Epidemiology
High Lp(a) is linked to diabetic peripheral neuropathy in Asian but not European studies, meta-analysis of 18,022 type 2 diabetes patients finds (Diabetol Metab Syndr 2025)
Original title: Association between lipoprotein(a) and diabetic peripheral neuropathy in patients with type 2 diabetes: a meta-analysis
This meta-analysis, following PRISMA 2020 guidelines, searched PubMed, Embase, Web of Science, Wanfang and CNKI through October 2024 for observational studies on Lp(a) and diabetic peripheral neuropathy (DPN) in type 2 diabetes. Eleven studies with 18,022 patients were included. Patients with DPN had significantly higher Lp(a) than those without (SMD 0.10, 95% CI 0.02-0.19, P = 0.01, I2 = 43%), and high Lp(a) was associated with DPN (OR 1.31, 95% CI 1.07-1.60, P = 0.009, I2 = 62%). Subgroup analyses by study design, patient age, Lp(a) measurement method, cutoff value, and study quality all gave consistent results, but a high Lp(a) was associated with DPN specifically in studies from Asian countries, not those from European countries (P for subgroup difference = 0.001). The authors conclude elevated Lp(a) is associated with DPN in type 2 diabetes, particularly in Asian populations, an ancestry-specific pattern that warrants further investigation.
Original abstract
Background: Diabetic peripheral neuropathy (DPN) is a common complication of type 2 diabetes (T2D). Lipoprotein(a) [Lp(a)], a known cardiovascular risk factor, has been hypothesized to influence the development of DPN. This meta-analysis aimed to investigate the relationship between Lp(a) levels and DPN in patients with T2D.
Methods: Following PRISMA 2020 guidelines, a systematic search of PubMed, Embase, Web of Science, Wanfang, and CNKI databases was performed up to October 12, 2024. Observational studies assessing blood Lp(a) levels in T2D patients with and without DPN or evaluating the association between Lp(a) and DPN risk were included. Data synthesis utilized a random-effects model to calculate standardized mean differences (SMDs) and odds ratios (ORs) with corresponding 95% confidence intervals (CIs).
Results: Eleven studies with 18,022 patients were included. Patients with DPN had significantly higher Lp(a) levels than those without DPN (SMD: 0.10, 95% CI: 0.02-0.19, p = 0.01; I² = 43%). High Lp(a) levels were associated with DPN (OR: 1.31, 95% CI: 1.07-1.60, p = 0.009; I² = 62%). Subgroup analyses according to study design, mean age of the patients, methods for measuring Lp(a) concentration, cutoff values of a high Lp(a), and study quality scores showed consistent results (p for subgroup difference all > 0.05). A high Lp(a) was associated with DPN in studies from Asian countries, but not in those from European countries (p for subgroup difference = 0.001).
Conclusion: Elevated Lp(a) levels are associated DPN in T2D patients, particularly in studies from Asian countries.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.