Epidemiology
Higher Lp(a) raises diabetic nephropathy odds by 63% in type 2 diabetes, a meta-analysis of 9,304 patients across 11 studies (Front Endocrinol 2021)
Original title: Association Between Lipoprotein (A) and Diabetic Nephropathy in Patients With Type 2 Diabetes Mellitus: A Meta-Analysis
This meta-analysis pooled 11 observational studies (9,304 patients with type 2 diabetes mellitus) examining Lp(a) and diabetic nephropathy. Patients with the highest Lp(a) had higher odds of diabetic nephropathy than those with the lowest (adjusted OR 1.63, 95% CI 1.25-2.14, I2=54%, P<0.001), a result consistent when Lp(a) was analysed as a continuous variable (adjusted OR 1.13 per 1 mg/dL increment, 95% CI 1.03-1.24, I2=36%, P=0.008). Subgroup analyses by nephropathy definition and study design did not significantly affect the association (all P>0.05). The findings support higher Lp(a) as an independent risk marker for diabetic nephropathy in type 2 diabetes, though the authors call for large prospective cohort studies to validate this and to explore whether Lp(a)-lowering could benefit renal function in this population.
Original abstract
Background: Lipoprotein (a) [Lp (a)] has been well recognized as a risk factor of cardiovascular disease. However, the association between serum Lp (a) and diabetic nephropathy in patients with type 2 diabetes mellitus (T2DM) remains unknown. We performed a meta-analysis to comprehensively evaluate the above association.
Methods: Observational studies aiming to evaluate the independent association between serum Lp (a) and diabetic nephropathy in T2DM patients were identified by systematic search of PubMed and Embase databases. A random-effect model which incorporated the potential intra-study heterogeneity was used for the meta-analysis.
Results: Eleven observational studies with 9304 T2DM patients were included. Results showed that compared to those with the lowest Lp (a), patients with the highest Lp (a) level had higher odds of diabetic nephropathy (adjusted odds ratio [OR]: 1.63, 95% confidence interval [CI]: 1.25-2.14, I2 = 54%, P < 0.001). Meta-analysis of studies in which Lp (a) was presented as continuous variables showed consistent result (adjusted OR: 1.13 for 1 mg/dl increment of Lp (a), 95% CI: 1.03-1.24, I2 = 36%, P = 0.008). Subgroup analyses showed that study characteristics such as definitions of diabetic nephropathy and study design did not significantly affect the association (P for subgroup difference all > 0.05).
Conclusions: Higher serum Lp (a) in patients with T2DM is independently associated with higher odds of diabetic nephropathy. Large scale prospective cohort studies are needed to validate this finding. Moreover, the potential influence of Lp (a) lowering on renal function in T2DM patients may be further investigated.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.