Genetics
Low Lp(a) predicts new-onset diabetes, yet high Lp(a) still raises cardiovascular risk in people who already have it, a review of causes and consequences (Curr Opin Endocrinol Diabetes Obes 2021)
Original title: Lipoprotein (a) and diabetes mellitus: causes and consequences
This review by Ward, Vickneswaran and Watts examines Lp(a) dual, paradoxical relationship with diabetes. Population-based studies consistently link low Lp(a) to higher risk of developing type 2 diabetes, though Mendelian randomisation studies do not consistently support a causal relationship. Conversely, among patients who already have type 2 diabetes, elevated Lp(a) is associated with increased cardiovascular event risk. Despite this, few trials have tested whether lowering Lp(a) benefits diabetic patients specifically, and current guidelines do not specifically address Lp(a)-related risk in this population. The authors nonetheless recommend measuring Lp(a) in patients with diabetes and factoring it into overall cardiovascular risk assessment.
Original abstract
Purpose Of Review: This review provides an update on the role of lipoprotein (a) [Lp(a)] in diabetes, including its impact as a risk factor as well as its contribution to the development of cardiovascular disease.
Recent Findings: Although a specific role for Lp(a) has not yet been conclusively established, it appears to have an inverse association with risk of diabetes. Several population-based studies have demonstrated associations between low levels of Lp(a) and increased risk of type 2 diabetes, but Mendelian randomization studies do not consistently support causality. Conversely, in patients with type 2 diabetes, elevated Lp(a) levels are associated with an increased risk of cardiovascular events.
Summary: Although Lp(a) contributes to the development of cardiovascular disease in patients with diabetes, few trials have investigated the benefits of reducing Lp(a) within this patient population. Furthermore, guidelines do not specifically address the risk associated with elevated Lp(a) levels. Despite this, Lp(a) should be measured in patients with diabetes and considered when evaluating their overall risk burden.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.