Epidemiology
High Lp(a) raises diabetic nephropathy risk 64% in type 2 diabetes, meta-analysis of 15 studies finds (Horm Metab Res 2025)
Original title: Can Lipoprotein(a) Predict the Risk of Diabetic Nephropathy in Type 2 Diabetes Mellitus?: A Systematic Review and Meta-Analysis
This systematic review and meta-analysis searched PubMed, Embase, Scopus and Web of Science through November 2024 for observational studies examining whether serum Lp(a) predicts diabetic nephropathy (DN) in type 2 diabetes. Fifteen studies were included (five cross-sectional, two case-control, eight prospective cohort). Pooled analysis found each incremental increase in Lp(a) was associated with a small but significant rise in DN risk (OR 1.03, 95% CI 1.01-1.04, I2 = 86%), and high Lp(a) levels specifically were associated with a substantially greater DN risk (OR 1.64, 95% CI 1.24-2.17, I2 = 67%). Subgroup analyses by study design, location, sample size, diabetes duration, baseline HbA1c and DN definition gave mixed results, reflecting substantial heterogeneity across studies. The authors conclude Lp(a) could serve as a potential marker for diabetic nephropathy risk in type 2 diabetes, though further investigation is needed to clarify its clinical utility given the study-to-study variability.
Original abstract
We aimed to examine if serum lipoprotein(a) [Lp(a)] values could be used to predict the risk of diabetic nephropathy (DN) in type 2 diabetes mellitus (T2DM). English-language observational studies available as full-texts on PubMed, Embase, Scopus, and Web of Science databases up to 28th November 2024 were included in the review. Studies were to assess the association between Lp(a) and DN and report adjusted effect size. Random-effects meta-analysis was conducted. Five cross-sectional, two case-control, and eight studies prospective cohort were included. Six studies used Lp(a) as a continuous variable while eight used it as a categorical variable. Two studies used Lp(a) as both. Meta-analysis showed that an incremental increase in Lp(a) was associated with a small increase in the risk of DN (OR: 1.03 95% CI: 1.01, 1.04 I2=86%). Meta-analysis also showed that high levels of Lp(a) were associated with a significant increase in the risk of DN (OR: 1.64 95% CI: 1.24, 2.17 I2=67%). Subgroup analysis based on study design, location, sample size, T2DM duration, baseline HbA1c, and definition of DN yielded mixed results. Lp(a) could be a potential marker for DN in T2DM. Further investigations may provide better evidence.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.