Journal Article

Lipoprotein(a) and incident type-2 diabetes: results from the prospective Bruneck study and a meta-analysis of published literature

Kiechl, Stefan, Paige, Ellie, Tsimikas, Sotirios, Kronenberg, Florian, Santer, Peter, Masconi, Katya L., Willeit, Peter, Weger, Siegfried, Willeit, Johann

2017

Overview

Aims We aimed to (1) assess the association between lipoprotein(a) [Lp(a)] concentration and incident type-2 diabetes in the Bruneck study, a prospective population-based study, and (2) combine findings with evidence from published studies in a literature-based meta-analysis. Methods We used Cox proportional hazards models to calculate hazard ratios (HR) for incident type-2 diabetes over 20 years of follow-up in 815 participants of the Bruneck study according to their long-term average Lp(a) concentration. For the meta-analysis, we searched Medline, Embase and Web of Science for relevant prospective cohort studies published up to October 2016. Results In the Bruneck study, there was a 12% higher risk of type-2 diabetes for a one standard deviation lower concentration of log Lp(a) (HR = 1.12 [95% CI 0.95–1.32]; P = 0.171), after adjustment for age, sex, alcohol consumption, body mass index, smoking status, socioeconomic status, physical activity, systolic blood pressure, HDL cholesterol, log high-sensitivity C-reactive protein and waist–hip ratio. In a meta-analysis involving four prospective cohorts with a total of 74,575 participants and 4514 incident events, the risk of type-2 diabetes was higher in the lowest two quintiles of Lp(a) concentrations (weighted mean Lp(a) = 3.3 and 7.0 mg/dL, respectively) compared to the highest quintile (62.9 mg/dL), with the highest risk of type-2 diabetes seen in quintile 1 (HR = 1.28 [1.14–1.43]; P < 0.001). Conclusions The current available evidence from prospective studies suggests that there is an inverse association between Lp(a) concentration and risk of type-2 diabetes, with a higher risk of type-2 diabetes at low Lp(a) concentrations (approximately <7 mg/dL).

• Publisher: BioMed Central,Springer Nature B.V
• Subject: Adult / Aged / Angiology / Apolipoproteins / Atherosclerosis / Autoimmune diseases / Cardiology / Cardiovascular disease / Causality / Cholesterol / Cross-Sectional Studies / Diabetes / Diabetes mellitus / Diabetes Mellitus, Type 2 - blood / Diabetes Mellitus, Type 2 - diagnosis / Diabetes Mellitus, Type 2 - epidemiology / Epidemiology / Female / Follow-Up Studies / Humans / Immunology / Incidence / Insulin / Italy - epidemiology / Laboratories / Lipids / Lipoprotein(a) - blood / Low density lipoprotein / Male / Medicine / Medicine & Public Health / Meta-analysis / Middle Aged / Original Investigation / Population / Population Surveillance - methods / Prospective Studies / Risk Factors / Studies