association journal: IMAJ, 18(12), 709-711.

Zhang, Y., Jin, J. L., Cao, Y. X., Zhang, H. W., Guo, Y. L., Wu, N. Q., ... & Li, J. J. (2020). Lipoprotein (a) predicts recurrent worse outcomes in type 2 diabetes mellitus patients with prior cardiovascular events: a prospective, observational cohort study. Cardiovascular diabetology, 19(1), 1-10.

Zheng, S., Han, T., Xu, H., Zhou, H., Ren, X., Wu, P., ... & Hu, Y. (2017). Associations of apolipoprotein B/apolipoprotein AI ratio with pre-diabetes and diabetes risks: a cross-sectional study in Chinese adults. BMJ open, 7(1), e014038.




How to Cite

Abdullah, B. I., & Salih, S. F. (2023). Lipoprotein (a) Level Among Patients with Type 2 Diabetes Mellitus and Prediabetes in Comparison with Healthy Controls. Science Journal of University of Zakho, 11(1), 30–36.



Science Journal of University of Zakho