Key result
Elevated Lp(a) linked to over ~4-fold higher ASCVD risk in patients with diabetes.
Why the study?
Elevated levels of lipoprotein(a) and diabetes have been identified as potential risk factors for CAD, motivating an investigation into the impact of various Lp(a) levels on ASCVD events in pre-diabetics and diabetics.
Does elevated lipoprotein(a) increase the risk of ASCVD events in patients with prediabetes and diabetes?
Meta-Analysis (n=20,271)
Does elevated lipoprotein(a) increase the risk of ASCVD events in patients with prediabetes and diabetes?
Answers are grounded in this paper and cite their sources.
Elevated Lp(a) levels >30 mg/dL are associated with a significantly higher risk of ASCVD events in patients with prediabetes and diabetes, highlighting its importance in risk stratification.
Background: Elevated levels of lipoprotein(a) [Lp(a)] and diabetes have been identified as potential risk factors for coronary artery disease (CAD). This study investigates various Lp(a) levels’ impact on atherosclerotic cardiovascular disease (ASCVD) events in pre-diabetics and diabetics. Methods: We included retrospective studies in English until May 2023, exploring the link between high Lp(a) levels and cardiovascular outcomes in humans with diabetes, prediabetes, or normal glucose levels. Studies were sourced from PubMed, Scopus, and Google Scholar, emphasizing detailed population and outcome data. We excluded studies with major methodological issues, low-quality data, missing key information, duplicates, and non-human subjects. We included high-quality retrospective studies on Lp(a) and cardiovascular outcomes, using risk of bias tools like Newcastle-Ottawa Scale (NOS) to ensure data integrity, and resolved discrepancies through discussion. Binary random-effects models were employed to estimate pooled hazard ratios (HRs) and 95% confidence intervals (CIs). Leave one out sensitivity analysis was performed. Heterogeneity was assessed using I2 statistics. For outcomes showing moderate or high heterogeneity, subgroup analyses were performed for follow-up duration or type of study. Results: A total of 20,271 patients with diabetes, prediabetes, and non-diabetics were included from three studies. In our analysis, compared to non-diabetics with Lp(a) <10 mg/dL, the risk of ASCVD increased with an increase in Lp(a) levels among pre-diabetics [Lp(a) <10 mg/dL (HR: 1.40, 95% CI: 1.17–1.67), Lp(a) 10–30 mg/dL (HR: 1.60, 95% CI: 1.30–1.96), Lp(a) >30 mg/dL (HR: 2.08, 95% CI: 1.49–2.90)] and diabetics [Lp(a) <10 mg/dL (HR: 2.42, 95% CI: 1.97–2.98), Lp(a) 10–30 mg/dL (HR: 2.26, 95% CI: 1.64–3.12), Lp(a) >30 mg/dL (HR: 4.17, 95% CI: 3.24–5.37)] with statistical significance (P<0.01). Conclusions: High Lp(a) (>30 mg/dL) is associated with more ASCVD events in diabetics and pre-diabetics vs. Lp(a) <30 mg/dL, underscoring Lp(a)’s clinical importance in risk stratification and intervention.
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Senapati et al. (2025) conducted a meta-analysis in Prediabetes and diabetes (n=20,271). Elevated lipoprotein(a) vs. Non-diabetics with Lp(a) <10 mg/dL was evaluated on Atherosclerotic cardiovascular disease (ASCVD) events (HR 4.17, 95% CI 3.24-5.37, p=<0.01). Elevated Lp(a) >/dL increased ASCVD risk in pre-diabetics and diabetics compared to non-diabetics with Lp(a) </dL.
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