Epidemiology
Low Lp(a) below 7 mg/dL, not high Lp(a), raises type-2 diabetes risk, the Bruneck study combined with a meta-analysis of 74,575 people (Cardiovasc Diabetol 2017)
Original title: Lipoprotein(a) and incident type-2 diabetes: results from the prospective Bruneck study and a meta-analysis of published literature
Researchers examined the association between Lp(a) and incident type-2 diabetes in the Bruneck study, a prospective population-based cohort of 815 participants followed for 20 years, then combined the findings with a meta-analysis of published prospective cohorts through October 2016. In Bruneck, a one standard deviation lower log Lp(a) was associated with a 12% higher diabetes risk (hazard ratio 1.12, 95% CI 0.95-1.32, P=0.171) after adjusting for standard risk factors. In the pooled meta-analysis of four cohorts (74,575 participants, 4514 incident diabetes events), diabetes risk was higher in the lowest two Lp(a) quintiles (weighted mean Lp(a) 3.3 and 7.0 mg/dL) than the highest quintile (62.9 mg/dL), with the highest risk in the lowest quintile (hazard ratio 1.28, 95% CI 1.14-1.43, P<0.001). The findings suggest an inverse association between Lp(a) and type-2 diabetes risk, with higher diabetes risk at Lp(a) concentrations below approximately 7 mg/dL.
Original abstract
Aims: We aimed to (1) assess the association between lipoprotein(a) [Lp(a)] concentration and incident type-2 diabetes in the Bruneck study, a prospective population-based study, and (2) combine findings with evidence from published studies in a literature-based meta-analysis.
Methods: We used Cox proportional hazards models to calculate hazard ratios (HR) for incident type-2 diabetes over 20 years of follow-up in 815 participants of the Bruneck study according to their long-term average Lp(a) concentration. For the meta-analysis, we searched Medline, Embase and Web of Science for relevant prospective cohort studies published up to October 2016.
Results: In the Bruneck study, there was a 12% higher risk of type-2 diabetes for a one standard deviation lower concentration of log Lp(a) (HR = 1.12 [95% CI 0.95-1.32]; P = 0.171), after adjustment for age, sex, alcohol consumption, body mass index, smoking status, socioeconomic status, physical activity, systolic blood pressure, HDL cholesterol, log high-sensitivity C-reactive protein and waist-hip ratio. In a meta-analysis involving four prospective cohorts with a total of 74,575 participants and 4514 incident events, the risk of type-2 diabetes was higher in the lowest two quintiles of Lp(a) concentrations (weighted mean Lp(a) = 3.3 and 7.0 mg/dL, respectively) compared to the highest quintile (62.9 mg/dL), with the highest risk of type-2 diabetes seen in quintile 1 (HR = 1.28 [1.14-1.43]; P < 0.001).
Conclusions: The current available evidence from prospective studies suggests that there is an inverse association between Lp(a) concentration and risk of type-2 diabetes, with a higher risk of type-2 diabetes at low Lp(a) concentrations (approximately <7 mg/dL).
diabetesepidemiologyrisk prediction
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.