Inflammation
Lp(a) predicts ASCVD across glucose-metabolism status independent of CRP, UK Biobank cohort of 307,269 (Diabetes Obes Metab 2026)
Original title: Lipoprotein(a) is associated with ASCVD in individuals with non-diabetes, prediabetes, or diabetes independent of CRP
UK Biobank cohort of 307,269 participants without prevalent ASCVD (253,746 normal glucose regulation, 38,020 prediabetes, 15,503 diabetes; mean age 57, 55.3% female), with Lp(a) and CRP measured 2006-2010, followed a median 13.2 years (29,521 ASCVD events), testing whether CRP modifies the Lp(a)-ASCVD association across glucose-metabolism strata. Comparing the top 10% versus bottom 33% of Lp(a), fully adjusted hazard ratios for ASCVD were 1.28 (95% CI 1.22-1.34) in normal glucose regulation, 1.23 (95% CI 1.12-1.35) in prediabetes, and 1.16 (95% CI 1.02-1.31) in diabetes. No significant interaction was found by CRP strata (below or at/above 2 mg/L) in any glucose-metabolism group (p for interaction above 0.05). The authors conclude elevated Lp(a) raises ASCVD risk across all glucose-metabolism statuses, most clearly in normal glucose regulation and prediabetes, independent of baseline CRP.
Original abstract
Aims: Conflicting data have explored the association between lipoprotein(a) [Lp(a)] and atherosclerotic cardiovascular disease (ASCVD) among individuals with different glucose metabolism statuses. We aimed to prospectively evaluate this association and to assess whether it is modified by C-reactive protein (CRP).
Materials And Methods: This population-based cohort study was derived from the UK Biobank database. Lp(a) and CRP were measured between 2006 and 2010. Cox proportional hazards models and restricted cubic spline curves were employed to assess the relationship between Lp(a) levels and time to ASCVD events.
Results: A total of 307 269 participants without prevalent ASCVD were included, comprising 253 746 individuals with normal glucose regulation (NGR), 38 020 with prediabetes, and 15 503 with diabetes. The mean age was 57 years (Q1-Q3: 50-63), and 55.3% were female. Over a median follow-up of 13.2 years, 29 521 ASCVD events occurred. Higher Lp(a) levels were associated with an increased risk of ASCVD across all glucose metabolism statuses. In fully adjusted models, the hazard ratio (95% confidence interval) for ASCVD comparing participants in the top 10% of Lp(a) with those in the bottom 33% was 1.28 (1.22-1.34) among those with NGR, 1.23 (1.12-1.35) among those with prediabetes, and 1.16 (1.02-1.31) among those with diabetes. No significant interactions were observed after stratification by CRP (<2/≥2 mg/L) across glucose metabolism groups (P for interaction >0.05).
Conclusions: Elevated Lp(a) levels were associated with a higher risk of ASCVD across different glucose metabolism statuses, particularly among individuals with NGR and prediabetes, independent of baseline CRP levels.
diabetesepidemiologyinflammation
Summary written by lp-a.org from the published abstract; figures as published. Page updated 17 August 2026. Methods.