2026 Volume 33 Issue 9 Pages 1180-1193
Aims: To investigate the association between Lipoprotein(a) (Lp(a)) levels and vascular complications, as well as related parameters, in a cohort of Japanese patients with type 2 diabetes.
Methods: This cross-sectional analysis was conducted using data from a cohort of patients with 1465 type 2 diabetes. Lp(a) was measured by a turbidimetric immunoassay. Participants were categorized according to Lp(a) levels: GI (＜30), GII (30–49), and GIII (≥ 50 mg/dL). Small dense low-density lipoprotein (LDL)-cholesterol (sdLDL-C) and LDL-triglycerides were measured using homogeneous assays.
Results: The median [interquartile range] plasma Lp(a) concentration was 12.7 [6.1–24.6] mg/dL (21.8 [6–50.5] nmol/L). The prevalence rates for GI, GII, and GIII were 80, 12, and 8%, respectively, while low Lp(a) levels (＜5 mg/dL) were present in 18%. These prevalence rates were comparable to those reported in the general Japanese population. Higher Lp(a) grades were associated with the prevalence of coronary artery disease (CAD), peripheral artery disease including borderline cases, severe diabetic retinopathy, and chronic kidney disease (CKD), but not with stroke. Lp(a) levels were higher in older individuals, female, kidney dysfunction, and statin users, whereas lower levels were observed in those with higher glycemia, current drinkers, and liver dysfunction. Patients with CAD or statin users had lower levels of LDL-C, sdLDL-C, LDL-triglycerides, and apolipoprotein B but higher Lp(a) concentrations compared to the control group.
Conclusions: Lp(a) levels were associated with the prevalence of diabetic complications, particularly CKD and CAD. Lp(a) remains relevant associated factor with CAD in cross-sectional studies influenced by ongoing lipid-lowering therapies.
