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Lipoprotein(a), Apolipoprotein(a) Phenotypes, and Nephropathy in NIDDM Patients

criteria) by blood test, either at our center or in any other clinic. Evidence for seasonality was tested using the test of Kendal and Ord (3). This is based on ranks, a simple adaptation of the nonparametric analysis of variance that ranks the figures within each year from the minimum to the maximum, from 1 to 12, for the monthly data. The test for seasonality was applied for the total group (n = 499) and for men and women separately. It was also done separately for those with age at diagnosis of ^15 years and for those >15 years. Although slight peaks were observed in January (cold weather) and in August (rainy season), and a trough in May (summer), the test for seasonality showed that the differences between the months were nonsignificant (x = 19.7, df 11, P 0.08). Nonsignificant values were obtained for both sexes and the different age-groups tested separately. The increased incidence of viral infections in cooler months has been implicated as a causative factor for the high incidence of IDDM in European children in winter. Although the EURODIAB study showed that seasonality was present in almost all populations across Europe, interestingly there was a lack of seasonality in high-risk populations in Scandinavian countries (1). Similarly, a study from the Liguria region in Italy, with a high incidence of IDDM, also reported lack of significant differences in seasonal pattern, probably explained by the fact that there are many different influences unrelated to the initial trigger of the disease (4). Is this true of low-risk populations? A study from Libya, although it had more cases during cooler months, failed to show a significant difference in seasonality (5). It is possible that both degree of risk of the population and the geographical location may be determinants of seasonality. The lack of wide variations in temperature in the tropical climate in areas like southern India may be one of the factors responsible for the lack of seasonality.