Epidemiology
Even mildly elevated Lp(a) doubles coronary heart disease risk in 591 patients with early-onset type 2 diabetes (Front Endocrinol 2025)
Original title: Elevated plasma concentrations of lipoprotein (a) are associated with cardiovascular diseases in patients with early-onset type 2 diabetes mellitus
In a cross-sectional study of 591 individuals with early-onset type 2 diabetes (median onset age 37 years, median diabetes duration 12 years, median HbA1c 8.8%), patients were grouped by Lp(a): very low (below 10 mg/dL), low (10-30), intermediate (30-50), and high (above 50). Median Lp(a) was 10.40 mg/dL and did not correlate with age, sex, or glycaemic control. Compared with the very low Lp(a) group, risk of coronary heart disease (CHD) rose progressively across low (odds ratio 2.12, 95% CI 1.17-3.84), intermediate (odds ratio 2.76, 95% CI 1.10-6.98), and high Lp(a) groups (odds ratio 4.79, 95% CI 2.03-11.31, P < 0.01), all after adjustment. No association was found between Lp(a) and cerebrovascular disease or microvascular complications. The findings suggest Lp(a) testing helps identify latent high CHD risk in early-onset T2DM patients even at levels well below the standard 50 mg/dL elevated threshold.
Original abstract
Objective: To ascertain whether vascular complications and high lipoprotein (a) [Lp(a)] concentrations are related in individuals with early-onset type 2 diabetes mellitus (T2DM).
Methods: This observational cross-sectional study included 591 individuals with early-onset T2DM who were divided into four groups based on Lp(a) values which was measured using immunoturbidimetry and presented as mg/dL: high, >50; intermediate, 30≤Lp(a)<50; low, 10≤Lp(a)<30; and very low, <10. The relationship between the risk of vascular complications and Lp(a) level was examined using a logistic regression model.
Results: The median age of onset for individuals with early-onset T2DM (n=591) was 37 years, duration of diabetes was 12 years, and glycated hemoglobin (HbA1c) level was 8.8%. The median Lp(a) was 10.40 (4.80-21.80) mg/dL, and Lp(a) concentration did not correlate with age, sex, or glycemic control (P>0.05). Individuals in the low Lp(a) (OR=2.12, 95% CI 1.17-3.84, P<0.05), intermediate Lp(a) (OR=2.76, 95% CI 1.10-6.98, P<0.05) and high Lp(a) (OR=4.79, 95% CI 2.03-11.31, P<0.01) groups had an increased risk of coronary heart disease (CHD) compared with those in the very low Lp(a) group after adjustment. Nevertheless, among individuals with early-onset T2DM, there was no correlation between Lp(a) concentration and the risk of cerebrovascular disease (CVL) and microvascular complications (P>0.05).
Conclusions: In patients with early-onset T2DM, Lp(a) concentration was independently associated with CHD. Lp(a) testing is essential to determine who has a latent high risk of CHD among patients with early-onset T2DM.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.