Epidemiology
Lp(a) independently predicts diabetic nephropathy with extreme statistical certainty in 6,993 type 2 diabetes patients (Front Endocrinol 2023)
Original title: Association between Lipoprotein(a) and diabetic nephropathy in patients with type 2 diabetes
In a cross-sectional study of 6,993 patients with type 2 diabetes (5,089 with diabetic nephropathy, 1,904 without), diabetic nephropathy patients were older, had longer diabetes duration, and more metabolic disorders. Among all serum lipids measured, Lp(a) was the most strongly correlated with markers of renal impairment. After adjusting for age, sex, diabetes duration, BMI, blood pressure and lipid-lowering drug use, Lp(a) remained independently and positively associated with diabetic nephropathy risk (odds ratio 1.115, 95% CI 1.079-1.151). The findings position Lp(a) as a promising biomarker for diagnosing and potentially guiding treatment of diabetic nephropathy in type 2 diabetes.
Original abstract
Background: Diabetic nephropathy (DN) is one of the most prevalent and severe microvascular complications of type 2 diabetes (T2DM). However, little is currently known about the pathogenesis and its associated risk factors in DN. The present study aims to investigate the potential risk factors of DN in patients with T2DM.
Methods: A total of 6,993 T2DM patients, including 5,089 participants with DN and 1,904 without DN, were included in this cross-sectional study. Comparisons between the two groups (DN vs. non-DN) were carried out using Student's t-test, Mann-Whitney U-test, or Pearson's Chi-squared test. Spearman's correlation analyses were performed to assess the correlations of serum lipids and indicators of renal impairment. Logistic regression models were applied to assess the relationship between blood lipid indices and the presence of DN.
Results: T2DM patients with DN were older, and had a longer duration of diagnosed diabetes compared to those without DN. Of note, the DN patients also more likely develop metabolic disorders. Among all serum lipids, Lipoprotein(a) [Lp(a)] was the most significantly correlated indicators of renal impairment. Moreover, univariate logistic regression showed that elevated Lp(a) level was associated with an increased risk of DN. After adjusted for confounding factors, including age, gender, duration of T2DM, BMI, SBP, DBP and lipid-lowering drugs usage, Lp(a) level was independently positively associated with the risk of DN [odds ratio (OR):1.115, 95% confidence interval (CI): 1.079-1.151, P=6.06×10-11].
Conclusions: Overall, we demonstrated that serum Lp(a) level was significantly positively associated with an increased risk of DN, indicating that Lp(a) may have the potential as a promising target for the diagnosis and treatment of diabetic nephropathy.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.