Association Between Serum Lipoprotein(a) and Diabetic Retinopathy in Han Chinese Patients With Type 2 Diabetes

Contrasting observations have been made on the relationship between lipoprotein(a) [Lp(a)] concentration and diabetic retinopathy (DR) in patients with type 2 diabetes (T2D).

To measure serum Lp(a) concentrations in patients with T2D to investigate whether Lp(a) affects risk for DR.

Serum Lp(a) was determined in 377 Han Chinese patients with T2D. Demographic and clinical information, including presence of DR and vision-threatening DR (VTDR), were collected on admission. The relationship between serum Lp(a) and DR or VTDR was evaluated using univariate and multivariate regression analyses.

Patients with DR or VTDR had significantly higher serum Lp(a) concentrations on admission (P < 0.001). The distribution across Lp(a) quartiles ranged from 11.7% (DR) and 4.3% (VTDR) in the first quartile to 47.9% (DR) and 19.1% (VTDR) in the fourth quartile (P for trend < 0.001). Multivariate logistic regression analysis adjusted for common DR and VTDR risk factors showed that the third and fourth Lp(a) quartiles were significantly associated with DR and VTDR compared with the first Lp(a) quartile (P < 0.001). The patient group with highest concentrations of both Lp(a) (fourth quartile) and hemoglobin A1c (≥7%) had an odds ratio for DR of 5.15 [95% confidence interval (CI), 2.78 to 9.55; P < 0.001] and for VTDR of 5.32 (95% CI, 2.92 to 10.15; P < 0.001) compared with patients with lower concentrations of both factors.

Lp(a) concentration was independently associated with DR in patients with T2D. More frequent retinal examinations should be recommended for patients with T2D and high Lp(a) concentrations.