Key result
Low Lp(a) (<8.5 mg/dL) combined with a high TyG index (≥8.93) was associated with a higher risk of incident T2DM (HR 2.45, 95% CI 1.08-5.57; p<0.05) compared to high Lp(a)/low TyG in prediabetes.
Why the study?
Low Lp(a) levels and high triglyceride-glucose index (TyG) have been linked to increased type 2 diabetes mellitus (T2DM) risk, motivating this investigation of their combined predictive value for T2DM incidence in individuals with prediabetes.
Does the combination of low lipoprotein(a) levels (<8.5 mg/dL) and high triglyceride-glucose index (≥8.93) predict incident type 2 diabetes mellitus in adults with prediabetes?
Cohort (n=215)
No
Does the combination of low lipoprotein(a) levels (<8.5 mg/dL) and high triglyceride-glucose index (≥8.93) predict incident type 2 diabetes mellitus in adults with prediabetes?
Hazard Ratio: 2.45 (95% CI 1.08–5.57)
p-value: p=<0.05
In individuals with prediabetes, the combination of low Lp(a) levels (<8.5 mg/dL) and a high TyG index (≥8.93) is independently associated with a 2.45-fold increased risk of developing type 2 diabetes over a median 7-year follow-up.
Prediabetes is associated with an increased risk of type 2 diabetes mellitus (T2DM). Low Lp(a) levels and high triglyceride-glucose index (TyG), a surrogate marker of insulin resistance, have been linked to increased T2DM risk. This study investigated glucose and lipid-related predictors of T2DM incidence in prediabetic subjects. This retrospective cohort study included 215 individuals with prediabetes and ≥5 years of follow-up. ROC curve analysis identified optimal thresholds for Lp(a) and TyG. Participants were stratified into four groups: high Lp(a)/low TyG (reference group), low Lp(a)/low TyG, high Lp(a)/high TyG, and low Lp(a)/high TyG. Over a median 7-year follow-up, 36 (16.7%) patients developed T2DM. Patients with incident T2DM showed higher TyG than non-diabetes subjects (9.0 [8.6 - 9.4] vs. 8.6 [8.3 - 9.0], p < 0.01), whereas Lp(a) levels were lower (12.0 [8.0 - 30.5] vs. 19.0 [9.0 - 51.0], p < 0.05). Cox regression showed that the low Lp(a)/high TyG group had the highest risk of incident T2DM (HR: 2.45; 95% CI 1.08 - 5.57; p < 0.05), while no associations were observed for the low Lp(a)/low TyG group (HR: 0.95; 95% CI: 0.30 - 2.95; p = 0.93) or the high Lp(a)/high TyG group (HR: 1.22; 95% CI: 0.70 - 2.11; p = 0.48). Hs-CRP was independently associated with incident T2DM (HR: 1.26; 95% CI: 1.06 - 1.50; p < 0.01). Low Lp(a) levels combined with a high TyG index are associated with increased risk of T2DM in prediabetic individuals. These findings are hypothesis-generating and warrant validation in larger studies to determine their potential value for risk stratification.
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Bosco et al. (2026) conducted a cohort in Prediabetes (n=215). Low Lp(a) (<8.5 mg/dL) and high TyG index (≥8.93) vs. High Lp(a) (≥8.5 mg/dL) and low TyG index (<8.93) was evaluated on Incident type 2 diabetes mellitus (T2DM) (HR 2.45, 95% CI 1.08 - 5.57, p=<0.05). Low Lp(a) (<8.5 mg/dL) combined with a high TyG index (≥8.93) was associated with a higher risk of incident T2DM (HR 2.45, 95% CI 1.08-5.57; p<0.05) compared to high Lp(a)/low TyG in prediabetes.
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