Inflammation
Lp(a) is significantly higher in Crohn's disease and ulcerative colitis than in healthy controls, meta-analysis of 1,978 participants finds (Ann Gastroenterol 2026)
Original title: Lipoprotein (a) and inflammatory bowel disease: a systematic review and meta-analysis
This systematic review and meta-analysis pooled data on lipoprotein(a) in inflammatory bowel disease, drawing on 11 studies (2,687 participants) with 6 studies (1,978 participants: 1,196 IBD patients, 782 healthy controls) eligible for meta-analysis. Crohn's disease patients had significantly higher Lp(a) than controls (mean difference 18.36 mg/dL, 95% CI 14.53 to 22.20; P<0.001), as did ulcerative colitis patients (mean difference 7.32 mg/dL, 95% CI 2.85 to 11.79; P=0.001), while Lp(a) did not differ significantly between the two IBD subtypes. Active Crohn's disease showed higher Lp(a) than inactive disease, a pattern not replicated in ulcerative colitis. The authors advise routine Lp(a) evaluation in IBD, though the underlying studies are heterogeneous and mechanism (an acute-phase effect versus a true metabolic shift) remains unresolved.
Original abstract
Background: Lipid profile alterations have been reported in patients with inflammatory bowel disease (IBD). Our aim was to systematically investigate all relevant evidence on the association between lipoprotein (a) [Lp(a)] and IBD.
Methods: We searched PubMed and Cochrane Library databases (up to 30 December 2024) for studies with evidence on Lp(a) in patients with IBD. A meta-analysis was performed to evaluate the mean differences (MD) in Lp(a) between patients with Crohn's disease (CD) or ulcerative colitis (UC), and healthy controls (HC).
Results: The literature search identified 11 studies (2687 participants) investigating the lipid profile of patients with IBD; however, only 6 studies were used for the meta-analysis. Overall, 1978 participants were included in the meta-analysis, of whom 1196 were IBD patients and 782 were HC. The pooled analysis from 4 studies showed that CD patients had significantly higher Lp(a) levels compared to HC (MD 18.36 mg/dL, 95% confidence interval [CI] 14.53-22.20; P<0.001). Similarly, a pooled analysis from 4 studies showed that UC patients had higher Lp(a) levels compared to HC (MD 7.32 mg/dL, 95% CI 2.85-11.79; P=0.001). A pooled analysis of 3 studies revealed a non-significant difference in Lp(a) levels between CD and UC patients. In subgroup analyses based on disease activity, CD patients with active disease exhibited significantly higher Lp(a) levels compared to those with inactive disease. No significant difference was observed in UC patients stratified by disease activity.
Conclusions: Lp(a) levels are significantly higher in both CD and UC patients compared to HC. Therefore, Lp(a) evaluation is advisable when assessing IBD patients.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 17 August 2026. Methods.