Epidemiology
Higher Lp(a) predicts a 61% lower risk of new-onset type 2 diabetes in patients with familial combined hyperlipidaemia, a 9-year follow-up of 474 patients (J Clin Lipidol 2023)
Original title: Lipoprotein(a), metabolic profile and new-onset type 2 diabetes in patients with familial combined hyperlipidemia: A 9 year follow-up study
In a cohort of 474 patients with familial combined hyperlipidaemia (FCH, mean age 49.7 years, 64% men) without diabetes at baseline, followed a mean 8.2 years, those with Lp(a) >=30 mg/dL had lower triglycerides (238 vs 268 mg/dL, P=0.01), higher HDL cholesterol (44 vs 41 mg/dL, P=0.01), and more hypertension (42% vs 32%, P=0.03) than those with Lp(a) <30 mg/dL. New-onset diabetes occurred in 10.1% (48 patients) during follow-up, and higher Lp(a) independently predicted lower diabetes incidence after adjustment (HR 0.39, 95% CI 0.17-0.90, P=0.02). The findings confirm an inverse relationship between Lp(a) and incident type 2 diabetes even in this metabolically distinct FCH population, alongside a shift toward lower triglycerides and higher HDL with elevated Lp(a).
Original abstract
Background: Lipoprotein(a) [Lp(a)] appears to have an inverse association with the risk of type 2 diabetes mellitus in the general population.
Objective: This study aimed to investigate the prognostic role of Lp(a) regarding the development of type 2 diabetes in the special population of subjects with familial combined hyperlipidemia (FCH).
Methods: This cohort study included 474 patients (mean age 49.7±11.3 years, 64% males) with FCH, without diabetes at baseline who were followed for a mean period of 8.2±6.8 years. At baseline evaluation venous blood samples were obtained for the determination of lipid profile and Lp(a) levels. The endpoint of interest was the development of diabetes.
Results: Patients with increased Lp(a) levels ≥30 mg/dl compared to those with low Lp(a) levels <30 mg/dl had lower levels of triglycerides (238±113 vs 268±129 mg/dl, p = 0.01), greater levels of high-density lipoprotein (HDL) cholesterol (44±10 vs 41±10 mg/dl, p = 0.01) and hypertension in a greater percentage (42% vs 32%, p = 0.03). The incidence of new-onset diabetes during the follow-up period was 10.1% (n = 48). Multiple Cox regression analysis revealed that increased Lp(a) is an independent predictor of lower diabetes incidence (HR 0.39, 95% CI 0.17-0.90, p = 0.02) after adjustment for confounders.
Conclusion: Among subjects with FCH those with higher Lp(a) levels have lower risk for the development of type 2 diabetes. Moreover, the presence of increased Lp(a) seems to differentiate the expression of metabolic syndrome characteristics in patients with FCH, as increased Lp(a) is related to lower levels of triglycerides, greater prevalence of hypertension and higher levels of HDL cholesterol.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.