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Lipoprotein (a) is not significantly associated with type 2 diabetes mellitus: cross-sectional study of 1604 cases and 7983 controls

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Abstract

Aims

Lipoprotein (a) (Lp(a)), a well-established risk factor for coronary artery diseases (CAD), would also be anticipated to be associated in a similar manner with risk of type 2 diabetes mellitus (T2DM) based on the common soil hypothesis of etiology of T2DM and CAD. Unfortunately, there remains considerable uncertainty regarding the association of Lp(a) with the risk of T2DM. We aimed to examine the association of Lp(a) with T2DM.

Methods

Cross-sectional study of 1604 cases and 7983 controls was performed for identifying the association of Lp(a) with T2DM, its possible interactions with risk factors and threshold effects on T2DM. The association of Lp(a) with CAD was also examined and compared within the same study.

Results

On a continuous scale, 10 mg/L higher Lp(a) levels were insignificantly associated with a fully adjusted OR of 1.011, 95% CI 0.961–1.063 for T2DM. On a categorical scale, the fully adjusted ORs for T2DM were 0.733 (0.526–1.022), 0.554 (0.387–0.793), 0.848 (0.612–1.176), 0.727 (0.515–1.026), 0.692 (0.488–0.981), 0.696 (0.492–0.985), 0.719 (0.509–1.016), 0.74 (0.523–1.045), 0.809 (0.571–1.146), and 0.99 (0.962–1.019) for decile 2–10 in reference to decile 1. The magnitude of association did not increase with increasing decile (P for trend test = 0.990). In contrast, higher Lp(a) levels were significantly associated with prevalent CAD on a continuous or categorical scale in a fully adjusted model. No threshold effects were observed in terms of association of Lp(a) with T2DM or with CAD in Lp(a) <50 mg/dL.

Conclusions

The current study suggested that there was a lack of association of Lp(a) levels with prevalent T2DM. In contrast, Lp(a) levels were significantly associated with CAD in a dose-responding manner. Our findings provided evidence for differential approaches to higher Lp(a) levels in patients with T2DM or with CAD.

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Acknowledgements

The current project has been in part supported by the National Natural Science Foundation of China (Grant No. 81472918). The authors thank Dr. Zhi-De Hu from Department of Laboratory Medicine, General Hospital of Ji’nan Military Command Region, Jinan, P. R. China, who gave much help with statistical analysis.

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    Authors and Affiliations

    1. Division of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, People’s Republic of China

      Chang Liu, Ming-Xing Xu, Yong-Ming He, Xin Zhao, Xiao-Jiao Du & Xiang-Jun Yang

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    1. Chang Liu
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    Correspondence to Yong-Ming He.

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    The authors declare that they have no conflict of interest.

    Ethical standard

    All procedures performed in this study involving participants were in accordance with the principles outlined in the Declaration of Helsinki and its later amendments.

    Informed consent

    All patient records were anonymized and de-identified, and the Institute Review Boards of Soochow University waived the need for informed consent before analysis due to the retrospective nature of the study.

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    Managed by Massimo Federici.

    Chang Liu and Ming-Xing Xu have contributed equally to this work.

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    Liu, C., Xu, MX., He, YM. et al. Lipoprotein (a) is not significantly associated with type 2 diabetes mellitus: cross-sectional study of 1604 cases and 7983 controls. Acta Diabetol 54, 443–453 (2017). https://doi.org/10.1007/s00592-017-0965-2

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    • DOI: https://doi.org/10.1007/s00592-017-0965-2

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