Lp(a) and high-sensitivity C-reactive protein are predictive biomarkers for coronary heart disease in Chinese patients with type 2 diabetes mellitus

Objective: Type 2 diabetes (T2DM) is a significant risk factor for coronary heart disease (CHD). This study aimed to assess the variations in biomarkers associated with CHD in T2DM patients across different age groups in the Han Chinese population.

Methods: A strict selection process was employed, involving three groups: a control group (n = 300) with no medical history, a new-onset T2DM group (n = 300), and a new-onset T2DM + CHD group (n = 300). Participants in each group were further categorized based on age: Group 1 (<60 years), Group 2 (60-75 years), and Group 3 (>75 years). Fasting glucose, hemoglobin A1c (HbA1c), triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), apolipoprotein A1 (ApoA1), apolipoprotein B (ApoB), ApoB/ApoA1 ratio, lipoprotein(a) [Lp(a)], high-sensitivity C-reactive protein (hsCRP), and homocysteine (HCY) levels were analyzed in all groups.

Results: Both T2DM and T2DM + CHD groups exhibited elevated levels of TG, TC, LDL-C, ApoB, ApoB/ApoA1, Lp(a), hsCRP, and HCY, alongside decreased levels of HDL-C and ApoA1 in comparison to the control group. Notably, when comparing the T2DM to the T2DM + CHD groups, significant increases were noted in ApoB, Lp(a), and hsCRP levels in the T2DM + CHD group, whereas other biomarkers did not show significant differences. Across all age groups, the patterns remained consistent, with the T2DM and T2DM + CHD groups showing elevated levels of TG, TC, LDL-C, ApoB, ApoB/ApoA1, Lp(a), hsCRP, and HCY, and decreased levels of HDL-C and ApoA1 compared to their respective age-matched control groups. Furthermore, within each age category, significant increases in ApoB, Lp(a), and hsCRP were specifically observed with advancing age in the T2DM + CHD group, with Lp(a) and hsCRP levels showing particularly notable elevations, underscoring their potential as significant indicators of CHD risk in the T2DM population.

Conclusion: Lp(a) and hsCRP may serve as valuable risk biomarkers for the development of CHD in T2DM patients. Understanding the variations in these biomarkers across different age groups can assist in risk assessment and the development of personalized management strategies for CHD in T2DM patients.