Lipoprotein(a) and diabetes. An update

Area of Science:

• Cardiovascular Medicine
• Endocrinology
• Metabolic Syndrome

Background:

• Lipoprotein(a) [Lp(a)] is an emerging cardiovascular risk factor.
• Its role in diabetes mellitus remains incompletely understood.
• Contradictory data necessitate a summary of current knowledge.

Purpose of the Study:

• To synthesize available data on the role of Lp(a) in diabetes.
• To clarify Lp(a) concentrations in Type 1 (IDDM) and Type 2 (NIDDM) diabetes.
• To assess the relationship between Lp(a), metabolic control, microalbuminuria, and coronary heart disease (CHD) in diabetic populations.

Main Methods:

• Review and synthesis of existing literature on Lp(a) in diabetes.
• Analysis of data regarding Lp(a) levels in relation to diabetes type, metabolic control, and complications.
• Evaluation of current evidence for Lp(a) as a CHD risk factor in diabetes.

Main Results:

• In IDDM, Lp(a) concentrations are likely elevated and associated with poorer metabolic control and microalbuminuria.
• In NIDDM, Lp(a) levels do not appear elevated and are not linked to metabolic control.
• Limited evidence currently supports Lp(a) as a significant CHD risk factor in diabetes, requiring more extensive prospective studies.

Conclusions:

• Lp(a) may play a differential role in Type 1 versus Type 2 diabetes.
• Metabolic control and microalbuminuria are potential factors influencing Lp(a) levels in IDDM.
• Further large-scale prospective research is essential to definitively establish Lp(a)'s role in cardiovascular risk among diabetic patients.