Epidemiology
Higher Lp(a) grade tracks with CAD, PAD, retinopathy and CKD but not stroke in Japanese type 2 diabetes, cohort of 1,465 (J Atheroscler Thromb 2026)
Original title: Cross-Sectional Association of Lipoprotein(a) Levels With Vascular Complications and Related Parameters in a Japanese Type 2 Diabetes Cohort
Cross-sectional analysis of 1465 Japanese patients with type 2 diabetes, categorised into Lp(a) grades (GI below 30, GII 30-49, GIII 50 mg/dL or more; median Lp(a) 12.7 mg/dL, IQR 6.1-24.6). Grade prevalences were 80%, 12% and 8% respectively, with low Lp(a) (below 5 mg/dL) in 18%, comparable to the general Japanese population. Higher Lp(a) grade was associated with coronary artery disease, peripheral artery disease, severe diabetic retinopathy and chronic kidney disease, but not stroke. Lp(a) was higher in older, female, kidney-impaired and statin-treated patients, and lower with higher glycaemia, current drinking and liver dysfunction; patients with CAD or on statins had lower LDL-C, small dense LDL-C, LDL-triglycerides and apoB but higher Lp(a) than controls. The authors conclude Lp(a) tracks diabetic vascular complications, particularly CKD and CAD, in this population.
Original abstract
Aims: To investigate the association between Lipoprotein(a) (Lp(a)) levels and vascular complications, as well as related parameters, in a cohort of Japanese patients with type 2 diabetes.
Methods: This cross-sectional analysis was conducted using data from a cohort of patients with 1465 type 2 diabetes. Lp(a) was measured by a turbidimetric immunoassay. Participants were categorized according to Lp(a) levels: GI (＜30), GII (30-49), and GIII (≥ 50 mg/dL). Small dense low-density lipoprotein (LDL)-cholesterol (sdLDL-C) and LDL-triglycerides were measured using homogeneous assays.
Results: The median [interquartile range] plasma Lp(a) concentration was 12.7 [6.1-24.6] mg/dL (21.8 [6-50.5] nmol/L). The prevalence rates for GI, GII, and GIII were 80, 12, and 8%, respectively, while low Lp(a) levels (＜5 mg/dL) were present in 18%. These prevalence rates were comparable to those reported in the general Japanese population. Higher Lp(a) grades were associated with the prevalence of coronary artery disease (CAD), peripheral artery disease including borderline cases, severe diabetic retinopathy, and chronic kidney disease (CKD), but not with stroke. Lp(a) levels were higher in older individuals, female, kidney dysfunction, and statin users, whereas lower levels were observed in those with higher glycemia, current drinkers, and liver dysfunction. Patients with CAD or statin users had lower levels of LDL-C, sdLDL-C, LDL-triglycerides, and apolipoprotein B but higher Lp(a) concentrations compared to the control group.
Conclusions: Lp(a) levels were associated with the prevalence of diabetic complications, particularly CKD and CAD. Lp(a) remains relevant associated factor with CAD in cross-sectional studies influenced by ongoing lipid-lowering therapies.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 17 August 2026. Methods.